Received through medicare and according to dr. Jason fullman and mr. Or dr. David rats are this unelected body will have the unprecedented ability to singlehandedly change the allocation of health care resurgence should medicare spending exceed medical inflation which for the record it consistently does. Dr. Novack what are your views on those ipaa i believe its called the independent payment Advisory Board . As i mentioned earlier its a serious area of concern. For those of us and from those families creating another new layer of bureaucracy making determinations about accessibility suspect in the right direction. I would add i think there is fairly significant bipartisan opposition to the independent advisory lord because of the way its structured. Their decisions effectively have the ability to bypass congress. Do you have evidence that competition and choice is a better way to increase value and reduce costs and the government bureaucracy and experts . I think theres a fair amount
That already on the provider side we spend enormous amounts of time as you mentioned enormous phonecalls trying to sort through these complicated issues regarding Health Insurance and by the way this is not just for people in the private market and not just for people on medicaid. Its equally true for people on medicare in the 130,000 regulations that go along with medicare. This is only going to grow and so at least for our practice since we have no idea what the exchange will bring in this 90day grace period issue is such an enormous issue for us that we dont feel we can actually see patients under these Exchange Contracts that we were pushed into without choice until this body or other bodies figures out what the rules are going to be so we can continue to provide service to be able to pay her staff. Thank you very much. Would the gentleman yield . Dr. Novack i just want to make it clear, under this 90day plan if you have lets say a 2 billiondollar practice that you pay all your peo