Meanwhile, "denied care" is a strong way to phrase the board’s possible effect. It’s expected to recommend cutting provider payments, with an eye on cutting waste and inefficiency. That could restrict some seniors’ access to care, depending on the what actions the board actually takes. Meanwhile, the board oversees only a small percentage of the Medicare savings in the health care law.
Ryan creates the specter of an unaccountable board making all of Medicare’s spending decisions, but that’s scarcely the case. There’s an element of truth to his claim, but his overstatements add up to a Mostly False impression.
This soft-pedaling of the very real issue that IPAB could lead to reduced access to health care for seniors is a bizarre conclusion to reach, considering what PolitiFact said about it in the same piece:
Ryan said the board would "cut Medicare in ways that will lead to denied care for current seniors."
But by law, the board can’t ration care. It can’t change benefits. It can’t change eligibility. It can’t increase what seniors pay.
So it’s expected to cut payments to providers. That could be a problem, since some providers say they’re underpaid already. New York Times and USA Today stories in 2009 and 2010, for example, feature doctors opting out of Medicare because of its low payment rates.
How might that affect care? Imagine, say critics, being unable to find a nearby hospital or doctor who takes Medicare. Or discovering that payments for a particular service or procedure have been reduced.
"In that way, at least in theory, you could get actual denial of care," said Michael Tanner, a health care analyst for the libertarian Cato Institute, who opposes the health care law.
The Medicare actuary, Richard Foster, estimated that savings from the entire health care law would make about 15 percent of hospitals, skilled nursing facilities and home health agencies unprofitable by 2019.
That means, presumably, that to stay open they would need to shift costs to non-Medicare patients, merge with other providers or withdraw from Medicare, he said.
That’s one reason he’s testified that growth reduction under the law isn’t sustainable in the long range.
It’s "a serious issue," said Wilensky, the Bush-era Medicare official.
What the heck is going on here? It's one thing to ignore the evidence that what Ryan is saying is entirely defensible, but it's quite another to report it and then pretend it's irrelevant to your conclusion that Ryan is making "overstatements" that add up to a "Mostly False impression."
Now that it's understood PolitiFact is going out of their way miscontrue what Paul Ryan is saying, let's look at how they defend a blatantly misleading charge about Ryan's health care plan from the Obama campaign. Here's an Obama campaign ad—unfortunately titled "facts"—that PolitiFact says is half-true:
At one point, the narrator says that "experts say (Ryan’s) voucher plan could raise future retirees’ costs more than $6,000." An on-screen visual adds the text, "Raise seniors’ costs by $6,400 a year. Center on Budget and Policy Priorities, 4/8/11."
Except that, as John McCormack noted, the Obama campaign is presenting figures from a questionable analysis of an outdated version of Ryan's plan that Romney and Ryan are not campaigning on. Here's how Ramesh Ponnuru explains the difference: