Remember the Obamacare “death panel”? Well, it’s baaaaack! Democratic presidential nominee Hillary Clinton wants to create her own death panel to determine who can and can’t have certain prescription drugs.
The Affordable Care Act created a 15-member panel of “independent” experts, officially known as the Independent Payment Advisory Board (IPAB). If the Medicare budget increased beyond certain target levels, the committee was supposed to recommend ways to reduce spending.
At the time, liberals and the media ridiculed concerns that IPAB could become a platform for rationing health care, even though the United Kingdom’s National Institute for Health and Care Excellence (NICE) does exactly that. The organization explicitly says, “NICE decides which drugs and treatments are available on the NHS [i.e., the government-run National Health Service] in England and Wales.”
But remember, liberals also ridiculed concerns about exploding health premiums, the young and healthy refusing to buy insurance, and warnings that millions would lose their coverage and their doctor—all of which have come true.
While the Obamacare IPAB debate of 2009 was hyperbolic, the threat from an unelected committee denying patients the care they needed was very real.
However, President Obama has never proposed a list of names for the IPAB board, and Republicans in Congress have managed to whittle away at the provision’s funding. So it’s possible the committee will never convene.
But if Clinton becomes president and establishes her prescription drug task force, it could be a bigger rationing threat than IPAB, since drugs play such an important and growing role in health care.
There was a day when agencies and advisory committees consisted of recognized experts who were expected to be independent. Those days have disappeared, especially over the last eight years.
Today, the president often appoints like-minded individuals whose mission is to implement his agenda, even if it means riding roughshod over dissenting committee members. The Federal Communications Commission (FCC) and the National Labor Relations Board (NLRB) are two good (or bad) examples.
Clinton’s prescription drug committee would almost surely follow the Obama command-and-control model.
If federal budget constraints or political concerns meant the country needed to spend less on health care, Clinton would only have to wink and soon we could see her committee claiming that aspirin was just as good as some prescription pain relievers, or that cancer-fighting drugs had not proven to be effective, or that other innovative but expensive drugs just weren’t worth the cost.
Clinton claims her efforts would increase competition. Just like the promised increased competition in health insurance options on the Obamacare exchanges? About 31 percent of those in exchanges will have only one coverage plan next year, according to the Wall Street Journal.
Ironically, Clinton touts her expertise by pointing to her efforts to pass the Vaccines for Children program (VFC). If that’s her model, patients better stock up on their medications now.
The VFC was supposed to increase access to childhood vaccines. But it imposed effective price controls that played a role in creating widespread vaccine shortages as manufacturers left the market.
As the policy journal Health Affairs pointed out in 2005, the VFC “purchases 55–60 percent of all vaccines. As a large single purchaser, the federal government creates a functional cap on vaccine prices and, more importantly, has contributed to shrinking the private market…” Changes were eventually made to improve the program.
Clinton’s prescription drug committee might begin on the right foot, but it would eventually become a tool of the political system and force innovative drug companies to focus their research dollars on politically popular diseases—because those are the ones the committee would be most likely to approve.
And it would impose price controls, whether directly or indirectly, that would force companies to limit research to the relatively small number of drugs that would be most likely to show a profit.
Clinton’s prescription drug panel is not about improving care; it’s about claiming she’s made drugs affordable. The term “death panel” may seem like an exaggeration, until you are one of those who’s denied the life-saving drugs you need.