|00:00:00||THOUSANDS OF MEDICARE PATIENTS.|
|00:00:03||AND MY CAREER ENDED PREMATURELY BECAUSE OF A DISABILITY.|
|00:00:07||BUT I LEARNED A LONG -- SOMETHING A LONG TIME AGO FROM MY FATHER AND THE MOST IMPORTANT THING HE TAUGHT ME, DESPITE ALL THE TECHNOLOGY WE HAVE IS THAT TRUST IN THE DOCTOR-PATIENT RELATIONSHIP IS THE MOST IMPORTANT THING, THE MOST IMPORTANT FOUNDATION OF GOOD HEALTH CARE, HIGH QUALITY HEALTH CARE.|
|00:00:29||LOOK AT THIS CHART.|
|00:00:32||WHAT'S WRONG WITH THIS?|
|00:00:33||CLEARLY, YOU CAN SEE ALL THE BUREAUCRATIC ENTITIES, BUT WHERE'S THE DOCTOR AND WHERE'S THE PATIENT?|
|00:00:40||THE DOCTOR IS DOWN HERE IN THE CORNER.|
|00:00:43||AND WAY OFF IN THE OTHER CORNER ARE THE PATIENTS.|
|00:00:45||SO ALL THIS STUFF IN THE MIDDLE IS WHAT UNDERMINES THE TRUST IN THE DOCTOR-PATIENT RELATIONSHIP.|
|00:00:53||NOW, WE HAD HEALTH AND HUMAN SERVICES SECRETARY, KATHLEEN SEBELIUS IN FRONT OF OUR COMMITTEE RECENTLY AND WE WERE ASKING ABOUT THIS INDEPENDENT PAYMENT ADVISORY BOARD AND ASKED THE QUESTION ABOUT RATIONING AND WHAT CAME OUT IS NUMBER ONE, THERE IS NO DEFINITION OF RATIONING IN THE STATUTE.|
|00:01:11||SO THE DEPARTMENT WILL HAVE TO WRITE RULES.|
|00:01:15||AND SHE ADMITTED IN COMMITTEE THAT NOT GOING TO BE ABLE TO WRITE RULES THAT CAN ACTUALLY PROTECT SENIORS FROM IPAB.|
|00:01:30||KAISER FAMILY FOUNDATION ADMITS THAT IPAB MUST MEET SPENDING TARGETS EVEN IF EVIDENCE OF QUALITY CONCERNS SURFACED, AARP WARNS IPAB'S MEDICARE CUTS COULD, I QUOTE, A NEGATIVE IMPACT ON ACCESS TO CARE.|
|00:01:51||THOSE ARE REALLY UNDERSTATEMENTS.|
|00:01:54||ACCORDING TO MEDICARE'S OWN ACTUARIES, AND PAYMENTS COULD FALL LESS TO HALF THAN MEDICARE RATES.|
|00:02:09||AND IF LEFT ON THE BOOKS, IPAB WILL ENDANGER THE LIVES OF SENIORS.|
|00:02:14||IT'S VERY CLEAR.|
|00:02:16||THIS UNDERMINES THE DOCTOR-PATIENT RELATIONSHIP AND UNDERMINES TRUST IN OUR HEALTH CARE SYSTEM.|
|00:02:22||IT UNDERMINES QUALITY AND WE WILL NOT CONTROL COSTS WITH IPAB AND THAT'S WHY WE MUST REPEAL IT.|
|00:02:28||I YIELD BACK.|
|00:02:29||THE SPEAKER PRO TEMPORE: THE CHAIR: THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME.|
|00:02:33||THE GENTLEMAN FROM MICHIGAN, MR.|
|00:02:34||LEVIN, IS RECOGNIZED.|
Mr. BOUSTANY. I thank the chairman of the full committee for yielding time to me.
I had a great career as a cardiac surgeon in treating thousands of Medicare patients in my career. And my career ended prematurely because of a disability.
But I learned something a long time ago from my father, who's a family doctor, who went before me, who taught me about the art of medicine. And the most important thing he taught me, despite all the technology we have, is that trust in the doctor-patient relationship is the most important thing, the most important foundation of good health care, high quality health care.
Look at this chart. What's wrong with this? Clearly, you could see all the bureaucratic entities. But where's the doctor, and where's the patient? The doctor is down here in the corner, and I think way off in the other corner are the patients. So all this stuff in the middle is what undermines the trust in the doctor-patient relationship.
Now, we had Health and Human Services Secretary Kathleen Sebelius in front of our committee recently, and [Page: H1477] we were asking about this Independent Payment Advisory Board. We asked the question about rationing, and what came out was, number one, there's no definition of rationing in the statute, so the Department will have to write rules. And she admitted in committee--very tacitly but effectively admitted--that they're not going to be able to write rules that can actually protect seniors from IPAB.
Even the left-leaning Kaiser Family Foundation admits, IPAB must issue cuts to meet spending targets ``even if evidence of access or quality concerns surfaced.'' AARP warns IPAB's Medicare cuts ``could have a negative impact on access to care.'' Both of those are really understatements. According to Medicare's own actuaries, Medicare physician payments could fall to less than half of projected Medicaid rates under current law.
The Acting CHAIR. The time of the gentleman has expired.