Obamacare has a 15 member board of bureaucrats whose job it is to determine who gets how much and what kind of care. That is rationing. Insurance companies don't ration, they pay for what the contract says they will pay for.
The IPAB is explicitly forbidden from making any recommendations to ration care (whatever that means) in the statute. Their job is to find ways to improve the way services for Medicare beneficiaries are paid for and delivered. They're like a version of
MedPAC with actual authority:
‘‘(B) ADDITIONAL CONSIDERATIONS.—In developing and submitting each proposal under this section in a proposal year, the Board shall, to the extent feasible—
‘‘(i) give priority to recommendations that extend Medicare solvency;
‘‘(ii) include recommendations that—
‘‘(I) improve the health care delivery system and health outcomes, including by promoting integrated care, care coordination, prevention and wellness, and quality and efficiency improvement; and
‘‘(II) protect and improve Medicare beneficiaries’ access to necessary and evidence-based items and services, including in rural and frontier areas;
‘‘(iii) include recommendations that target reductions in Medicare program spending to sources of excess cost growth;
‘‘(iv) consider the effects on Medicare beneficiaries of changes in payments to providers of services (as defined in section 1861(u)) and suppliers (as defined in section 1861(d));
‘‘(v) consider the effects of the recommendations on providers of services and suppliers with actual or projected negative cost margins or payment updates;
‘‘(vi) consider the unique needs of Medicare beneficiaries who are dually eligible for Medicare and the Medicaid program under title XIX; and
‘‘(vii) take into account the data and findings contained in the annual reports under subsection (n) in order to develop proposals that can most effectively promote the delivery of efficient, high quality care to Medicare beneficiaries.
That said, the IPAB only makes recommendations when Medicare per capita spending is growing faster than certain targets. Given the recent slowdown in Medicare spending (
"Slower Growth in Medicare Spending — Is This the New Normal?"), they may not have much to do:
Indeed, in its
March 2011 Medicare Baseline, the CBO anticipated that the IPAB wouldn't be called upon to make any recommendations in the 2011-2021 period.
So no need to change your shorts just yet.