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President Barack Obama’s health care law includes a mighty powerful board that will dictate treatment decisions for Medicare patients, said Mitt Romney at the Oct. 3 debate in Denver.
When explaining why he opposed the health care law, Romney said Barack Obama "put in place a board that can tell people ultimately what treatments they're going to receive."
He also said this: "And then he has as a model for doing that a board of people at the government, an unelected board, appointed board, who are going to decide what kind of treatment you ought to have." And later: "In order to bring the cost of health care down, we don't need to have a board of 15 people telling us what kinds of treatments we should have."
Obama refuted Romney’s remark, saying, "Let me just point out first of all this board that we're talking about can't make decisions about what treatments are given."
For this fact-check, we will focus on Romney’s statement about whether the unelected board -- formally called the Independent Payments Advisory board, or IPAB for short -- can tell people what kind of treatments they can have.
We’ve previously checked a whole slew of claims about the health care law and the IPAB. Many of the variations of Romney’s claim have been in false territory -- depending on the wording -- including a Pants on Fire for Pat Boone who said the board "can ration care and deny certain Medicare treatments." (That was one of our Top 5 falsehoods on the health care law.)
We gave a Mostly False to Paul Ryan who said that the "unelected, unaccountable" board created by the health care law "will lead to denied care for current seniors."
We will note up front that Romney used somewhat softer words than some other critics of the board in that he didn’t use the words "ration" or "unaccountable."
IPAB can’t ration care or make decisions for individuals
We will borrow from our previous items to explain the board and Romney’s claim. Some of our information comes from the Kaiser Family Foundation, a nonprofit, nonpartisan group that studies health care, which put out a primer in 2010 about the board and a longer paper in 2011.
The health care law directs a new national board — with 15 members who are political appointees — to identify Medicare savings. It's forbidden from submitting "any recommendation to ration health care," as Section 3403 of the health care law states. It may not raise premiums for Medicare beneficiaries or increase deductibles, coinsurance or co-payments. The IPAB also cannot change who is eligible for Medicare, restrict benefits or make recommendations that would raise revenue.
What it can do is reduce how much the government pays health care providers for services, reduce payments to hospitals with very high rates of re-admissions or recommend innovations that cut wasteful spending. Some argue that because the IPAB can reduce the money a doctor receives, this could lead to an indirect form of rationing.
But the board wouldn't make any health care decisions for individual Americans. Instead, as PolitiFact Georgia reported, it would make broad policy decisions that affect Medicare's overall cost.
For this fact-check, a Romney campaign spokesman sent us a 2011 POLITICO article that largely focused on the challenges of filling the spots on the board, which the headline described as "Medicare cost-cutting job could be worst in D.C." The article mentioned that Republicans have portrayed it as rationing care, but that the law prohibits the board from rationing health care.
The Romney campaign also cited the New York Times health care blog Prescriptions, which stated in 2010 that the drug industry, hospitals and doctors’ groups want to get rid of the board.
"While the board is not supposed to be able to cut benefits, industry groups fear that its actions would result in rationing care," stated the New York Times blog. "The board, known as IPAB, could cut payments to health care providers."
When Romney was talking about the Independent Payment Advisory Board and Medicare, he said, Barack Obama "put in place a board that can tell people ultimately what treatments they're going to receive."
He avoided the more inaccurate and harsher wording of some other critics, who have falsely described the board as "rationing" care. But Romney’s claim can leave viewers with the impression that the board will sit around a table and talk about whether grandpa can get his bypass or not, and that’s not the case.
The board can reduce how much the government pays health care providers for services, reduce payments to hospitals with very high rates of re-admissions or recommend innovations that cut wasteful spending. And there are questions about whether that could lead to different treatment decisions, but Romney's comments give a misleading impression. We rate his statement Mostly False.
PolitiFact, "Pat Boone says health care advisory board can ration care and deny Medicare treatments," March 19, 2012
PolitiFact, "IPAB board is 15 bureaucrats who will decide for the nation, Michele Bachmann says," Oct. 12, 2011
PolitiFact, "Paul Ryan said ‘15 unelected, unaccountable bureaucrats" could "lead to denied care for current seniors," Aug. 23, 2012
PolitiFact, "Gingrey claims federal health care board can decide if you get dialysis, chemo," Aug. 2, 2011
PolitiFact, "Allen West turns to talking points on 2010 health care law," Nov. 1, 2011
PolitiFact, "Top 5 false hoods about the health care law," June 27, 2012
POLITICO, "Medicare cost-cutting job could be worst in D.C.," May 14, 2011
Kaiser Family Foundation, "Explaining health reform: Medicare and the New Independent Payment Advisory Board," May 2010
Kaiser Family Foundation, "Medicare policy: The independent payment advisory board: a new approach to controlling Medicare spending," April 2011
Interview, Robert Terra, spokesman for the Mitt Romney campaign, Oct. 3, 2012
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