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January 12, 2010

Honorable Nancy Pelosi

Speaker of the House of Representatives

H-232, US Capitol / 235 Cannon HOB
Washington, DC 20515

Dear Madame Speaker:
  On behalf of our 400,000 senior-citizen supporters across America, RetireSafe urges you to stand up to the Senate’s ill-considered health care reform effort to establish a “Super MedPAC” that will, in its present form, clearly usurp your Constitutional powers, insert itself between doctors and their patients, and ultimately ration Medicare benefits for the elderly to meet preconceived spending targets.  Despite Senate protests to the contrary, that is exactly the result of the Independent Payment Advisory Board (IPAB) included in H.R. 3590 and the Patient Protection and Affordable Care Act, as passed by the Senate. Unless House Members take action to mitigate this disaster, the IPAB will indeed serve as a Super MedPAC with the uncontrolled power to ration care for your older constituents. We urge you to act now, before it’s too late for America's Seniors!


 In addition to unprecedented cuts to Medicare and an effort in the legislation to destroy the operation and growth of high-quality physician hospitals, what could be more insulting to older Americans than the IPAB, a Medicare rationing board set up to mandate “meat-axe” spending cuts to all Medicare providers, thus harming the providers and their patients? And without changes to the Senate language, this will all happen without your ability to provide any real input!


RetireSafe often disagrees with the AARP on many policy issues, but on this issue I’m sure you will find AARP and every other senior group opposing the IPAB in its present form. Commonsense changes could include a required up or down vote within 90 days of receipt by Congress of the IPAB recommendations. If the recommendations are not acted upon during that period, then the Department of Health and Human Services would be directed to implement only those recommendations that fall within its current statutory authority. This would be a reasonable alternative to the automatic implementation procedure now in the Senate language. The IPAB should not be allowed to legislate.


Because of its impact on patients, any prevailing IPAB vote should be a “super-majority” vote of at least two-thirds. This would ensure a well-founded consensus. There should be a broad, diversified representation on the Board, with some members being appointed by the President, and even more appointed by House and Senate Leadership from both the Majority and the Minority parties. Finally, game-changing innovation must be given the leeway to flourish, and mandated cost-shifting between exempted providers and those still covered must be thwarted to diminish the cost burden on impacted patients. The IPAB disaster can be mitigated, but only if the House acts now to lessen the damage.


Advisory boards are important purveyors of information to the medical community, and we support advisory boards that work to discover new innovations that improve the quality of care and inform Congress and the appropriate federal agencies as to the best health care policy. They should not have powers that go beyond those duties, and they should in no way supersede or dilute the present powers of Congress when it comes to Medicare. The Senate IPAB language must be either fixed, or stricken from the final health care reform legislation. RetireSafe urges you to make every effort to stop or change this Medicare rationing board before it harms every older American. As senior advocates, we will monitor your efforts on this issue and report accordingly to our supporters.



  Thair Phillips, President 


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