My mother is 84 going on 85 and going through a hard time of it lately. She has several issues that have been exacerbated by losing my father about six months ago. He was her partner of nearly 60 years and had become her caregiver. Recently she began losing weight and so has been seeing her doctor on a near monthly basis as he, and her family, nurse her through this downturn.
She had one of those appointments earlier this week. I took her there and accompanied her into the doctor's office for the examination.
The exam itself was not remarkable other than she is showing improvement and gaining weight. The part of interest though for this community, was the discussion she and the doctor had on their way out the door.
Now from comments he has made previously I assumed her doctor is very conservative, to the point of being a tea-party sympathizer, if not supporter. Still my mother and father both liked him as a doctor and he seemed to genuinely like them and be looking out for them, so I let his politics and any comments slide.
On their way out we were talking about his being busy enough to have hired an additional physicians' assistant for the office. The discussion continued, took a few turns about modern economic realities of the medical world, and eventually my mother made a comment along the lines of "who knows what's going to happen now", meaning the impact of the Affordable Care Act (ACA), usually referred to as Obamacare, on medical practice.
That's all the opening her doctor needed. He told her of hearing of a woman who called into an office because something that had been covered in the past suddenly wasn't. It was not specified whether this was a procedure or a prescription. When she called she was told that because of Obamacare, Medicare no longer covered whatever it was because she was older than 80 years of age. So Obamacare was cutting costs by rationing care for the elderly, after a certain age you just get maintenance/palliative care.
The doctor then went on about how if Obamacare wasn't defunded this is what was coming. That there was a panel of 18 people, named by the President and approved by Congress, who were empowered to do what was necessary to cut costs. They could determine what is and isn't covered and it would take a 3/5 vote of Congress to overturn any of their decisions. Sounded like the dreaded "death panels" all over again.
Now rightly or wrongly I hate to argue from a position of ignorance and I had no facts to engage the good doctor. So I let it ride and we left the office. But since then I burned up the internet tubes checking this out.
First of all the assertions sounded too ridiculous to be true on their face. If Medicare under Obamacare was going to ration care for seniors it seems very unlikely AARP would have ever climbed on board the healthcare reform bandwagon. Sure enough a trip to their web site found several positives noted that Medicare recipients can expect from the ACA.
Just to see what it would look like I took the AARP questionnaire at HealthLawAnswers.org. I entered that I was over age 65, already on Medicare, had a household of 2 people, and fell into the middle income range provided (30,000 to 62,000 annual income). None of that is true but I wanted to see what they would tell me.
I received a 3 page report telling me basically I didn't have to do anything, was not required to get any additional coverage and then enumerating the different ways Medicare is being improved by Obamacare. More emphasis on preventative care, everything you have been covered for is still covered, can still see the same doctor, if you have Part D the doughnut hole is shrinking so you might save money on drug purchases, and on and on and on...hardly the disaster depicted by my mother's doctor.
I then moved on to the "death panel" claim. I found a post at The Hill that points to the Independent Payment Advisory Board, or IPAB, set up by the ACA as the target of this claim. This group is charged under the law with making recommendations to cut Medicare costs, if the costs rise above a certain level [emphasis mine]. Whatever recommendations the board makes do have to be fast-tracked through Congress (which is different than requiring 3/5 to overturn). But the law expressly forbids the board from recommending reductions to coverage or services to save money, you know, to "ration care".
Now the IPAB is controversial. As noted, it is the source of the "death panel" charge and the charge that this will lead to care rationing for the elderly. Howard Dean wrote an op-ed in the Wall Street Journal calling for it be abolished. Several vulnerable House Democrats have joined with House Republicans introducing bills to strip the IPAB from the Affordable Care Act. The argument seems to be that the board will save money by reducing reimbursements to providers for certain services, which will lead to the providers not being able to afford to perform them. The end result is the same as if you were rationing care by eliminating the service. But the board also has its proponents as being very necessary and not having to lead to rationing of care at all.
But here's the rub vis a vis the comments made by my mother's doctor and that story about "some woman" now denied coverage for something under Medicare "because of Obamacare" that used to be covered. The IPAB doesn't exist yet. It has not been staffed. It has made no recommendations. Not only that, Medicare cost increases have been slowing, so the threshold that would trigger recommendations from the IPAB (if it was operational) has not been met. But as with most things these days involving conservative "thought", why let facts get in the way of a good scare?
I'll be sure to set my mother straight the next time I see her, she has nothing to fear from death panels or rationed care.
The real object lesson here though is to stay informed. I know something of the ACA and its highlights. But it is almost impossible to anticipate all the arguments thrown at this or any other issue by the right wing and have the facts all lined up ready for a rebuttal. But it's good to still do the research and be prepared in case that particular lunacy arises again. Of course the next time it will likely be some other nonsense on some other issue that you just know can't be true.
Originally posted at Views on Brews