Today on Forbes on Fox, viewers were exposed to a fact that rarely makes an appearance on Fox News: Health care in America is already rationed, mainly by insurance companies. Rationing isn't an insidious creation of the health care reform law enacted last year -- it's something we all deal with when we interact with health care in our country.
A panelist on Forbes on Fox, DePauw University professor Mark Tatge, made that point during a discussion of the Independent Payment Advisory Board (IPAB). The board was created by the health care law to propose ways to control Medicare costs, should they rise above a certain rate of growth.
Tatge told host David Asman:
We already ration care, David. I mean, we have 47 million Americans who can't get health insurance, who don't have health insurance. The unemployed and the underemployed don't have health care, or have very limited access to health care. So, I don't see what the big deal is about a bipartisan panel that's going to try to limit cost increases in Medicare, which have been runaway. So what's the big deal about this?
After being prompted for a response, Forbes said, in part:
David, this panel is really almost unconstitutional. It has no judicial review and no administrative review, and in terms of what they do, the way they ration health care -- and let's call them what they are, death panels -- is they'll say certain procedures, you don't get reimbursed for. That effectively cuts those procedures off. And Rich is right. It's going to be right after the -- they're going to go right after the elderly.
Two facts put to rest the falsehood Forbes is pushing.
First, the health care law specifically prohibits IPAB from making “any recommendations to ration health care ... or otherwise restrict benefits.” The board can't “ration health care,” as Forbes said.
Second, IPAB's proposals can be replaced by Congress with alternative proposals that achieve the same amount of savings. So, despite the fact that there isn't a judicial or administrative review of IPAB's proposals, as Forbes said, Congress itself can reject them.
The nonpartisan Kaiser Family Foundation detailed the process in a May 2010 document explaining IPAB:
The recently enacted health reform law (P.L. 111-148; P.L. 111-152) establishes a new Independent Payment Advisory Board with authority to recommend proposals to limit Medicare spending growth. If projected per capita Medicare spending exceeds target growth rates, the Board is required to recommend proposals to reduce Medicare spending by specified amounts, with the first set of recommendations due in 2014 for implementation in 2015 (see “Key Implementation Dates” below). If the Board fails to submit a proposal, the Secretary of the Department of Health and Human Services is required to develop a detailed proposal to achieve the required level of Medicare savings. The Secretary is further required to implement the Board's (or Secretary's) proposals to achieve savings, unless Congress adopts alternative proposals resulting in an equivalent level of savings or if the President vetoes the Congressional package and the veto is not overridden. Implementation of the Board's recommendations by the Secretary is not subject to administrative or judicial review. The establishment of the Board represents the first time that the Medicare program will be subject to spending limits, with statutory requirements to achieve savings targets.
Forbes on Fox also employed a misinformation technique commonly seen on Fox News: flashing an incredibly misleading -- or sometimes flat-out false -- graphic to tease the segment.
About six minutes before the segment on IPAB began, Fox displayed the following graphic:
So, if you didn't watch the next segment, which came after a commercial break, or were watching with the sound off, you never got to hear Tatge make the point that rationing already occurs.