Rationing and taxes lurk in Obamacare — and the worst is yet to come

Guest opinion by Helen Gohsler, Pennsylvanians For Human Life, Scranton Chapter

Hidden under the radar by the mainstream media in the current debate on Obamacare is the rationing of health services to Medicare and private pay patients.

With all of the hullabaloo about the malfunctioning website and inadequate enrollment numbers, it is not common knowledge that the 18-member “Independent Advisory Board” is charged with the task of slowing the growth in national health expenditures to below the rate of medical inflation.

On January 15, 2015, and every two years thereafter, the Board, headed by the HHS secretary, will make the recommendation to slow the growth of health expenses. The secretary is empowered to impose “quality and efficiency” measures on hospitals, and requiring them to report on their compliance with those regulations. This, in effect, gives the federal government the power to force doctors to limit care by requiring them to comply with “quality” measures in order to be able to contract with qualified health insurance plans. Such requirements are forcing doctors into early retirement, or causing them to leave their medical practice completely.

The National Right to Life Committee (NRLC) was an early voice exposing how the law would cause rationing of healthcare. Obamacare supporters mocked the claim saying the legislation’s aim was to expand coverage, not reduce it. Carol Tobias, president of NRLC, says that Americans don’t yet realize that Obamacare will prevent them from spending their own money to pursue treatments deemed “ineffective” by the unelected, largely unaccountable Independent Payment Advisory Board (IPAB).

Last summer, former Vermont governor and Democratic presidential candidate Howard Dean let the cat out of the bag when he said the IPAB set up by Obamacare was “essentially a health care rationing board.” Additional comments made by analyst Mark Halperin, an avowed supporter of universal health care coverage, conceded “rationing of health care is built into the plan — that’s going to be part of how costs are contained.”

Looking deeper into the role of the IPAB, it will not review individual cases. In speaking to LifeNews.com, Carol Tobias says that Obamacare actually gives IPAB far more power to ration healthcare than if it were acting as judge and jury to individual patients. “Broadly speaking, IPAB is given sweeping powers to recommend to the Department of Health and Human Services (HHS) whether and how whole categories of treatments are to be reimbursed — and is required to use these powers to prevent overall health care spending from being allowed even to keep up with medical inflation. Thus, it is their job to limit reimbursement and ration care from thousands or millions of people at a time.”

Unfortunately, most Americans don’t know that the IPAB, which is central to cost control in Obamacare, empowers those 18 unelected members to be fully in charge of how much and what kind of healthcare we are entitled to. If that doesn’t make you scared, it should.

“For example,” Mrs. Tobias explains, “IPAB might decide that a new, promising treatment for breast cancer is not ‘cost-effective,’ given the board’s calculation of the number of lives it might save versus the cost to offer the treatment. HHS might then issue a ‘quality measure’ binding on health care providers that does not authorize use of the treatment. Effectively, HHS would have the power to drive many doctors out of business if they ignore its directives to ration.” Currently, if an insurance company, doctor, or hospital denies you a treatment, you have the right to appeal. Tobias makes clear that under Obamacare, these avenues will be largely closed off to you and your loved ones. “If the government says you can’t get a treatment, your current ability to appeal to a government body will be curtailed, and Americans don’t yet realize the law will prevent you from spending your own money to get treatments deemed in an Orwellian way ‘ineffective’ by the unelected, largely unaccountable IPAB board.”

Jennifer Popik, a medical ethics attorney with National Right to Life, explains that Obamacare is drawing critics from all over the country. In particular, she says, organized labor, an initial supporter of the law, is now at odds with a provision of the law that will tax insurance plans less likely to deny life-saving medical treatment and other healthcare — plans that they have long provided to attract members.

Popik says this tax on health insurance plans is a major component of the health law. The primary purpose is to discourage businesses from providing what Obamacare advocates view as too much health coverage. Starting in 2018, there will be a 40 percent tax on insurers — which would be passed on to employers — for any health coverage that exceeds annual premiums of $10,200 for individuals and $27,500 for families.

The Chicago Sun-Times reported last fall that “although the tax doesn’t start until 2018, employers are now ‘passing the cost onto employees in higher premiums and more cost sharing or requiring higher deductibles and copays’ and scaling back offerings.”

Popik warns that with this tax on health insurance, Americans can expect that plans that allow more access to healthcare will begin to disappear. There is evidence this is happening already . . . and implementation is only in the beginning phases.

We are already seeing large specialized medical institutions such as the Mayo Clinic and others refusing to participate in the health care law. Unfortunately, the more we learn about Obamacare and how it will work, the less we like it. And not only will abortion be covered, but rationing will be far more prevalent than we would ever have imagined.

While several sections of the health care law specifically state that rationing is not allowed, a closer reading of the regulations reveals that what will be implemented indeed results in rationing. It’s a case of the devil being in the details.

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