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By Willoughby Mariano August 2, 2011

Gingrey claims federal health care board can decide if you get dialysis, chemo

U.S. Rep. Phil Gingrey, who’s also a doctor, is aiming his scalpel at a lesser-known provision of last year’s health care overhaul.

The Marietta Republican recommends swift removal of the Independent Payment Advisory Board, which was created to rein in growing Medicare costs.

Gingrey, an obstetrician-gynecologist, wants the board repealed. He said at a recent news conference it’s worse than tossing Granny off Stone Mountain.

"Democrats like to picture us as pushing Grandmother over the cliff or throwing someone under the bus. In either one of those scenarios, at least the senior has a chance to survive," Gingrey said June 22.

"But under this IPAB we described that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you, when you withdraw that, the patient is going to die," said Gingrey. "It’s rationing."

What a bleak prognosis. Under the IPAB, does "a bunch of bureaucrats" really "decide whether you get care"?

PolitiFact Georgia asked a Gingrey spokeswoman for proof, but she did not provide any.

We turned to four health care policy experts with differing opinions on the IPAB. They all told us that Gingrey was wrong.

But before we explain their reasoning, here’s more about the Independent Payment Advisory Board.

Lawmakers created the board in response to criticism that Congress has been unable to make the politically risky and technically complex decisions needed to slow the growth of costs for Medicare, the federal program that provides health care for seniors.

Under the health care reform bill, if Medicare spending growth is projected to exceed certain targets, the IPAB must come up with plans to slow the increase. If Congress does not act on the recommendation within a set time frame, it is automatically implemented.  

Both sides of the aisle have their problems with the board. Some worry it will be too hard for Congress to overrule IPAB recommendations, or that the board will stifle innovation. In recent months, Republicans such as Gingrey and even Democrats have signed on to repeal the board.

This brings us back to Gingrey’s claim that under the IPAB, "a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy."

Gingrey is "not even close to correct," said Michael Tanner, a scholar with the libertarian Cato Institute. He opposes the IPAB.

"It [IPAB] has nothing to do with individual care at all. It’s not making decisions on individuals," Tanner said.

Experts agree that the IPAB has no say in whether a specific person receives dialysis, chemotherapy or any other such treatment. The board does not intercede in individual patient cases. It makes broad policy decisions that affect Medicare’s overall cost.

Furthermore, the IPAB is barred from making policy recommendations that would block patients from receiving needed care, experts told PolitiFact Georgia.

"The legislation explicitly forbids the board from rationing care," said Stuart Guterman, a health policy expert with the Commonwealth Fund, a nonpartisan group which works to improve health care access, quality and efficiency. Guterman said he thinks the IPAB can help with health care savings.

Our analysis of the bill only found language designed to avoid the result Gingrey foretells.

For instance, the IPAB may not submit "any recommendation to ration health care," Section 3403 states.   

The same section also bars raising premiums for Medicare beneficiaries, as well as increasing deductibles, coinsurance or co-payments. The IPAB cannot change who is eligible for Medicare, restrict benefits or make recommendations that would raise revenue, either.

The IPAB can reduce how much the government pays health care providers for services, reduce payments to hospitals with very high rates of readmissions, or recommend innovations that cut wasteful spending. Some may argue that because the IPAB can reduce the money a doctor receives for giving chemotherapy to a Medicare patient, this could lead to an indirect form of rationing.

If Medicare reimbursements for chemotherapy drop too low, doctors might stop treating Medicare patients, or avoid recommending chemotherapy.

But this is not the scenario that Gingrey describes.

Gingrey makes no mention of indirect or long-term consequences. He says that with the IPAB, "a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy. I guarantee you, when you withdraw that, the patient is going to die."  

In other words, Gingrey says that bureaucrats will have the power to deny you treatment. And because of the bureaucrats, you could die.

This claim is incorrect. The IPAB does not have anything close to the power that Gingrey suggests. It cannot raise costs to Medicare recipients, much less kill them off by denying lifesaving care.

The claim is also outrageous. A policy board is not deadlier than pushing Grandma off a cliff.   

We diagnose Dr. Gingrey with a not-quite-fatal case of False.

Featured Fact-check

Our Sources, "Phil Gingrey: IPAB will cause seniors to die," June 22, 2011

The Kaiser Family Foundation, "The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending," April 2011, "John Raese says health care law forces patients to go to a bureaucrat before a doctor," Oct. 19, 2010

Politico, "Medicare pay board is losing vital support," June 8, 2011

H.R. 452, 2011, "Medicare Decisions Accountability Act of 2011," accessed July 19, 2011

Email interview, Henry Aaron, senior fellow with the Brookings Institution, July 19, 2011
Email interview, Michael Tanner, senior fellow, Cato Institute, July 19, 2011

Email interview, Linda J. Blumberg, senior fellow, the Urban Institute, July 20, 2011

Interview, Stuart Guterman, executive director, Commission on a High Performance Health System, The Commonwealth Fund, July 19, 2011

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