If The Right-Wing Media Are Right, Romney Is In Favor Of "Death Panels"

››› ››› KEVIN ZIEBER & ANDY NEWBOLD

Right-wing media are reviving the "death panels" lie in reaction to Mitt Romney's criticism of a health-care advisory board during the first presidential debate. In fact, that board, established under the 2010 health care reform law, is forbidden from rationing health care, and Romney's own health care reform in Massachusetts includes a similar unelected board.

Romney Claims Obama's Health Care Reform Created A Board That Will Tell People What Treatments They Can Have

In Debate, Romney Claimed The Affordable Care Act Put In Place "An Unelected Board That's Going To Tell People Ultimately What Kind Of Treatments They Can Have." When asked by debate moderator Jim Lehrer why he wanted to repeal the Affordable Care Act, Romney stated, in part, that "it puts in place an unelected board that's going to tell people ultimately what kind of treatments they can have. I don't like that idea." [Presidential debate transcript, 10/3/12, via Politico]

Right-Wing Media Use Romney's Attack To Claim Obama Supports "Death Panels" 

Daily Caller: "Obama Backs IPAB 'Death Panel' Again." Following the debate, The Daily Caller attacked President Obama for "his support for the controversial Medicare Independent Payment Advisory Board (IPAB) -- often dubbed by conservatives as Obamacare's 'death panels.' " The headline stated: "Obama backs IPAB 'death panel' again, despite bipartisan support for repeal":

During Wednesday evening's presidential debate, President Barack Obama repeated his support for the controversial Medicare Independent Payment Advisory Board (IPAB) -- often dubbed by conservatives as Obamacare's "death panels" -- in a back-and-forth with GOP presidential candidate Mitt Romney. [The Daily Caller, 10/3/12]

Fox Nation: "Obama Backs 'Death Panels' At Debate." Fox Nation linked to the Daily Caller piece with the headline: "Obama Backs 'Death Panels' at Debate."

[Fox Nation, 10/4/12]

National Review Online Claimed "Obama's Government-Board IPAB" Either Rations Care Or Punishes Health-Care Providers. A National Review Online blog post by Michael Graham stated: "President Obama was then forced to say that IPAB 'can't limit your health-care choices.' Okay, then -- how does it cut costs? If it doesn't ration care, what does it do? The answer, of course, is that it punishes health-care providers who won't do what they're told." From the post:

Mitt Romney's "pay for performance" model is the perfect counter to President Obama's government-board IPAB. One approach says, "Hey, I know you want to make a profit, so get smart and make more money." The other says, "I think you're corrupt or stupid, so I'm going to tell you what to do."

President Obama was then forced to say that IPAB "can't limit your health-care choices." Okay, then -- how does it cut costs? If it doesn't ration care, what does it do?

The answer, of course, is that it punishes health-care providers who won't do what they're told.

One system is human nature and incentives. The other is government bureaucracy trying to get people to obey rules they don't like. [National Review Online, 10/3/12]

Breitbart.com: "Obama Defends 'Death Panels' During Debate." Breitbart.com blogger Tony Lee posted a piece with the headline: "Obama Defends 'Death Panels' During Debate." In the post, Lee stated:

During Tuesday's presidential debate, Mitt Romney said the Independent Payment Advisory Board (IPAB), also known as a "death panel," was one of the reasons he would repeal Obamacare. And President Barack Obama continued to defend his controversial death panels. [Breitbart.com, 10/4/12

Wash. Post's Rubin Praised Romney For Suggesting That IPAB Will "Cut Care." The Washington Post's Jennifer Rubin:

When the conversation got to Obamacare, Romney ticked through the reasons to get rid of it, including its impact on job creation and the Independent Payment Advisory Board. He scolded Obama for working on Obamacare for two years, rather than focusing on jobs. Bizarrely, the president pointed to Romneycare in defense of Obamacare. Romney blew him back by saying his plan didn't cut Medicare, didn't put a board in place to cut care and didn't raise taxes or force people to drop their current coverage. He stressed that his was a bipartisan effort. It was a stunningly effective performance.

Oddly, Obama defended the IPAB, saying it was a fine idea because it was made up of experts. Huh? Romney went back to skewer him on that point ("15 people telling us what kind of care" we can have) and spoke passionately about private-sector innovation. Obama looked extremely annoyed, stumbling when trying to mischaracterize Romney's plan. He began to flail, complaining about Romney's tax and regulatory plans. [Washington Post, 10/3/12]

But The Federal Board Is Forbidden By Law To Make "Any Recommendation To Ration Health Care"

Politifact: The Federal Board "Wouldn't Make Any Health Care Decisions For Individual Americans." A Politifact analysis of the claim that IPAB would make the final decision on available treatments found that IPAB would make broad policy decisions, not individual recommendations. It also noted that IPAB is "forbidden from submitting 'any recommendation to ration health care'":

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. [Politifact, 10/3/12]

Politico: The Federal Board "Cannot By Law Make Recommendations About What Treatments People Get." In a presidential debate fact-check, Politico pointed out that the IPAB "cannot 'ration' care":

Romney claim: "He has as a model for [cost control] 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."

False. The Independent Payment Advisory Board, whose members must be confirmed by the Senate, will make recommendations about Medicare payments to providers, when spending exceeds targets specified in the law. They cannot by law make recommendations about what treatments people get, what people pay in premiums or co-pays, and they cannot "ration" care. Congress can reject their payment recommendations as long as they come up with other savings. [Politico, 10/4/12]

Wash. Post's Glenn Kessler: The Affordable Care Act "Explicitly Says That The Recommendations Cannot Lead To Rationing Of Health Care." Washington Post fact checker Glenn Kessler wrote that IPAB "appears aimed at doing the same thing as the House Republican Medicare plan":

The health-care law explicitly says that the recommendations cannot lead to rationing of health care. Of course, "rationing" is in the eye of beholder, and one common complaint is that rationing is not defined. The law also limits recommendations that would change benefits, modify eligibility or increase Medicare beneficiary cost-sharing, such as deductibles, coinsurance and co-payments.

On the surface, the IPAB appears aimed at doing the same thing as the House Republican Medicare plan -- reducing the runaway costs of Medicare, except on a faster track. (The GOP plan would not kick in until 2021, just a few years before the Medicare hospital fund begins to run dry.) [Washington Post, 10/4/12]

And Romney's Health Care Plan In Massachusetts Also Established An Independent Board To Oversee Insurance Coverage

The Hill: Both Romney's Mass. Law And The Affordable Care Act "Established Unelected Boards To Help Accomplish The Laws' Objectives." The Hill reported that the health care law Romney passed in Massachusetts established the unelected Commonwealth Health Insurance Connector Authority to help "regulate insurance in the state":

Both the Massachusetts law and President Obama's Affordable Care Act seek to expand healthcare coverage through an individual mandate to buy insurance. Both also established unelected boards to help accomplish the laws' objectives.

[...]

Under the Affordable Care Act, the 15-member Independent Payment Advisory Board (IPAB) will advise Congress on slowing cost growth in Medicare. Sarah Palin referred to IPAB as a "death panel," and other Republicans have attacked it as a rationing board.

In Massachusetts, the Commonwealth Health Insurance Connector Authority Board helps to regulate insurance in the state. [The Hill, 8/23/12]

The New Republic: Romney's Law Creates An Unelected Board That "Actually Has More Power" Than The IPAB. The New Republic reported that "the board, known as the Connector Authority, has power to define what benefits insurers must cover, among other things." Moreover, the article reported that the executive director of the Massachusetts board said that "the Connector Authority actually has more power" than the IPAB:

The Massachusetts health law created an independent board, with members not directly elected by the people, to oversee its universal health care scheme. The board, known as the Connector Authority, has power to define what benefits insurers must cover, among other things.

[...]

It's true that the Connector Authority had different responsibilities than the IPAB will. But, according to [former Connector Authority executive director Jon] Kingsdale, the difference actually undermines the Republican talking point, because the Connector Authority actually has more power. [The New Republic, 8/28/12]

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