[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[House]
[Pages 20441-20442]
[From the U.S. Government Publishing Office, www.gpo.gov]




           IMAC, NOT THE SILVER BULLET IT WAS PROMISED TO BE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Georgia (Mr. Price) is recognized for 5 minutes.
  Mr. PRICE of Georgia. Mr. Speaker, before I came to Congress I spent 
20-plus years as a physician taking care of folks in the north Atlanta 
area, so this whole debate about the health care bill, there are many 
aspects of it that give me great concern. And the fact of the matter 
is, Mr. Speaker, there are many aspects of it that give the Nation 
great concern.
  So whether it's the government-run program or the takeover of health 
care or whether it's the potential for huge mandates from the Federal 
Government, many aspects point to areas of different concern for the 
American people. And one of them is the issue of rationing, the issue 
of whether or not the Federal Government should be deciding to what 
extent which Americans receive medical care.
  So earlier this year when there was a proposal that was passed in 
this House and in the Senate signed by the President for something 
called the Comparative Effectiveness Research Council, fancy name for a 
potential rationing board, many people voiced concerns about that, as 
did I.
  And what we heard from the other side of the aisle, the majority 
party, the Democrats, they said, Don't worry about that. There will be 
congressional oversight. Congress will be able to hold their feet to 
the fire. Well, Mr. Speaker, what's now come out is that may not be the 
case.
  The IMAC program, or the Independent Medicare Advisory Council, is a 
proposal that is being added to the current health care bill that would 
create a new Presidentially appointed board empowered to make 
recommendations on cost savings proposals. These are very, very 
personal medical decisions that we're talking about here, and cost 
savings proposals oftentimes means rationing.
  This proposal in the health care bill right now would eliminate all 
congressional oversight of the Medicare program and put it in the hands 
of, you guessed it, the White House and the President. It creates a new 
executive branch agency with unelected board members appointed by the 
President to make recommendations on the reductions in Medicare payment 
levels, reimbursement for providers, potentially refusing to pay for 
services or care prescribed by doctors as they are deemed not to be 
``cost efficient.'' That's the language, Mr. Speaker.
  The bill says that the reforms must ``either improve the quality of 
medical care received by the beneficiaries of the Medicare program 
or,'' not and, ``improve the efficiency of the Medicare program's 
operation.''
  Mr. Speaker, this is extremely concerning. This Congress has created 
the Comparative Effectiveness Resources Board that will have the power 
to ration care based on cost or quality. It would make the board's 
recommendations binding in the absence of action by Congress within 30 
days if the President approved the recommendation.
  Now, many Members of Congress are concerned about payment rates in 
rural parts of the country, yet this board eliminates State and 
community input into the Medicare program by rendering irrelevant the 
influence of local Medicare Carrier Advisory Communities, or MCACs, to 
develop and implement policies expressly applicable to their patient 
population.
  Further, it would reduce the availability of patient advocacy groups 
to implement new policies that would improve the health care of our 
Nation's seniors.
  The real concern as a physician is that nonmedical people will be 
making medical decisions. It's a terrible idea. It's not what the 
American people want, and they are actually waking up to the proposal 
that's before Congress right now. And that's why you see the numbers of 
support across this land decreasing.
  Let's move in a positive direction. There is a positive direction, 
and that is to allow quality decisions, medical decisions to be made 
between patients and their families and caring and compassionate 
physicians. It's a simple

[[Page 20442]]

way to do it, not put it in the hands of a bureaucrat, not put it in 
the hands of the White House, not put it in the hands of the President. 
Let patients and doctors decide.
  Mr. Speaker, that's the right way. Mr. Speaker, that's the American 
way.

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