An Independent Payment Advisory Board (IPAB) will oversee cuts in the Medicare Program. The Board will consist of 15 members. Upwards of $700 billion dollars of cuts may be achieved by implementation of various reforms aimed at streamlining the process of actually paying claims for medical service for patients. The implementation of cooperative purchasing exchanges should reduce costs through centralized purchasing and the discounts achieved by buying a commodity in great quantity. In addition, expiring pharmaceutical patents will result in cheaper generic drug alternatives.
The IPAB is charged with implementing specific programs to reduce Medicare per capita spending. A three fifths (60%) Senate vote will be needed to override IPAB cuts. Another way around IPAB proposed cuts would be through supplemental congressional legislation for Medicare.
Under the current Medicare system, physicians can order tests without excessive restrictions or denials. A recent Doctor Patient Medical Association poll finds that nearly three quarters of physicians have reservations about accepting Medicare patients under Obamacare. Luckily, this statistic represents a response rate of only 4% on a poll of over 30,000 physicians. Clearly, according to the poll, physicians have unanswered questions on how Obamacare will work in actual implementation. Here are some examples of real concerns.
Physicians have concerns about disturbing the special relationship between the doctor and patient. For instance, a physician may order a CT scan that provides better information than a cheaper ultrasound yet the IPAB may deny approval of the CT scan for specific types of medical encounters.
The most problematic area of medical practice is in emergency medicine, where life and death issues can be limited to an opportunity window of just minutes. A bureaucratic approval process which delays providing immediate medical diagnostics and care can be fatal to the patient. Examples would include diagnosing and treating a bursting appendix or gall bladder or a near fatal heart attack or stroke.
There are things that an Independent Payment Advisory Board (IPAB) can do to lessen cost burdens. An example would be extending outreach of artificial intelligence (AI) advice giving systems to medical providers. Advice giving systems in medicine provide physicians with diagnostic impressions based upon previously input symptoms, blood profiles and other data decided upon by knowledge profiles developed by a community of medical experts. This AI feature would reduce medical provider guessing in difficult cases where a community of experts could be accessed to assist individual physicians pressed for time and the need for an accurate diagnosis.