Ain't That A Shame: Pat Boone And 60 Plus Attack Sen. Sherrod Brown With Recycled Health Care Lies

November 09, 2011 10:56 am ET

In a new ad from the 60 Plus Association, renowned Top 40 crooner Pat Boone misrepresents the role, responsibilities, and powers of the Independent Payment Advisory Board (IPAB) set up by the Affordable Care Act to slow the dangerous rise of health care costs. But Boone, whose cover of Fats Domino's "Ain't That A Shame" was a No. 1 hit in 1955, is behind the times. It's been well established for a year now that IPAB doesn't have the power to ration care or change Medicare benefits, and the board's members have to be confirmed by the Senate. Furthermore, while Boone claims IPAB's savings will "fund more wasteful spending" and accuses Sen. Sherrod Brown (D-OH) of "ignoring the problem" with Medicare's finances, the changes in the health care law actually extended the life of Medicare. Boone leaves one golden oldie about $500 billion in Medicare cuts to the narrator — but it's still not true.

60 Plus Ad: "This IPAB Board Can Ration Care And Deny Certain Medicare Treatments"

[Pat Boone:] Hi friend, I'm Pat Boone. Last year a lot of promises were made regarding health care reform. But America's seniors knew forcing a bill through Congress when Americans overwhelmingly opposed it would be disastrous, and we were right.

[Narrator:] President Obama's health care law cuts 500 billion from Medicare and creates a board of 15 unelected, unaccountable bureaucrats. It's like a Medicare IRS, with the power to cut Medicare in order to pay for new government programs.

[Boone:] This IPAB board can ration care and deny certain Medicare treatments, so Washington can fund more wasteful spending. Your choices could be limited and you may not be able to keep your own doctor. Medicare will be bankrupt in nine years, but Washington politicians like Sherrod Brown are ignoring the problem, putting their own re-elections first. Call Senator Brown. Urge him to support real Medicare reform and protect our seniors. Tell him unaccountable bureaucrats should never have the power to deny you the care you deserve.

IPAB Is Prohibited From Rationing Care, Increasing Taxes, Or Changing Medicare Benefits Or Eligibility

IPAB Cannot Ration Care, Increase Taxes, Change Benefits Or Eligibility, Or Increase Premiums And Cost-Sharing Requirements. According to the Kaiser Family Foundation: "The Board is prohibited from submitting proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase beneficiary premiums and cost-sharing requirements, or reduce low-income subsidies under Part D. Prior to 2019, the Board is also prohibited from recommending changes in payments to providers and suppliers that are scheduled to receive a reduction in their payment updates in excess of a reduction due to productivity adjustments, as specified in the health reform law." [Kaiser Family Foundation, May 2010]  

FactCheck.org: "It's Wrong To Say That The Advisory Board Will Ration Care." FactCheck.org addressed Rep. Paul Ryan's (R-WI) claim that IPAB rations care:

Ryan twice warns of Obama's plan to "ration" health care for the elderly. He also says, "The greatest threat to the health security of America's seniors is the President's plan to deeply and systematically ration Medicare."

Ryan spokesman Conor Sweeney told us in an e-mail that the claim of rationing refers to funding for the Independent Payment Advisory Board created by the federal health care law.But it's wrong to say that the advisory board will ration care or that it will be run by bureaucrats, as we wrote when Sarah Palin made a similar claim.

The Patient Protection and Affordable Care Act says the advisory board "shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums." Also, the board isn't made up of Washington bureaucrats. The 15 voting members will be appointed by the president in consultation with congressional leaders; they must include doctors and other health care professionals, economists and health care finance experts, and representatives of consumers and seniors, as the American Medical Association explains. There will also be three non-voting members: the Health and Human Services secretary, and the administrators of the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration. [FactCheck.org, 5/6/11, emphasis added]

IPAB Members Will Be Appointed By The President And Confirmed By The Senate

IPAB Has 15 Full-Time Members That The President Appoints And The Senate Confirms. According to the Kaiser Family Foundation: "IPAB is established as an independent board in the executive branch, composed of 15 full-time members appointed by the President and confirmed by the Senate. The statute sets out an array of qualifications for Board members: expertise in health care, economics, research and technology assessment, experience with employers and third-party payers, and consumers. It requires a balance between urban and rural representation. A majority of members must be non-providers." [Kaiser Family Foundation, April 2011]

Obama Wants To Fill The Board With "Doctors, Nurses, Medical Experts And Consumers." According to the Washington Post: "Obama hasn't nominated anyone yet, but said last month that he hopes to fill the slots with 'doctors, nurses, medical experts and consumers.'" [Washington Post, 5/8/11]

Board Members Will Serve Six-Year Terms. According to the Washington Post"Board members, who will serve six-year terms, are to be paid the salary of senior executives in the federal government - $165,300 this year - and cannot hold any other jobs." [Washington Post5/8/11]

IPAB Helps Takes The Politics Out Of Medicare Payment Decisions

IPAB Recommendation Process Requires Congress To Implement Proposal Or Pass An Amendment Meeting The Same Targets. Tim Jost wrote in the New England Journal of Medicine: "Each September 1, the IPAB must submit a draft proposal to the secretary of health and human services. On January 15 of the following year (beginning with 2014), the board must submit a proposal to Congress. If the board fails to submit a proposal on deadline, the DHHS must itself submit a proposal. Congress must consider the proposal under an expedited procedure. Congress cannot consider any amendment to the proposal that does not meet the same cost-reduction goals, unless both houses of Congress (and three fifths of the Senate) vote to waive this requirement. If Congress fails to adopt a substitute provision complying with the statute by August 15, the DHHS must implement the board's proposal." [New England Journal of Medicine7/8/10]

IPAB "Insulate[s]" Medicare From The "Normal Politics Of Congressional Decision-Making." Neera Tanden wrote in The New Republic: "At a time when rising health care costs are a concern for families' pocketbooks and the federal budget, the IPAB was a means to maintain public oversight of Medicare but insulate it from the normal politics of congressional decision-making, thus helping ensure that best medicine was the driver of cost reductions." [The New Republic4/30/11]

IPAB Was Partly Created "To Mitigate The Influence Of Politics And Stakeholders On Medicare Payment Decisions." According to the Kaiser Family Foundation: "The Independent Payment Advisory Board was established, at least in part, to mitigate the influence of politics and stakeholders on Medicare payment decisions and give authority to a group of outside experts to recommend savings proposals, rather than Members of Congress." [Kaiser Family Foundation, May 2010]

IPAB "Was Specifically Designed To Reduce The Influence Of 'Special Interests' On Medicare Payment Policy." Kaiser Health News wrote: "And, in response to complaints from the health care industry, Sen. John Rockefeller, D-W.Va., who was one of IPAB's architects, said that the board was specifically designed to reduce the influence of 'special interests' on Medicare payment policy. Those interests, he and others say, have kept Congress from making the tough decisions needed to hold down spending and reduce the deficit." [Kaiser Health News, 5/8/11]

Far From "Ignoring The Problem," President Obama's Signature Health Care Reform Law Extended The Life Of Medicare By Years

PolitiFact: Latest Medicare Trustees Report Says Affordable Care Act Extended Life Of The Program By Eight Years, After Previous Report Put That Number At 12 Years. From a PolitiFact item fact checking Rep. Debbie Wasserman Schultz's (D-FL) claim that the Affordable Care Act extended the life of Medicare by 12 years:

The bigger problem with Wasserman Schultz's statement is that just a few weeks ago, the board of trustees issued a new report that revised its estimates for the health care law. Instead of adding 12 years of solvency, the board concluded, the law will only add eight years of solvency. Starting in 2024, the program will need either new revenues or reduced expenses to meet all of its obligations. The board said the shortfall was because of the continuing economic slowdown, which has reduced the Medicare program's income from taxes, and a few other lesser factors.

So Wasserman Schultz's number is off by about a third.

Nevertheless, her overall point, that the Democrats' health reform law added to the overall solvency of Medicare, is correct. The 2011 report included the same warnings that estimating health care savings for the future is an uncertain process, but it also concluded that the financial outlook for Medicare is "substantially improved as a result of the changes in the Affordable Care Act."

The law reduced spending and increased revenues in several ways. It slows increases in payments to hospitals and nursing homes. It raises Medicare hospital taxes for high earners. And it introduces several new programs aimed at steering the health system away from paying doctors and hospitals per procedure ("fee for service") and instead paying for good outcomes. [PolitiFact, 5/27/11, emphasis added]

Affordable Care Act's Medicare Savings Come From Eliminating Wasteful Overpayments, Not Cutting $500 Billion

New England Journal Of Medicine: The Affordable Care Act Phases Out "Substantial Overpayments" To Medicare Advantage Plans. From the New England Journal of Medicine: "A phased elimination of the substantial overpayments to Medicare Advantage plans, which now enroll nearly 25% of Medicare beneficiaries, will produce an estimated $132 billion in savings over 10 years. [...] The ACA also produces nearly $200 billion in savings by assuming that providers can improve their productivity as firms in other industries have done. On the basis of this presumed improvement, the law reduces Medicare's annual 'market basket' updates for most types of providers - a provision that has generated controversy." [New England Journal of Medicine7/8/10]

FactCheck.org: Cost Saving Provisions "Not A Slashing Of The Current Medicare Budget Or Benefits." According to FactCheck.org: "Whatever you want to call them, it's a $500 billion reduction in the growth of future spending over 10 years, not a slashing of the current Medicare budget or benefits. It's true that those who get their coverage through Medicare Advantage's private plans (about 22 percent of Medicare enrollees) would see fewer add-on benefits; the bill aims to reduce the heftier payments made by the government to Medicare Advantage plans, compared with regular fee-for-service Medicare. The Democrats' bill also boosts certain benefits: It makes preventive care free and closes the 'doughnut hole,' a current gap in prescription drug coverage for seniors." [FactCheck.org, 3/19/10]

Cuts Would Only Affect Medicare Advantage Plans. As reported by Kaiser Health News:

The new health law will cut $136 billion in spending on the Advantage program by 2019, which currently pays private plans to administer Medicare benefits and pays them about 14 percent more than the per-patient cost of the traditional Medicare program. Plans use that subsidy to lure members with lower premium costs or extra benefits not normally paid for by Medicare, such as vision care or better prescription drug coverage. Some Democrats and analysts have argued the higher rates are wasteful. 

Even experts who support the change concede that the impact of the cuts could be evident. Robert Berenson, a scholar at the Urban Institute and former Medicare official, said some Advantage plan members will notice skimpier benefits, "but the Republicans have really exaggerated that this will wipe out the Advantage plans." 

Marsha Gold, a health policy analyst for the private research group Mathematica, said, "Over time, there will be less rich benefits or higher premiums, but it's going to be gradual," noting that the largest cuts do not begin until 2015. [Kaiser Health News, 4/6/10]

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