AFFORDABLE HEALTHCARE OR OBAMACARE, officially known as the Affordable Care Act (ACA) of 2010, is about to be ruled on by SCOTUS.
One item that physicians with difficult, challenging, and unusual patients need to worry about is how the ruling will challenge their ability to take care of complicated patients who have proved refractory to standard therapies, or who have failed conventional treatment protocols. These physicians and their patients could well have their hands tied unless Section 10320 is modified or eliminated. Section 10320 allows for the appointment of an Independent Payment Advisory Board (IPAB), a tribunal of persons who need not necessarily be physicians. This panel will determine what the ACA will cover. The IPAB will not report to the people or to Congress. Ensconced in legislative fiat, it is poised to ration care by finding various procedures and protocols outside the mandate of coverage. In California where we watch the misuse of Utilization Review in Workers Compensation, we see how it works: treatments with lower success rates or that aren't buttressed by what authorities consider sufficient Evidence Based Medicine are disallowed no matter how carefully a specific treatment or study may be indicated on an indivdual basis and even though the patient may have failed everything else. Injured workers in California are deprived of indicated care by this method on a daily basis. So may it be with other patients covered by the ACA unless Section 10320 is altered or repealed. Watch for our follow-up on this issue.
Showing posts with label ACA. Show all posts
Showing posts with label ACA. Show all posts
Sunday, June 24, 2012
Wednesday, January 25, 2012
WHERE WAS OBAMACARE IN THE PRESIDENT'S STATE OF THE UNION ADDRESS?
OBAMACARE is correctly known as the Affordable Care Act (ACA) or as the Patient Protection and Affordable Care Act, nick-named "Pee-Pahka" after its initials.
Precious little was heard about the ACA in the president's State of the Union speech. Some pundits suspect the president is preparing to slip away quietly from support of the ACA since specific parts of the bill are under bipartisan attack, e.g., Section 10320 which sets up the Independent Payment Advisory Board (the IPAB). The IPAB was originally the IMAB, Independent Medicare Advisory Board, derisively known at the time as Euthanasia for the Elderly. Disguised now as a more equitable board, the IPAB still aims its arrows straight for the hearts of the elderly. In fact, the IPAB would be made up of appointed persons, none elected, and would not have to be comprised of physicians. The IPAB would appoint bean counters, annoint them as health care deciders, and give them the power to undercut the best efforts of caring physicians.
The purpose of the IPAB would be to reduce costs and to decide which procedures in medical care, what facilities, and which equipment used in patient care should be considered medically necessary. There is resistance in Congress since an effort to repeal Section 10320 surfaced long ago, viz., Sen. John Cornyn, R- Texas. The president expects a tough time for re-election. Speculation is that he may not want to drag the ACA, mocked as Obamacare, behind him as he swims for political survival. Neither does he want to abandon it.
Earlier references to the ACA and Sec. 10320 appear in this blog, issues of 4/6/11 (Obamacare revisited), 1/18/11 (Repeal Section 10320), and 11/04/10 (Obamacare needs instant revision).
Precious little was heard about the ACA in the president's State of the Union speech. Some pundits suspect the president is preparing to slip away quietly from support of the ACA since specific parts of the bill are under bipartisan attack, e.g., Section 10320 which sets up the Independent Payment Advisory Board (the IPAB). The IPAB was originally the IMAB, Independent Medicare Advisory Board, derisively known at the time as Euthanasia for the Elderly. Disguised now as a more equitable board, the IPAB still aims its arrows straight for the hearts of the elderly. In fact, the IPAB would be made up of appointed persons, none elected, and would not have to be comprised of physicians. The IPAB would appoint bean counters, annoint them as health care deciders, and give them the power to undercut the best efforts of caring physicians.
The purpose of the IPAB would be to reduce costs and to decide which procedures in medical care, what facilities, and which equipment used in patient care should be considered medically necessary. There is resistance in Congress since an effort to repeal Section 10320 surfaced long ago, viz., Sen. John Cornyn, R- Texas. The president expects a tough time for re-election. Speculation is that he may not want to drag the ACA, mocked as Obamacare, behind him as he swims for political survival. Neither does he want to abandon it.
Earlier references to the ACA and Sec. 10320 appear in this blog, issues of 4/6/11 (Obamacare revisited), 1/18/11 (Repeal Section 10320), and 11/04/10 (Obamacare needs instant revision).
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