If the ACA goes into effect as currently written, the IPAB will make choices about how to trim Medicare costs and improve the quality of health care. Decisions made by the panel will directly affect certain segments of the population, and experts will need to maintain public trust and support.
The panel will begin its deliberations in a climate where two-thirds of Americans (67 percent) already believe that the government and private insurance plans withhold high-cost prescription drugs and treatments very or somewhat often from some people who might benefit from them in order to save money. In addition, about six in ten Americans (61 percent) say they do not trust the federal government to make the right health care decisions.
Even before the IPAB is established, polls show that a substantial proportion of Americans express little trust in expert panels in health care to make recommendations about coverage and spending. When asked how much they would trust a panel of experts from a scientific organization to make recommendations about the tests and treatments that should be covered by insurance companies, more than four in ten (41 percent) said they would trust such a panel “just a little” or “not at all.”When such a panel was described explicitly as being appointed by the federal government from an independent scientific organization, a majority (57 percent) expressed little or no trust.
When Americans were asked how much they would trust an independent panel of fulltime experts appointed by the president and confirmed by the Senate to make proposals about ways to reduce Medicare spending and keep the program sustainable in the future, nearly half (47 percent) expressed little or no trust. These are exactly the type of decisions that the IPAB is charged with making.
Added to this level of public distrust of expert panels are large differences in the views of Republicans and Democrats, likely to be reflected in Congress. In each of the three cases described above, a clear majority (57 percent to 69 percent) of Republicans expressed little or no trust in expert panels. When it comes to an independent panel to make proposals about Medicare, 59 percent of Republicans expressed this level of distrust, compared with 33 percent of Democrats.
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