Romney: Obama board will rule on patient care

Mitt Romney contended six times Wednesday night that a panel established by President Obama's health law will make decisions about patients' medical care.

The charge echoed Sarah Palin's widely challenged claim about Obama "death panels" from this summer, though Romney never spoke that phrase during Wednesday's debate.

Both Romney and Palin, in the June iteration of her "death panels" attack, were referring to the healthcare law's Independent Payment Advisory Board (IPAB), a panel designed to curb cost growth in Medicare.

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The Affordable Care Act states that IPAB cannot "ration healthcare, raise revenues or Medicare beneficiary premiums … or otherwise restrict benefits." 

But in Wednesday's debate, Romney insisted that the board "can tell people, ultimately, what [medical] treatments they're going to receive."

"The right course for America's government … is not to become the economic player picking winners and losers, telling people what kind of health treatment they can receive, taking over the healthcare system," Romney said.

IPAB will function as an accounting board, cutting Medicare reimbursement rates only when the program's spending per capita reaches a level deemed too great. 

The panel is sometimes confused with Patient-Centered Outcomes Research Institute (PCORI), also established by the healthcare law, which will study health outcomes and the effectiveness of different medical treatments. That 19-member board is prohibited from mandating or endorsing rules about healthcare coverage based on its research. 

Conservatives have long argued that IPAB will bring about "de facto rationing" by reducing payments to Medicare providers, causing them to limit their services.

With this reasoning, the GOP-led House approved legislation to repeal the panel earlier this year. Seven Democrats supported the effort, arguing that IPAB should not be permitted to cut Medicare reimbursements without lawmakers' input.

But on Wednesday night, Romney took those arguments a step further, saying that IPAB would be able to "tell a patient and a doctor what kind of treatment they can have."

"I don't like the idea," Romney added. 

The head of the liberal group Health Care for America Now (HCAN) blasted Romney for the remarks, calling them a "grotesque political scare tactic."

"What Romney said last night about this board was a bald-faced lie, and he knows it," said HCAN Executive Director Ethan Rome in a statement to The Hill.

"The board is explicitly prohibited from making any recommendations that would reduce benefits, increase the cost of care, or change eligibility. It's about reducing costs, not care."

But Romney's campaign pointed to a study by the Medicare agency that cited skepticism among some health economists about IPAB's long-term success.

One expert, Dr. Joseph Newhouse of Harvard University, wrote that a growing gap between Medicare and private insurance on the amount of money paid to doctors could potentially "jeopardize Medicare beneficiaries' access to mainstream medical care."

Another authority, Timothy Jost of Washington and Lee University, wrote that if the gap continues to grow, "healthcare providers may well abandon Medicare."

But those scenarios differ somewhat from what Romney described Wednesday night — "a board of people at the government … who are going to decide what kind of treatment you ought to have."

Palin used a similar description in June, slamming IPAB in a Facebook post ahead of the Supreme Court's decision on healthcare reform.

"ObamaCare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about healthcare funding," Palin wrote.

She went on to link IPAB's "subjective rationing of care" to her previous writings about "Obama's 'death panel.'"

In a previous Facebook post, Palin had used the phrase "death panel" to refer to board in which federal bureaucrats decide whether "my parents or my baby with Down Syndrome … are worthy of healthcare" based on an estimation of their "level of productivity in society."

Palin originally penned this description to protest draft provisions of the healthcare law that encouraged end-of-life planning. The proposals she objected to were scrapped after a public outcry.

A poll released last week found that about four in 10 U.S. adults believe that the health law establishes panels to decide patients' fitness for care. 


— This story was updated at 5:39 p.m.