By Janet Sabol
MINOT -- For the 108,000 North Dakotans relying on Medicare -- both adults with disabilities, and seniors -- the program's financial future is immensely important.
Unfortunately, the new government panel charged with putting the program's fiscal house in order could compromise care.
As part of the health care reform bill passed this year, the Independent Payment Advisory Board consists of 15 members appointed by the president and confirmed by the Senate. Starting in April 2013, their job will be to institute cost-cutting measures in Medicare any year that the program's projected annual expenses exceed a preset limit.
The board is prohibited from raising premiums, co-payments or deductibles. It also can't change eligibility requirements, ration care or restrict benefits.
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Notably, it can't cut reimbursements to hospitals in its first decade. Payments to hospitals form the largest part of Medicare's budget; but the reserves for Medicare Part A -- which covers inpatient hospital stays -- will be depleted in just seven years.
Most experts agree that decisive action is needed to protect Medicare's future. The program is projected to run a $38 trillion shortfall over the next 75 years.
The question is whether the Independent Payment Advisory Board is the right answer.
The board's recommendations automatically become law unless Congress either passes an alternative bill with the same amount of Medicare savings or completely overturns the recommendations through a three-fifths supermajority vote. Both of these options will be very difficult politically.
So, the board's power to cut Medicare services and treatment coverage largely will be unchecked. Seniors and Medicare beneficiaries need to understand this new law and how it potentially will affect them.
In 2020, the board will be able to institute across-the-board reimbursement cuts for physicians and hospitals that serve Medicare patients. Equally devastating is that the board will be able to make decisions that could result in the loss of access to certain treatments or drugs.
This could be devastating for those on Medicare who rely on this program for vital services, seniors and adults with disabilities including mental illness.
When I served as president of the National Alliance on Mental Illness -- North Dakota organization (NAMI ND), I saw firsthand the vital role Medicare plays in the treatment of mental illness. Depression also is a big problem in the senior community, affecting more than 6.5 million Americans over age 65.
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Reducing Medicare coverage for vital mental health programs and driving out caregivers unwilling to take much reduced Medicare payments can only worsen the treatment options for people with mental illness.
It's time for North Dakota Sen. Kent Conrad, Sen.-elect John Hoeven and Rep.-elect Rick Berg to come out strongly against the powers of the Independent Payment Advisory Board and reform this part of the health care law.
The board has a laudable goal: controlling Medicare spending. But it needs to be reformed so that it can make effective cuts without compromising the care of North Dakota's Medicare beneficiaries.
Sabol is past president of the National Alliance on Mental Illness -- North Dakota.
