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The law that created the agency is the most reliable source. -- Dauster ( talk) 09:40, 16 September 2010 (UTC)
I don't like this section. I think comments and continuing developments on IPAB should be placed in context instead of grouped together at the bottom of the page. I also do not like the idea of a "reception" section as it almost seems like an invitation to debate. Intermittentgardener ( talk) 12:52, 19 December 2010 (UTC)
The legislation that created the board calls it the Independent Medicare Advisory Board and not the Independent Payments Advisory Board. The bill does refer in places to "Independent Payment Advisory Board" but makes it clear that the proper name is INDEPENDENT MEDICARE ADVISORY BOARD. There are 18 instances of the term "Independent Medicare Advisory Board" and the other only 3 instances in relation to a correction.
See the consolidated bill which says
INDEPENDENT MEDICARE ADVISORY BOARD SEC. 1899A ø42 U.S.C. 1395kkk¿. (a) ESTABLISHMENT.
There is established an independent board to be known as the ‘Independent Medicare Advisory Board’ (øNote: Referred to as the ‘‘Independent Payment Advisory Board’’¿.
::I think the agency has gone through 3-4 name changes. But the present IPAB is correct.
Angel's flight (
talk)
21:01, 11 January 2011 (UTC)
Since the article name was changed to Independent Payment Advisory Board, can we change the name of this talk page to Talk:Independent Payment Advisory Board too? The redirect is a bit of a kludge. -- 208.81.184.4 ( talk) 18:56, 25 January 2011 (UTC)
I was very disappointed by what happened on this article today. Properly referenced, NPOV, and encyclopedic material was deleted in about the rudest manner possible. If this behavior continues I will involve administrators. Intermittentgardener ( talk) 19:38, 25 January 2011 (UTC)
So in summary I am going to revert your reversions of my edits but add back the section on legal challenges.
If you wish to challenge my edits please do so. But please give detailed explanations of the basis of your challenges. Simple reverts without explanation are NOT acceptable. Hauskalainen ( talk) 03:29, 26 January 2011 (UTC)
:::::Hauskalainen, you are editing tendentiously on this and related articles. You should stop. Your conduct has already come up once before at ANI, and at the rate you are going, it is likely to happen again.
Angel's flight (
talk)
03:03, 3 February 2011 (UTC)
:::::::Your editing is tendentious because you ignore the justifications that others make. Your basic argument, repeated ad infinitum, is that you disagree with what the cited sources say, so therefore you must delete the references. That's not how Wikipedia works. You could be the most competent health care analyst in the world, but under Wikipedia policy, we must still include viewpoints that you disagree with, provided that they are published in reliable sources, which they are.
Angel's flight (
talk)
04:09, 3 February 2011 (UTC)
How can I verify the DOJ source "Department of Justice. Coons v. Geithner, Response to Plaintiffs’ Motion for Preliminary Injunction. Filed December 10, 2010."? Thanks. Jesanj ( talk) 23:33, 3 February 2011 (UTC)
This looked lopsided because it doesn't appear the DOJ says anything about the constitutionality. Jesanj ( talk) 23:34, 3 February 2011 (UTC)
Why are we citing legal issues from WP:PRIMARY sources such as goldwater's website and the DOJ? This is a task for WP:SECONDARY sources, in my opinion. Jesanj ( talk) 02:24, 4 February 2011 (UTC)
This edit summary, states "removed misleading text. There are NO serious efforts to have the IPAB proposals repealed. It has widespread support". This edit summary is contradicted by published material, which states
“ | Drug companies fear the board may consider reducing subsidies to Medicare prescription drug plans. They also want stronger congressional oversight of the board. The CEO of drugmaker Sanofi-aventis, Chris Viehbacher, told Kaiser Health News he wants the provision repealed or amended ... “There needs to be transparency and oversight. [The board] has to be accountable. ... Their evaluation is going to be flawed, because a major chunk of costs aren’t included, like ... hospitals, and there needs to be a process of oversight,” said Viehbacher, chairman of PhRMA’s board of directors. ... “The AMA will work to stop the IPAB from causing this type of double-jeopardy situation for physicians and compromising access to care for seniors and baby boomers.” ... The providers’ messages resonate with many congressional Republicans who have attacked the board for its expansion of government power over the health care system. ... Georgia Rep. Phil Gingrey, a physician and co-chairman of the 18-member Republican Doctors Caucus, said in searching for cuts, the board will have no choice but to target “payments to providers. We just absolutely must repeal that provision.” Many House Democrats share that view. Last January, 72 Democrats joined their Republican colleagues in sending a letter to then-Speaker Nancy Pelosi (D-Calif.), opposing the board. In September, 14 Democrats, three of whom were reelected, voted to repeal the board." | ” |
Though yes, the article states "Those who want to kill or weaken the board face significant hurdles." Please stop the POV & battleground editing. Jesanj ( talk) 14:40, 4 February 2011 (UTC)
I removed the following text from the article again:
Some opponents of IPAB argue that it amounts to unconstitutional "entrenchment." Specifically, Jeff Flake, Trent Franks, and John Shadegg, Members of the United States House of Representatives argued that allowing IPAB proposals to become law without congressional or presidential approval and the requirement that IPAB cannot be repealed until 2017, and then only under stringent rules, unconstitutionally restrict the freedom of future congresses to pass legislation in violation of the First Amendment, the Separation of Powers, and the Article I powers of Congress. [2] [3]
A motion drafted by the conservative Goldwater Institute has requested that District Court Judge Murray Snow issue an injunction against provisions of the healthcare reform law that restrict repeal of IPAB. [4] In its brief defending the law, the United States Department of Justice says: "the challenged provision does no such thing. Rather, it creates a parliamentary procedure whereby Congress may use an expedited process to consider legislation that would discontinue the Independent Payment Advisory Board . . . . Plaintiffs’ claim that the provision somehow blocks repeal is simply incorrect. As with all statutes, plaintiffs remain free to introduce or vote on legislation to repeal the statutory provision that creates the Board." [5]
Motherjones
was invoked but never defined (see the
help page).I have raised some issues above but they were not discussed any before the material was reinserted into the article. Please discuss. Thanks. Jesanj ( talk) 17:47, 4 February 2011 (UTC)
Here is one source that seems to be reliable enough. http://thehill.com/blogs/healthwatch/health-reform-implementation/114165-ariz-congressmen-join-health-reform-lawsuit- Intermittentgardener ( talk) 02:24, 5 February 2011 (UTC)
::::::U.S. Reps. Jeff Flake, Trent Franks and John Shadegg are part of the suit, which argues the Republicans won't have the right to repeal the health care bill. The plan aims to contain costs through the powerful Independent Payment Advisory Board that lacks meaningful oversight by Congress or courts, Bolick said. Congress can repeal the law only during a brief time in 2017, Bolick said, which violates the separation of powers doctrine.
Once again, you are confused about how things work here. We do not pass judgement on what is reported in the media. Our job is to faithfully recount what has been reported by secondary sources. How we feel about the IPAB has nothing to do with what we include in the article. You cannot delete things just because you do not like them. Intermittentgardener ( talk) 17:22, 7 February 2011 (UTC)
Pursuant to recent thread at the administrator's noticeboard, here, this article has been protected for 24 hours. Contributors are reminded, please, to work constructively towards consensus on the talk page, utilizing dispute resolution, including reaching out to the wider community for further opinions if necessary. Constructive consensus building involves civil communication about the development of articles and taking reasonable time to allow feedback from others. Content disputes should not be worked out by repeated reversions, but by communication here. -- Moonriddengirl (talk) 23:33, 4 February 2011 (UTC)
Yesterday I had to warn Intermittentgardener about blatant POV pushing here. I was asked to cross post that warning here also and have thus done so. Hauskalainen ( talk) 11:41, 5 February 2011 (UTC)
I see that Intermittentgardener has been up to his old tricks again. Look, there is no justification for mixing up OPINIONS which everyone has about things with the LEGISLATIVE PROCESS which is a very different thing. It is far better to have OPINIONS in a clearly defined section. It is clear that some people pushing a POV clearly wants that there should be a section named "rationing" because that would draw the reader towards an argument that IPAB is a rationing body. But it is not. The rationing argument is (a) a fringe theory and (b) rationing is not even the right word for what it will do. As far as I know, IPAB will not be issuing coupons telling who can get health care and who cannot. It will just set the price for something that the government buys for the people it insures. If the government decides that today it will pay 10 cents less per pound for the lemons it buys for use in government canteens, nobody in their right mind would claim that the "government is now rationing lemons". Its complete nonsense. And what's more, I think he knows it. Hauskalainen ( talk) 17:35, 7 February 2011 (UTC)
That sounds like a fair characterization based on my reading of the source. It seems that I was sloppy about putting this material together. I am re-reading the sources and putting the sections that have been removed back together in a more faithful manner. Intermittentgardener ( talk) 04:42, 8 February 2011 (UTC)
There is a lot of conflict at this article. It would be great if we could get more editors involved to build consensus. Intermittentgardener ( talk) 18:25, 7 February 2011 (UTC)
Pinch me if I'm dreaming, but Phil Roe wrote an op-ed attempting to associate the IPAB with the "death panel" term. It appears this story Health-related money continues to flow to members of Congress by R. Jefferey Smith, February 6, 2011, mentions him, $ and the IPAB. Jesanj ( talk) 03:15, 8 February 2011 (UTC)
I didn't see this material in the source. Where is it? Jesanj ( talk) 21:48, 15 February 2011 (UTC)
Political debate is not what Wikipedia is for. Nor are the opinions of individual politicians particularly informative unless they reflect the policies of the party they represent. I have grave reservations about this section meeting WP standards for inclusion of material and its POV. For example the section on the opinion of politicians on the bi-partisan political group on the budget voted overwhelmingly in favour of strenghtening IPAB but this political opinion has been removed from this section.
According to Wikipedia's rules, we have to reflect the main stream opinions of EXPERTS. IPAB is a body that determines the reward structure for medical services provided to the elderly and to the disabled. What we need are the opinions of experts in this field. That I guess means medical econonomists, people already working for Medicare, doctors involved in Geriatric medicine and the needs of the classes of disabled persons in receipt of Medicare, cost accontants working for hospital groups etc. The opinions of politicians (who lets face it, have received hundreds of millions of dollars if not billions from the medical industry and who are constantly lobbied) are NOT independent observers in this field. I do not think that politicans (especially ex politicians such Palin and Gingrich) count for very much. Hauskalainen ( talk) 07:14, 16 February 2011 (UTC)
This is why I think the section should be called opinion and not political debate. It should only contain the opinions of experts. Wikipedia is not a forum for airing political debate. We should concentrate on the opinions of experts supported by factual data. Yet again the user User:Intermittentgardener is using Wikipedia for purposes of propogating a political view of IPAB that is held by a minority of people and not reflecting the wide support that IPAB has from real experts, or moving those opinions to another section so that it seems that opinions are more strongly on the side of his/her preferred POV than they really are. For instance the section used to say that the law explicitly forbids rationing, but after his edits he has reduced this to "Mother Jones reported that, in reality, the rules governing IPAB explicitly bar 'any recommendation to ration health care.". If people are alarmed about the rationing of care they should take comfort in the fact that the law forbids IPAB from doing this. Reducing this fact to a statement that "someone says that the rules disallow this" gives a wholly misleading picture. The law forbids it. FULL STOP. I want User:Intermittentgardener to justify his edit that did this. Though not factually incorrect, it is misleading. Hauskalainen ( talk) 10:12, 16 February 2011 (UTC)
:::This question has come up a few dozen times now. The standard for inclusion is not whether the opinion is correct, politically, scientifically, or otherwise, but whether it has been published in reliable sources. If in the judgment of editors the opinion is dubious, then it should be properly attributed so that the reader knows where it comes from. And Hauskalainen, I must request that you refrain from asserting your own personal opinion about the correctness or incorrectness of published commentary about IPAB and related topics. It's pretty much irrelevant under Wikipedia policy.
Angel's flight (
talk)
16:49, 16 February 2011 (UTC)
::::::Seconded.
Angel's flight (
talk)
02:03, 17 February 2011 (UTC)
I don´t see problem to include what notable politicians think about the topic. Wikipedia is not from paper. -- Dezidor ( talk) 09:35, 17 February 2011 (UTC)
@Jesanj Firstly, your comment following my comment of 15:05, 18 February 2011 (UTC) shows that you cannot justify including the views of ex politicians who represent no one but themselves. WP is not a place where talking points in debates get aired. It is especially misleading if the views aired are not in the mainstream. Now you claim that it is me that is POV pushing! Why would I do that? I do not even live in the US so I am not affected by the health care system and I do not benefit by taking mone from it. Phil Roe and Pete Stark do benefit from the medical services industry. Their views are probably tainted by the money they receive. These are NOT neutral observers and experts that WP:OPINION says we should use as our sources for claims of interpretation. Secondly, you are highly selective as to which opinions go in here. Why aren't you arguing that we put back Pete Orzag's opinion (a former budget director and therefore a person with practical administrative expertise) who argued that IPAB is going to be the trans formative change needed to fix the budget crisis in years to come? I liked the Nyhan article, which says a great deal about why government needs to get involved to fix America's health care system (which is run for the benefit of special interests rather than the people, but the only snippet you want from his bit is a reference where he says the new law may (my emphasis) lead to more restrictive rationing....) when actually his substantive argument is not about IPAB or rationing. You only want the bit that says "more restrictive rationing" because it suits the talking point you want included and that is that it is about rationing (even though the law forbids rationing of any kind!). I don't know what Nyhan was referring to (and I suspect you don't either) because he does not tell us. It was not his point, but you have taken him out of context and made it seem that it was. Sure, the pieces you want in the article are published opinions but as I have said over and over, not everything that gets published makes it eligible for inclusion in Wikipedia. Most of it is unencyclopedic. Thirdly, you claim that I cannot know what the silent majority are thinking. That is of course true. But if the silent majority were all in favor of abolishing IPAB then the bill calling for that would have been passed by now. What happened to it? Sweet FA because it has NO SUPPORT. So its not a case of being able to read minds but checking on their deeds. The latter is far more reliable. There must have been republicans on that bi partisan committee that voted in favor of bringing forward in time some of IPAB's assigned tasks. Now you are saying that "i'd be fine with removing pete stark if we put uwe reinhardt back in saying why some democrats may not like the idea (less power) -- which means less reason to get $" which clearly shows again that you are editing for political purposes. The reason WP allows the opinions of experts is that they tell us something from their deep knowledge of their subject area. I agree that Reinhardt meets the criteria as a person whose opinion is worthy of including. He is a medical economist and one of the few real experts. And from what I have read he is sceptical that IPAB can do more than make a slight dent in the huge financial costs of health care in America (and as your comment shows he recognizes that even Democrat politicians have their fingers in the health care pie) though I think he regards it as a step in the right direction. We should discuss how to summarize his views and get them in the article. Hauskalainen ( talk) 07:46, 19 February 2011 (UTC)
An editor has expressed the idea that this content [9] is not worth including, and removed it. I undid the edit. [10] It was removed again by the same editor who finds it problematic. [11] Someone else restored the information. [12] It was removed again by the same editor. [13]
The first edit summary which removed this information said "remove more Palin. She is no expert and represents no one". The last edit summary which removed this information said "removed unencyclodepedic content.Palin's fame is her ignorance (Katie Curic interviews) and propensity to tell whoppers ("Lie of the year" no less). We should not repeat this nonsense even with the put down it got."
I have a few problems with the logic of removing this content:
In my mind, it seems moderately notable that Palin made this claim given the context of the concern and the fact-checking. Jesanj ( talk) 12:40, 22 February 2011 (UTC)'
" Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of or as detailed a description as more widely held views. Generally, the views of tiny minorities should not be included at all. "
"Wikipedia should not present a dispute as if a view held by a small minority deserved as much attention overall as the majority view. Views that are held by a tiny minority should not be represented except in articles devoted to those views. To give undue weight to the view of a significant minority, or to include that of a tiny minority, might be misleading as to the shape of the dispute. Wikipedia aims to present competing views in proportion to their representation in reliable sources on the subject. This applies not only to article text, but to images, wikilinks, external links, categories, and all other material as well."
I propose the following text in the political debate section:
“ | Douglas Holtz-Eakin, a former CBO director, thinks that despite "requirements that would force Congress to adopt the recommendations or find comparable savings", "cuts will be politically infeasible, as Congress is likely to continue regularly to override scheduled reductions". [1] In Holtz-Eakin's view, no IPAB "will ever succeed in saving lawmakers from their own selfpreserving instincts to pander". [2] | ” |
Jesanj ( talk) 12:40, 25 February 2011 (UTC)
The opinions of Holtz-Eakin seem to be relevant given their detailed reasoning and his past position with the CBO. Intermittentgardener ( talk) 13:13, 9 March 2011 (UTC)
References
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But this inside the-trenches view conflicts with the more general impressions of the many doubters on the prospects for curvebending, including Douglas Holtz-Eakin and Michael J. Ramlet, who rightly invoke past instances when Congress squeezed the health system and later retrenched under political pressure. From their perspective, no Independent Payment Advisory Board will ever succeed in saving lawmakers from their own selfpreserving instincts to pander.
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The AMA president raised the issues of payment cuts and reduced congressional influence. [15] We could include these points perhaps. Also, I recall Uwe Reinhardt and a letter from lawmakers making the point that congress doesn't want its power reduced. Given the low approval ratings for congress, I would think there are articles with arguments supporting congress' power to be reduced by the IPAB. The reduced influence of congress seems to be a common theme in multiple sources. Perhaps eventually a section on this is warranted. Jesanj ( talk) 14:09, 25 February 2011 (UTC)
(outdent) Yes I do stand by that statement. What we know about IPAB is the task that congress has set for it and all CBO has done is to assume what IPAB will achieve the reduction in the growth of spending. That is entirely logical and honest and fair presentation of factual information to our readers. All the other stuff you want to include is speculation because it is entirely unknowable at this stage. IPAB has not even be formed yet and so its very stupid as well as highly speculative to ponder the effect of its decisions when the decisions themselves are not yet known. Hauskalainen ( talk) 20:07, 1 March 2011 (UTC)
Hauskalainen, you are confusing the reliability of the person quoted with the reliability of the source reporting his words. You are still here filibustering the talk page and you are still engaged in a slow-motion edit war. Your behavior has really got to stop. Intermittentgardener ( talk) 21:56, 7 March 2011 (UTC)
As I understand it, the dispute about this article concerns including or not including information published in reliable sources that isn't "official" information, but rather consists of opinions an speculation by individuals who are notable, but possibly politically motivated. Correct?
I'll offer my view as a third opinion:
Like it or not, opinions can and do have a place in Wikipedia articles, if the opinions originate from someone with knowledge resulting from analysis or study. A reasoned argument from, say, an economics professor or insurance industry analyst is worth including.
Politically-motivated or ignorant opinions, even if they originate from notable people, may be worth including if actual reasoning can be found for them. The term "death panels" seems merely like name-calling to make a political/rhetorical point with no real argument behind it. I suppose such opinions could simply be summarized, with a few selected quotations, but one runs the risk of such a paragraph growing without bound as every editor with an agenda inserts a quote from their favorite critic. You'd need to establish an agreement on what constitutes a critic suitable for inclusion in the article.
See also Wikipedia:Mediation Cabal (less formal) or Wikipedia:Mediation Committee (more formal) for help in resolving your dispute. ~ Amatulić ( talk) 23:49, 28 February 2011 (UTC)
Blanking out whole sections is rarely an appropriate way to handle concerns about content. If you see a problem you should re-write the content or flag it so that someone else can fix it. Intermittentgardener ( talk) 17:34, 14 March 2011 (UTC)
The amount of text devoted to Death Panels section is entirely reasonable. This section is concise, contains all the relevant facts, and is even-handed. I just do not see any problem. I suspect that you just disagree with the the whole death panel smear and thus do not want it hear. Unfortunately, that is not how Wikipedia works. Our job is to faithfully recount what is in the sources. Intermittentgardener ( talk) 11:45, 5 April 2011 (UTC)
I noticed that you removed the Death panels sub-section without making a note here and without mentioning anything in the edit summary. What was the point of flagging it if you were planning on doing that? I have re-added it along with the tag that you added. I suggest you read the tag in its entirety. I am beginning to suspect bad faith on your part. If you keep doing stuff like that my suspicions will be confirmed. I hope you prove me wrong. Intermittentgardener ( talk) 11:51, 5 April 2011 (UTC)
What is it about the headline "Death panel controversy" that misleads? Would putting Death panel in quotes make you feel better about it? The fact is that there is a controversy involving death panels and IPAB. I would also point out that I am not doing anything unilateral here. The current text was the product of at least three different editors.
As for those section headings, they are completely non-POV. "Claims of rationing" is a fair title. It does not pass judgement and makes it clear that the allegations about rationing are just that, merely claims. The same goes for "Constitutionality." Many people claim that IPAB is unconstitutional. Also, the title does not pass judgement. An example of a POV title might be "Unconstitutionality." "Constitutionality" is merely an accurate description of the topic. Finally, I found titles that are also Non-POV in response to concerns from other editors. All the content I have added has been reflective of the accounts in reliable sources.
You need to consider your own actions. Are you trying to keep this out because you think it detracts from the value of the article or because you simply wish to cover up controversy?
That said, stop section blanking. And please start being cooperative. I keep answering objections and making reasonable changes. You keep deleting and that is not appropriate. Intermittentgardener ( talk) 11:07, 9 April 2011 (UTC)
In my opinion, this article is too dedicated to collecting the opinions of those who oppose this entity while it excludes the opinions of those who support or have spoken positively towards the board. A Mother Jones article currently used as a source gives some detail on support from Congress and Uwe Reinhardt has spoken of the board's opportunity. Until we can get some more coverage of support, I think a neutrality tag is warranted. Jesanj ( talk) 03:39, 24 March 2011 (UTC)
Ok, you folks have been reverting this back and forth for a month. Knock it off. I've protected the article for a month. If you can agree on mutually-acceptable wording before that, all the better.-- SarekOfVulcan ( talk) 15:04, 11 April 2011 (UTC)
I am 71, a CPA, conservative, Tea Party member, lever pulling Republican and former CFO of a major teaching hospital. First in my opinion (first formed 40 years ago) Medical technology has surpassed society's ability to provide the current state of art technology to everyone. Therefore: we must have "death panels", or whatever you want to call them.
One time I had to choose to expand the neonatal intensive care beds, or establish regional walk-in clinics. We did not have money in the budget for both. I chose the clinics and therefore acted as a one man “death panel” for the babies that died because there was not an intensive care bed available for them.
My question: How is this INDEPENDENT ADVISORY BOARD going to “develop a proposal to reduce per capita Medicare spending without” including “any recommendation to ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria”.
Answer: reduce payments to medical providers and/or recommend that we “ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria”? Texbum —Preceding unsigned comment added by 75.140.243.180 ( talk) 22:44, 20 April 2011 (UTC)
I removed some material and it was restored. [23] My rationale for removal was because the cited source does not appear to maintain text-source integrity and the other content looks off-topic. I'm unsure where the source says that 1) the IPAB was discussed during the 31 meetings 2) that the board was informally called "MedPAC on steroids". And wouldn't the second sentence be better off at the article on the Affordable Care Act? Jesanj ( talk) 00:41, 20 June 2011 (UTC)
There is obviously room for improvement in the CBO scoring section. This was on NYT "The bill would yield less in the way of savings as a result of a new commission to recommend changes in Medicare spending. The commission, called the Independent Payment Advisory Board, is now expected to save $13.3 billion over 10 years, rather than the $28 billion in the Senate-passed bill." [24] And on May 13, 2011 the CBO estimated repealing the IPAB would cost 2.4 billion from 2018 to 2021. [25] [26] Jesanj ( talk) 23:05, 7 July 2011 (UTC)
Original: The Independent Payment Advisory Board, or IPAB, is a fifteen-member, unelected United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which has the explicit task of reducing the rate of growth in Medicare without affecting coverage or quality.[1] Under previous law, changes to Medicare reimbursement rates were recommended by MedPAC but required an act of congress to take effect, but the new system devolves responsibility to IPAB with the Congress being given the power to overrule the agency's decisions.
The Board is required to implement its first proposals in 2015 with its first report being produced by July 2014. The Chief Actuary of the Centers for Medicare and Medicaid Services will determine in particular years the projected per capita growth rate for Medicare for the second year thereafter. If the projection exceeds a target growth rate, IPAB must develop a proposal to reduce per capita Medicare spending.
Discussion of changes I will implement and those I think are needed:
I intend to delete "unelected" in the first sentence because it is superfluous and nonneutral. The only elected positions in the US Federal Government are the President, Vice President, and members of Congress. So, with the exception of the White House and Congress, every federal agency is run by unelected officials. Elected officials do have substantial responsibility for selecting the members of the board. They are to be nominated by the President based on recommendations from the four corners of Congressional leadership, and they must be confirmed by the Senate.
I intend to change "reimbursement" to "payment" because the former term is not neutral.
I intend to change "which has the explicit task of reducing the rate of growth in Medicare" to "which has the explicit task of achieving specified savings in Medicare." The former statement is a very common misunderstanding, which stems, I believe, from conflating the measures used to trigger action by the IPAB with the effect of any such action.[ | see the CBO memo linked at the bottom of this article] The circumstances that will trigger action are based on the difference between two rate-of-growth measures--the five year moving average in the rate of growth in:
The five-year moving averages will be calculated by the Chief Actuary of CMS using projected spending and economic measures for the year that is two years in the future compared to the actual spending and economic measures from the year that is three years in the past. (I will refer to the year that is two years in the future as the "implementation year" because that is the year in which the IPAB might be obligated to achieve savings.)
The requirement for the Board to act will be triggered if the spending measure exceeds the economic measure. The requirement, if triggered, is for the Board to achieve projected savings in the implementation year (as estimated by the Chief Actuary) that equal the difference between the spending and economic measures (in percentage points) applied to the Chief Actuary's projection of spending in the implementation year. A percentage applied to a dollar amount results in a savings target measured in dollars (that is, in terms of levels) and not in terms of growth rates. Moreover, the Board is under no obligation to reduce levels of spending in subsequent years. Thus, it is conceivable that actions by the Board affecting any given implementation year could have no effect on the level of spending (and thus no effect on rates of growth) in subsequent years.
If the requirement for the Board to act is triggered, it must submit its recommendations in January of the year before the implementation year. The first potential implementation year is 2015, so the first potential deadline for the Board to submit its recommendations is January, 2014.
The Board will not implement its recommendations; the Secretary of HHS will be required to do so.
More wordsmithing needed: The Board consists of 15 members; the agency will have a staff (the law authorizes the Board to employ staff and to use staff detailed from [that is, paid by] other federal agencies). Thus, "fifteen members" is accurate when referring to composition of the Board, but is not accurate when referring to the size of the agency.
MedPAC continues to exist and its role in advising Congress on Medicare policy was not changed by the legislation that created the IPAB. So the whole tone of the discussion of the relationship of the IPAB mechanism to MedPAC is off. Pl0rtn1pZ ( talk) 02:58, 22 January 2012 (UTC)
I added content saying that the "death panels" charge has been debunked, and cited two fact checkers. My changes were reverted with the comment: "numerous commentators have made the "death panel" charge, not just Palin." Why this is relevant is beyond my comprehension. Could someone please explain what was wrong with my addition? -- Dr. Fleischman ( talk) 22:42, 7 August 2013 (UTC)
"Resource 17" has a dead link. I checked it out and think it should be replaced with http://www.nrlc.org/News_and_Views/Oct10/nv100110part2.html . Can I get confirmation for this?
The original, non-working link is: http://www.nrlc.org/news_and_views/Oct10/nv100110part2.html . — Preceding unsigned comment added by Lightvd ( talk • contribs) 20:29, 9 August 2013 (UTC)
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The law that created the agency is the most reliable source. -- Dauster ( talk) 09:40, 16 September 2010 (UTC)
I don't like this section. I think comments and continuing developments on IPAB should be placed in context instead of grouped together at the bottom of the page. I also do not like the idea of a "reception" section as it almost seems like an invitation to debate. Intermittentgardener ( talk) 12:52, 19 December 2010 (UTC)
The legislation that created the board calls it the Independent Medicare Advisory Board and not the Independent Payments Advisory Board. The bill does refer in places to "Independent Payment Advisory Board" but makes it clear that the proper name is INDEPENDENT MEDICARE ADVISORY BOARD. There are 18 instances of the term "Independent Medicare Advisory Board" and the other only 3 instances in relation to a correction.
See the consolidated bill which says
INDEPENDENT MEDICARE ADVISORY BOARD SEC. 1899A ø42 U.S.C. 1395kkk¿. (a) ESTABLISHMENT.
There is established an independent board to be known as the ‘Independent Medicare Advisory Board’ (øNote: Referred to as the ‘‘Independent Payment Advisory Board’’¿.
::I think the agency has gone through 3-4 name changes. But the present IPAB is correct.
Angel's flight (
talk)
21:01, 11 January 2011 (UTC)
Since the article name was changed to Independent Payment Advisory Board, can we change the name of this talk page to Talk:Independent Payment Advisory Board too? The redirect is a bit of a kludge. -- 208.81.184.4 ( talk) 18:56, 25 January 2011 (UTC)
I was very disappointed by what happened on this article today. Properly referenced, NPOV, and encyclopedic material was deleted in about the rudest manner possible. If this behavior continues I will involve administrators. Intermittentgardener ( talk) 19:38, 25 January 2011 (UTC)
So in summary I am going to revert your reversions of my edits but add back the section on legal challenges.
If you wish to challenge my edits please do so. But please give detailed explanations of the basis of your challenges. Simple reverts without explanation are NOT acceptable. Hauskalainen ( talk) 03:29, 26 January 2011 (UTC)
:::::Hauskalainen, you are editing tendentiously on this and related articles. You should stop. Your conduct has already come up once before at ANI, and at the rate you are going, it is likely to happen again.
Angel's flight (
talk)
03:03, 3 February 2011 (UTC)
:::::::Your editing is tendentious because you ignore the justifications that others make. Your basic argument, repeated ad infinitum, is that you disagree with what the cited sources say, so therefore you must delete the references. That's not how Wikipedia works. You could be the most competent health care analyst in the world, but under Wikipedia policy, we must still include viewpoints that you disagree with, provided that they are published in reliable sources, which they are.
Angel's flight (
talk)
04:09, 3 February 2011 (UTC)
How can I verify the DOJ source "Department of Justice. Coons v. Geithner, Response to Plaintiffs’ Motion for Preliminary Injunction. Filed December 10, 2010."? Thanks. Jesanj ( talk) 23:33, 3 February 2011 (UTC)
This looked lopsided because it doesn't appear the DOJ says anything about the constitutionality. Jesanj ( talk) 23:34, 3 February 2011 (UTC)
Why are we citing legal issues from WP:PRIMARY sources such as goldwater's website and the DOJ? This is a task for WP:SECONDARY sources, in my opinion. Jesanj ( talk) 02:24, 4 February 2011 (UTC)
This edit summary, states "removed misleading text. There are NO serious efforts to have the IPAB proposals repealed. It has widespread support". This edit summary is contradicted by published material, which states
“ | Drug companies fear the board may consider reducing subsidies to Medicare prescription drug plans. They also want stronger congressional oversight of the board. The CEO of drugmaker Sanofi-aventis, Chris Viehbacher, told Kaiser Health News he wants the provision repealed or amended ... “There needs to be transparency and oversight. [The board] has to be accountable. ... Their evaluation is going to be flawed, because a major chunk of costs aren’t included, like ... hospitals, and there needs to be a process of oversight,” said Viehbacher, chairman of PhRMA’s board of directors. ... “The AMA will work to stop the IPAB from causing this type of double-jeopardy situation for physicians and compromising access to care for seniors and baby boomers.” ... The providers’ messages resonate with many congressional Republicans who have attacked the board for its expansion of government power over the health care system. ... Georgia Rep. Phil Gingrey, a physician and co-chairman of the 18-member Republican Doctors Caucus, said in searching for cuts, the board will have no choice but to target “payments to providers. We just absolutely must repeal that provision.” Many House Democrats share that view. Last January, 72 Democrats joined their Republican colleagues in sending a letter to then-Speaker Nancy Pelosi (D-Calif.), opposing the board. In September, 14 Democrats, three of whom were reelected, voted to repeal the board." | ” |
Though yes, the article states "Those who want to kill or weaken the board face significant hurdles." Please stop the POV & battleground editing. Jesanj ( talk) 14:40, 4 February 2011 (UTC)
I removed the following text from the article again:
Some opponents of IPAB argue that it amounts to unconstitutional "entrenchment." Specifically, Jeff Flake, Trent Franks, and John Shadegg, Members of the United States House of Representatives argued that allowing IPAB proposals to become law without congressional or presidential approval and the requirement that IPAB cannot be repealed until 2017, and then only under stringent rules, unconstitutionally restrict the freedom of future congresses to pass legislation in violation of the First Amendment, the Separation of Powers, and the Article I powers of Congress. [2] [3]
A motion drafted by the conservative Goldwater Institute has requested that District Court Judge Murray Snow issue an injunction against provisions of the healthcare reform law that restrict repeal of IPAB. [4] In its brief defending the law, the United States Department of Justice says: "the challenged provision does no such thing. Rather, it creates a parliamentary procedure whereby Congress may use an expedited process to consider legislation that would discontinue the Independent Payment Advisory Board . . . . Plaintiffs’ claim that the provision somehow blocks repeal is simply incorrect. As with all statutes, plaintiffs remain free to introduce or vote on legislation to repeal the statutory provision that creates the Board." [5]
Motherjones
was invoked but never defined (see the
help page).I have raised some issues above but they were not discussed any before the material was reinserted into the article. Please discuss. Thanks. Jesanj ( talk) 17:47, 4 February 2011 (UTC)
Here is one source that seems to be reliable enough. http://thehill.com/blogs/healthwatch/health-reform-implementation/114165-ariz-congressmen-join-health-reform-lawsuit- Intermittentgardener ( talk) 02:24, 5 February 2011 (UTC)
::::::U.S. Reps. Jeff Flake, Trent Franks and John Shadegg are part of the suit, which argues the Republicans won't have the right to repeal the health care bill. The plan aims to contain costs through the powerful Independent Payment Advisory Board that lacks meaningful oversight by Congress or courts, Bolick said. Congress can repeal the law only during a brief time in 2017, Bolick said, which violates the separation of powers doctrine.
Once again, you are confused about how things work here. We do not pass judgement on what is reported in the media. Our job is to faithfully recount what has been reported by secondary sources. How we feel about the IPAB has nothing to do with what we include in the article. You cannot delete things just because you do not like them. Intermittentgardener ( talk) 17:22, 7 February 2011 (UTC)
Pursuant to recent thread at the administrator's noticeboard, here, this article has been protected for 24 hours. Contributors are reminded, please, to work constructively towards consensus on the talk page, utilizing dispute resolution, including reaching out to the wider community for further opinions if necessary. Constructive consensus building involves civil communication about the development of articles and taking reasonable time to allow feedback from others. Content disputes should not be worked out by repeated reversions, but by communication here. -- Moonriddengirl (talk) 23:33, 4 February 2011 (UTC)
Yesterday I had to warn Intermittentgardener about blatant POV pushing here. I was asked to cross post that warning here also and have thus done so. Hauskalainen ( talk) 11:41, 5 February 2011 (UTC)
I see that Intermittentgardener has been up to his old tricks again. Look, there is no justification for mixing up OPINIONS which everyone has about things with the LEGISLATIVE PROCESS which is a very different thing. It is far better to have OPINIONS in a clearly defined section. It is clear that some people pushing a POV clearly wants that there should be a section named "rationing" because that would draw the reader towards an argument that IPAB is a rationing body. But it is not. The rationing argument is (a) a fringe theory and (b) rationing is not even the right word for what it will do. As far as I know, IPAB will not be issuing coupons telling who can get health care and who cannot. It will just set the price for something that the government buys for the people it insures. If the government decides that today it will pay 10 cents less per pound for the lemons it buys for use in government canteens, nobody in their right mind would claim that the "government is now rationing lemons". Its complete nonsense. And what's more, I think he knows it. Hauskalainen ( talk) 17:35, 7 February 2011 (UTC)
That sounds like a fair characterization based on my reading of the source. It seems that I was sloppy about putting this material together. I am re-reading the sources and putting the sections that have been removed back together in a more faithful manner. Intermittentgardener ( talk) 04:42, 8 February 2011 (UTC)
There is a lot of conflict at this article. It would be great if we could get more editors involved to build consensus. Intermittentgardener ( talk) 18:25, 7 February 2011 (UTC)
Pinch me if I'm dreaming, but Phil Roe wrote an op-ed attempting to associate the IPAB with the "death panel" term. It appears this story Health-related money continues to flow to members of Congress by R. Jefferey Smith, February 6, 2011, mentions him, $ and the IPAB. Jesanj ( talk) 03:15, 8 February 2011 (UTC)
I didn't see this material in the source. Where is it? Jesanj ( talk) 21:48, 15 February 2011 (UTC)
Political debate is not what Wikipedia is for. Nor are the opinions of individual politicians particularly informative unless they reflect the policies of the party they represent. I have grave reservations about this section meeting WP standards for inclusion of material and its POV. For example the section on the opinion of politicians on the bi-partisan political group on the budget voted overwhelmingly in favour of strenghtening IPAB but this political opinion has been removed from this section.
According to Wikipedia's rules, we have to reflect the main stream opinions of EXPERTS. IPAB is a body that determines the reward structure for medical services provided to the elderly and to the disabled. What we need are the opinions of experts in this field. That I guess means medical econonomists, people already working for Medicare, doctors involved in Geriatric medicine and the needs of the classes of disabled persons in receipt of Medicare, cost accontants working for hospital groups etc. The opinions of politicians (who lets face it, have received hundreds of millions of dollars if not billions from the medical industry and who are constantly lobbied) are NOT independent observers in this field. I do not think that politicans (especially ex politicians such Palin and Gingrich) count for very much. Hauskalainen ( talk) 07:14, 16 February 2011 (UTC)
This is why I think the section should be called opinion and not political debate. It should only contain the opinions of experts. Wikipedia is not a forum for airing political debate. We should concentrate on the opinions of experts supported by factual data. Yet again the user User:Intermittentgardener is using Wikipedia for purposes of propogating a political view of IPAB that is held by a minority of people and not reflecting the wide support that IPAB has from real experts, or moving those opinions to another section so that it seems that opinions are more strongly on the side of his/her preferred POV than they really are. For instance the section used to say that the law explicitly forbids rationing, but after his edits he has reduced this to "Mother Jones reported that, in reality, the rules governing IPAB explicitly bar 'any recommendation to ration health care.". If people are alarmed about the rationing of care they should take comfort in the fact that the law forbids IPAB from doing this. Reducing this fact to a statement that "someone says that the rules disallow this" gives a wholly misleading picture. The law forbids it. FULL STOP. I want User:Intermittentgardener to justify his edit that did this. Though not factually incorrect, it is misleading. Hauskalainen ( talk) 10:12, 16 February 2011 (UTC)
:::This question has come up a few dozen times now. The standard for inclusion is not whether the opinion is correct, politically, scientifically, or otherwise, but whether it has been published in reliable sources. If in the judgment of editors the opinion is dubious, then it should be properly attributed so that the reader knows where it comes from. And Hauskalainen, I must request that you refrain from asserting your own personal opinion about the correctness or incorrectness of published commentary about IPAB and related topics. It's pretty much irrelevant under Wikipedia policy.
Angel's flight (
talk)
16:49, 16 February 2011 (UTC)
::::::Seconded.
Angel's flight (
talk)
02:03, 17 February 2011 (UTC)
I don´t see problem to include what notable politicians think about the topic. Wikipedia is not from paper. -- Dezidor ( talk) 09:35, 17 February 2011 (UTC)
@Jesanj Firstly, your comment following my comment of 15:05, 18 February 2011 (UTC) shows that you cannot justify including the views of ex politicians who represent no one but themselves. WP is not a place where talking points in debates get aired. It is especially misleading if the views aired are not in the mainstream. Now you claim that it is me that is POV pushing! Why would I do that? I do not even live in the US so I am not affected by the health care system and I do not benefit by taking mone from it. Phil Roe and Pete Stark do benefit from the medical services industry. Their views are probably tainted by the money they receive. These are NOT neutral observers and experts that WP:OPINION says we should use as our sources for claims of interpretation. Secondly, you are highly selective as to which opinions go in here. Why aren't you arguing that we put back Pete Orzag's opinion (a former budget director and therefore a person with practical administrative expertise) who argued that IPAB is going to be the trans formative change needed to fix the budget crisis in years to come? I liked the Nyhan article, which says a great deal about why government needs to get involved to fix America's health care system (which is run for the benefit of special interests rather than the people, but the only snippet you want from his bit is a reference where he says the new law may (my emphasis) lead to more restrictive rationing....) when actually his substantive argument is not about IPAB or rationing. You only want the bit that says "more restrictive rationing" because it suits the talking point you want included and that is that it is about rationing (even though the law forbids rationing of any kind!). I don't know what Nyhan was referring to (and I suspect you don't either) because he does not tell us. It was not his point, but you have taken him out of context and made it seem that it was. Sure, the pieces you want in the article are published opinions but as I have said over and over, not everything that gets published makes it eligible for inclusion in Wikipedia. Most of it is unencyclopedic. Thirdly, you claim that I cannot know what the silent majority are thinking. That is of course true. But if the silent majority were all in favor of abolishing IPAB then the bill calling for that would have been passed by now. What happened to it? Sweet FA because it has NO SUPPORT. So its not a case of being able to read minds but checking on their deeds. The latter is far more reliable. There must have been republicans on that bi partisan committee that voted in favor of bringing forward in time some of IPAB's assigned tasks. Now you are saying that "i'd be fine with removing pete stark if we put uwe reinhardt back in saying why some democrats may not like the idea (less power) -- which means less reason to get $" which clearly shows again that you are editing for political purposes. The reason WP allows the opinions of experts is that they tell us something from their deep knowledge of their subject area. I agree that Reinhardt meets the criteria as a person whose opinion is worthy of including. He is a medical economist and one of the few real experts. And from what I have read he is sceptical that IPAB can do more than make a slight dent in the huge financial costs of health care in America (and as your comment shows he recognizes that even Democrat politicians have their fingers in the health care pie) though I think he regards it as a step in the right direction. We should discuss how to summarize his views and get them in the article. Hauskalainen ( talk) 07:46, 19 February 2011 (UTC)
An editor has expressed the idea that this content [9] is not worth including, and removed it. I undid the edit. [10] It was removed again by the same editor who finds it problematic. [11] Someone else restored the information. [12] It was removed again by the same editor. [13]
The first edit summary which removed this information said "remove more Palin. She is no expert and represents no one". The last edit summary which removed this information said "removed unencyclodepedic content.Palin's fame is her ignorance (Katie Curic interviews) and propensity to tell whoppers ("Lie of the year" no less). We should not repeat this nonsense even with the put down it got."
I have a few problems with the logic of removing this content:
In my mind, it seems moderately notable that Palin made this claim given the context of the concern and the fact-checking. Jesanj ( talk) 12:40, 22 February 2011 (UTC)'
" Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of or as detailed a description as more widely held views. Generally, the views of tiny minorities should not be included at all. "
"Wikipedia should not present a dispute as if a view held by a small minority deserved as much attention overall as the majority view. Views that are held by a tiny minority should not be represented except in articles devoted to those views. To give undue weight to the view of a significant minority, or to include that of a tiny minority, might be misleading as to the shape of the dispute. Wikipedia aims to present competing views in proportion to their representation in reliable sources on the subject. This applies not only to article text, but to images, wikilinks, external links, categories, and all other material as well."
I propose the following text in the political debate section:
“ | Douglas Holtz-Eakin, a former CBO director, thinks that despite "requirements that would force Congress to adopt the recommendations or find comparable savings", "cuts will be politically infeasible, as Congress is likely to continue regularly to override scheduled reductions". [1] In Holtz-Eakin's view, no IPAB "will ever succeed in saving lawmakers from their own selfpreserving instincts to pander". [2] | ” |
Jesanj ( talk) 12:40, 25 February 2011 (UTC)
The opinions of Holtz-Eakin seem to be relevant given their detailed reasoning and his past position with the CBO. Intermittentgardener ( talk) 13:13, 9 March 2011 (UTC)
References
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But this inside the-trenches view conflicts with the more general impressions of the many doubters on the prospects for curvebending, including Douglas Holtz-Eakin and Michael J. Ramlet, who rightly invoke past instances when Congress squeezed the health system and later retrenched under political pressure. From their perspective, no Independent Payment Advisory Board will ever succeed in saving lawmakers from their own selfpreserving instincts to pander.
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The AMA president raised the issues of payment cuts and reduced congressional influence. [15] We could include these points perhaps. Also, I recall Uwe Reinhardt and a letter from lawmakers making the point that congress doesn't want its power reduced. Given the low approval ratings for congress, I would think there are articles with arguments supporting congress' power to be reduced by the IPAB. The reduced influence of congress seems to be a common theme in multiple sources. Perhaps eventually a section on this is warranted. Jesanj ( talk) 14:09, 25 February 2011 (UTC)
(outdent) Yes I do stand by that statement. What we know about IPAB is the task that congress has set for it and all CBO has done is to assume what IPAB will achieve the reduction in the growth of spending. That is entirely logical and honest and fair presentation of factual information to our readers. All the other stuff you want to include is speculation because it is entirely unknowable at this stage. IPAB has not even be formed yet and so its very stupid as well as highly speculative to ponder the effect of its decisions when the decisions themselves are not yet known. Hauskalainen ( talk) 20:07, 1 March 2011 (UTC)
Hauskalainen, you are confusing the reliability of the person quoted with the reliability of the source reporting his words. You are still here filibustering the talk page and you are still engaged in a slow-motion edit war. Your behavior has really got to stop. Intermittentgardener ( talk) 21:56, 7 March 2011 (UTC)
As I understand it, the dispute about this article concerns including or not including information published in reliable sources that isn't "official" information, but rather consists of opinions an speculation by individuals who are notable, but possibly politically motivated. Correct?
I'll offer my view as a third opinion:
Like it or not, opinions can and do have a place in Wikipedia articles, if the opinions originate from someone with knowledge resulting from analysis or study. A reasoned argument from, say, an economics professor or insurance industry analyst is worth including.
Politically-motivated or ignorant opinions, even if they originate from notable people, may be worth including if actual reasoning can be found for them. The term "death panels" seems merely like name-calling to make a political/rhetorical point with no real argument behind it. I suppose such opinions could simply be summarized, with a few selected quotations, but one runs the risk of such a paragraph growing without bound as every editor with an agenda inserts a quote from their favorite critic. You'd need to establish an agreement on what constitutes a critic suitable for inclusion in the article.
See also Wikipedia:Mediation Cabal (less formal) or Wikipedia:Mediation Committee (more formal) for help in resolving your dispute. ~ Amatulić ( talk) 23:49, 28 February 2011 (UTC)
Blanking out whole sections is rarely an appropriate way to handle concerns about content. If you see a problem you should re-write the content or flag it so that someone else can fix it. Intermittentgardener ( talk) 17:34, 14 March 2011 (UTC)
The amount of text devoted to Death Panels section is entirely reasonable. This section is concise, contains all the relevant facts, and is even-handed. I just do not see any problem. I suspect that you just disagree with the the whole death panel smear and thus do not want it hear. Unfortunately, that is not how Wikipedia works. Our job is to faithfully recount what is in the sources. Intermittentgardener ( talk) 11:45, 5 April 2011 (UTC)
I noticed that you removed the Death panels sub-section without making a note here and without mentioning anything in the edit summary. What was the point of flagging it if you were planning on doing that? I have re-added it along with the tag that you added. I suggest you read the tag in its entirety. I am beginning to suspect bad faith on your part. If you keep doing stuff like that my suspicions will be confirmed. I hope you prove me wrong. Intermittentgardener ( talk) 11:51, 5 April 2011 (UTC)
What is it about the headline "Death panel controversy" that misleads? Would putting Death panel in quotes make you feel better about it? The fact is that there is a controversy involving death panels and IPAB. I would also point out that I am not doing anything unilateral here. The current text was the product of at least three different editors.
As for those section headings, they are completely non-POV. "Claims of rationing" is a fair title. It does not pass judgement and makes it clear that the allegations about rationing are just that, merely claims. The same goes for "Constitutionality." Many people claim that IPAB is unconstitutional. Also, the title does not pass judgement. An example of a POV title might be "Unconstitutionality." "Constitutionality" is merely an accurate description of the topic. Finally, I found titles that are also Non-POV in response to concerns from other editors. All the content I have added has been reflective of the accounts in reliable sources.
You need to consider your own actions. Are you trying to keep this out because you think it detracts from the value of the article or because you simply wish to cover up controversy?
That said, stop section blanking. And please start being cooperative. I keep answering objections and making reasonable changes. You keep deleting and that is not appropriate. Intermittentgardener ( talk) 11:07, 9 April 2011 (UTC)
In my opinion, this article is too dedicated to collecting the opinions of those who oppose this entity while it excludes the opinions of those who support or have spoken positively towards the board. A Mother Jones article currently used as a source gives some detail on support from Congress and Uwe Reinhardt has spoken of the board's opportunity. Until we can get some more coverage of support, I think a neutrality tag is warranted. Jesanj ( talk) 03:39, 24 March 2011 (UTC)
Ok, you folks have been reverting this back and forth for a month. Knock it off. I've protected the article for a month. If you can agree on mutually-acceptable wording before that, all the better.-- SarekOfVulcan ( talk) 15:04, 11 April 2011 (UTC)
I am 71, a CPA, conservative, Tea Party member, lever pulling Republican and former CFO of a major teaching hospital. First in my opinion (first formed 40 years ago) Medical technology has surpassed society's ability to provide the current state of art technology to everyone. Therefore: we must have "death panels", or whatever you want to call them.
One time I had to choose to expand the neonatal intensive care beds, or establish regional walk-in clinics. We did not have money in the budget for both. I chose the clinics and therefore acted as a one man “death panel” for the babies that died because there was not an intensive care bed available for them.
My question: How is this INDEPENDENT ADVISORY BOARD going to “develop a proposal to reduce per capita Medicare spending without” including “any recommendation to ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria”.
Answer: reduce payments to medical providers and/or recommend that we “ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria”? Texbum —Preceding unsigned comment added by 75.140.243.180 ( talk) 22:44, 20 April 2011 (UTC)
I removed some material and it was restored. [23] My rationale for removal was because the cited source does not appear to maintain text-source integrity and the other content looks off-topic. I'm unsure where the source says that 1) the IPAB was discussed during the 31 meetings 2) that the board was informally called "MedPAC on steroids". And wouldn't the second sentence be better off at the article on the Affordable Care Act? Jesanj ( talk) 00:41, 20 June 2011 (UTC)
There is obviously room for improvement in the CBO scoring section. This was on NYT "The bill would yield less in the way of savings as a result of a new commission to recommend changes in Medicare spending. The commission, called the Independent Payment Advisory Board, is now expected to save $13.3 billion over 10 years, rather than the $28 billion in the Senate-passed bill." [24] And on May 13, 2011 the CBO estimated repealing the IPAB would cost 2.4 billion from 2018 to 2021. [25] [26] Jesanj ( talk) 23:05, 7 July 2011 (UTC)
Original: The Independent Payment Advisory Board, or IPAB, is a fifteen-member, unelected United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which has the explicit task of reducing the rate of growth in Medicare without affecting coverage or quality.[1] Under previous law, changes to Medicare reimbursement rates were recommended by MedPAC but required an act of congress to take effect, but the new system devolves responsibility to IPAB with the Congress being given the power to overrule the agency's decisions.
The Board is required to implement its first proposals in 2015 with its first report being produced by July 2014. The Chief Actuary of the Centers for Medicare and Medicaid Services will determine in particular years the projected per capita growth rate for Medicare for the second year thereafter. If the projection exceeds a target growth rate, IPAB must develop a proposal to reduce per capita Medicare spending.
Discussion of changes I will implement and those I think are needed:
I intend to delete "unelected" in the first sentence because it is superfluous and nonneutral. The only elected positions in the US Federal Government are the President, Vice President, and members of Congress. So, with the exception of the White House and Congress, every federal agency is run by unelected officials. Elected officials do have substantial responsibility for selecting the members of the board. They are to be nominated by the President based on recommendations from the four corners of Congressional leadership, and they must be confirmed by the Senate.
I intend to change "reimbursement" to "payment" because the former term is not neutral.
I intend to change "which has the explicit task of reducing the rate of growth in Medicare" to "which has the explicit task of achieving specified savings in Medicare." The former statement is a very common misunderstanding, which stems, I believe, from conflating the measures used to trigger action by the IPAB with the effect of any such action.[ | see the CBO memo linked at the bottom of this article] The circumstances that will trigger action are based on the difference between two rate-of-growth measures--the five year moving average in the rate of growth in:
The five-year moving averages will be calculated by the Chief Actuary of CMS using projected spending and economic measures for the year that is two years in the future compared to the actual spending and economic measures from the year that is three years in the past. (I will refer to the year that is two years in the future as the "implementation year" because that is the year in which the IPAB might be obligated to achieve savings.)
The requirement for the Board to act will be triggered if the spending measure exceeds the economic measure. The requirement, if triggered, is for the Board to achieve projected savings in the implementation year (as estimated by the Chief Actuary) that equal the difference between the spending and economic measures (in percentage points) applied to the Chief Actuary's projection of spending in the implementation year. A percentage applied to a dollar amount results in a savings target measured in dollars (that is, in terms of levels) and not in terms of growth rates. Moreover, the Board is under no obligation to reduce levels of spending in subsequent years. Thus, it is conceivable that actions by the Board affecting any given implementation year could have no effect on the level of spending (and thus no effect on rates of growth) in subsequent years.
If the requirement for the Board to act is triggered, it must submit its recommendations in January of the year before the implementation year. The first potential implementation year is 2015, so the first potential deadline for the Board to submit its recommendations is January, 2014.
The Board will not implement its recommendations; the Secretary of HHS will be required to do so.
More wordsmithing needed: The Board consists of 15 members; the agency will have a staff (the law authorizes the Board to employ staff and to use staff detailed from [that is, paid by] other federal agencies). Thus, "fifteen members" is accurate when referring to composition of the Board, but is not accurate when referring to the size of the agency.
MedPAC continues to exist and its role in advising Congress on Medicare policy was not changed by the legislation that created the IPAB. So the whole tone of the discussion of the relationship of the IPAB mechanism to MedPAC is off. Pl0rtn1pZ ( talk) 02:58, 22 January 2012 (UTC)
I added content saying that the "death panels" charge has been debunked, and cited two fact checkers. My changes were reverted with the comment: "numerous commentators have made the "death panel" charge, not just Palin." Why this is relevant is beyond my comprehension. Could someone please explain what was wrong with my addition? -- Dr. Fleischman ( talk) 22:42, 7 August 2013 (UTC)
"Resource 17" has a dead link. I checked it out and think it should be replaced with http://www.nrlc.org/News_and_Views/Oct10/nv100110part2.html . Can I get confirmation for this?
The original, non-working link is: http://www.nrlc.org/news_and_views/Oct10/nv100110part2.html . — Preceding unsigned comment added by Lightvd ( talk • contribs) 20:29, 9 August 2013 (UTC)