Monday, October 22, 2012

Does the PPACA ration care for disabled and elderly citizens?

I am back - trying to find income takes time and the blog has been content limited during the pause...

Below is a written op-ed that I have written, looking to be published for a pittance perhaps but does reflect concerns that I have about the PPACA (aka: Obamacare) regarding potential rationing, and have had for awhile with my Muscular Dystrophy (MD). Access to health insurance is admirable, but are there unintended costs and consequences in the law?

Does the PPACA (aka Obamacare) ration care despite what its proponents say?

As someone afflicted with Muscular Dystrophy and uses a power wheelchair for ambulation, I pay attention to the nuance of laws that may offer unintended consequences to myself. Such as the Patient Protection and Affordable Care Act (PPACA), aka Obamacare.

There are a few that might advise me that such a law could be beneficial to a disabled consumer. Perhaps in part, however one aspect concerns me greatly: the Independent Payment Advisory Board (IPAB). The term ‘death panel’ has been used frequently, and the biggest reason that term may be appropriate is just who makes determinations in available care. Per Public Law PL 111–148, dated 20 March 2010, on Page 189:

This advisory board under this paragraph shall consist of 15 members appointed by the Comptroller General of the United States…”

How great is that? A politically appointed Comptroller General of the US and head of the U.S. Government Accountability Office (GAO) gets to select this board of 15. Will they be chosen for the knowledge and competence unexpected of most bureaucrats - especially from the spendthrift GAO?

So I wonder if such parameters such as my condition Limb Girdle Muscular Dystrophy determine the quality of care I may or may not receive. Will such a bureaucracy consider my ‘quality of life’ to be sufficient in determining what care I may need – and perhaps not receive? Further, the secretary of HHS, an unelected position, has extraordinarily broad powers to enforce the law. A text search of the public law mentions the HHS secretary over 100 times.

The media seems to indicate the IPAB will likely ‘ration’ care. The libertarian  opines: “Obamacare requires IPAB to issue "legislative proposals" to reduce future spending. Those proposals could include drastic cuts that jeopardize seniors' access to care” notes that the law that the law states “The Obamacare law doesn’t define what it means by the ‘rationing’ it says IPAB can’t use… the standards limiting treatment are simply ‘cost-effective’ means of assuring patients get ‘appropriate’ care’ ”. Whatever the HHS says is appropriate – whatever that means.

The liberal New York Times printed an opinion piece by Steven Rattner, once the auto czar in the Obama administration. The lede to the September 30 story notes that "We need death panels". The NYT seems to de-emphasize or ignore in the past this term - that Rattner really said this here says that perhaps the NYT thinks this type of rationing is indeed a possibility despite any denials in the past.

Is the IPAB part of the law designed to ration care? Given the law as it reads, it probably does despite any (and all) disclaimers to the contrary. Will disabled and elderly persons be denied life-saving care? Given my physical issues and look into it, I have concluded that it does.

Comments are welcome!


  1. «Louis» thanks you for your visit to San Francisco Bay Daily Photo and your comments on his post about the Ford Skyliner.

  2. Thanks Ralph for visiting my post on the cycle of life. I didn't read your post here as it is about your laws and conditions in the US. I admire your enthusiasm for being a very useful citizen, I know there are many people with physical disabilities, but at least in your part of the world you are much attended. There are many people like you here who cannot even get a wheelchair, at least you are much favored by circumstances. take care!

  3. Wonderful informative and insightful post ~ send you lot of healing reiki energy ~ further enhance your wonderful spirit of strength and courage ~

    (A Creative Harbor)

  4. You are absolutely correct - witholding of care from older and 'nonproductive' members of society is a major part of this travesty. See the UN 'Agenda 21' for even more blatant examples of their intent.

  5. Informative post, Ralph. Good luck in all your ventures and may this blog give you a strong voice.

  6. Thanks for visiting my blog and for your comment. If you visit me often you may have picked up on the fact that I use a power wheelchair to get around. The casual visitor will have missed that because I don't mention it often. It does present a challenge considering that all my photos have to be shoot from either my van or wheelchair. In any case it seems we have that in common. I wish you and your family all the best and will look for you in the blogosphere.