Organizations unite in opposition to the establishment of the Independent Payment Advisory Board (IPAB)

January 11, 2010

Dear Leader Reid and Speaker Pelosi:

The organizations signing this letter represent millions of Medicare beneficiaries and the millions of Americans who care for and provide a wide range of services, treatments and medical technologies to this important segment of our population. Our organizations believe we are on the cusp of enacting historic health care reform legislation that is vitally important for all Americans and for the Medicare program. Collectively, we support health care reform legislation that will positively impact millions of Medicare beneficiaries by improving benefits, reforming payment and delivery systems to promote the delivery of high-quality care, and ensuring access to the full range of health care providers, treatments and technologies.

However, the organizations signing below are united in strong opposition to the establishment of the Independent Payment Advisory Board (IPAB) included in the Senate-passed bill. We are writing to urge the elimination of the Board as House and Senate leaders work to reconcile differences between the House- and Senate-passed bills.

While the purpose of the Independent Payment Advisory Board is to reduce the per capita rate of growth in Medicare spending indefinitely, in most years Medicare's per capita growth has been below or equal to growth in the private sector. The IPAB reductions would be in addition to the $400-500 billion savings in provider payments already included in health care reform legislation, which could jeopardize both access for Medicare beneficiaries and even infrastructure for the entire health care system.

The Independent Payment Advisory Board would essentially assume authority over the Medicare program. This Board of officials appointed by the President would be required to make recommendations to reduce per capita Medicare spending regardless of whether it was growing faster than general health care inflation. Replacing elected officials with political appointments from the President does not remove "politics" from the equation. Indeed, we are concerned that this construct would create a body that is not accountable to anyone but the President.

The proposal usurps Congressional authority over the Medicare program. IPAB would also greatly limit the ability of Medicare beneficiaries, advocates and providers to work with Congress to improve the program, making it especially difficult to include coverage of new and better treatments, procedures and technologies.

Together, we agree that IPAB is an ill-advised provision for the future of Medicare. We favor responsible containment of rising health care costs, but we urge you to strongly oppose the inclusion of the Independent Payment Advisory Board in final health care reform legislation.

Sincerely,

AIDS Action Baltimore

The AIDS Institute

Alliance for Aging Research

American Academy of Dermatology Association

American Academy of Facial Plastic and Reconstructive Surgery

American Academy of Ophthalmology

American Academy of Otolaryngology—Head and Neck Surgery

American Academy of Physician Assistants

American Association for Marriage and Family Therapy

American Association of Clinical Endocrinologists (AACE)

American Association of Homes and Services for the Aging (AAHSA)

American Association of Neurological Surgeons

American Association of Oral and Maxillofacial Surgeons

American Association of Orthopaedic Surgeons

American College of Gastroenterology

American College of Nurse-Midwives

American College of Osteopathic Surgeons

American College of Radiology

American College of Surgeons

American Counseling Association

American Gastroenterological Association

American Health Care Association

American Hospital Association

American Occupational Therapy Association

American Osteopathic Academy of Orthopedics

American Osteopathic Association

American Rhinologic Society

American Society for Gastrointestinal Endoscopy

American Society for Metabolic & Bariatric Surgery

American Society of Anesthesiologists

American Society of Breast Surgeons

American Society of Cataract and Refractive Surgery

American Society of General Surgeons

American Society of Plastic Surgeons

American Urological Association

Association for Gerontology and Human Development

in Historically Black Colleges and Universities

Association of American Medical Colleges

Association of BellTel Retirees

Association of Jewish Aging Services of North America

B'nai B'rith International

California Medical Association

Center for Medicare Advocacy

Community Legal Services, Inc., Philadelphia , PA

Congress of Neurological Surgeons

Connecticut Academy of Family Physicians

Easter Seals

Empire Justice Center

The Gerontological Society of America

Heart Rhythm Society

HIV Medicine Association

The Jewish Federations of North America

Kansas Medical Society

Massachusetts Medical Society

Medical Group Management Association

Medical Society of Delaware

Medicare Advocacy Project, Greater Boston Legal Services, on behalf of its clients

Medicare Rights Center

National Academy of Elder Law Attorneys

National Association for Home Care & Hospice

National Association of Area Agencies on Aging

National Association of Nutrition and Aging Services Programs

National Association of Professional Geriatric Care Managers

National Association of Social Workers

National Committee to Preserve Social Security and Medicare

National Hospice and Palliative Care Organization

National Senior Citizens Law Center

OWL – The Voice of Midlife and Older Women

PTPN (National network of independent practices providing physical therapy, occupational therapy and speech-language pathology services)

Services and Advocacy for GLBT (Gay, Lesbian, Bisexual and Transgender)

Elders (SAGE)

Society for Vascular Surgery

Society of Gynecologic Oncologists

Texas Medical Association

VITAS Innovative Hospice Care

Volunteers of America