President Obama’s deficit commission has not been very kind to his signature Obamacare program, not only does it say that the healthcare savings promised by the president are a total mirage, but it reports that to keep Federal Government health care spending in check, the Department of Health and Human Services will have to rely on what Sarah Palin called “death panels.”

As you may remember, during the Obamacare debate the progressives promised that the plan would save $170 Billion during the first ten years and much more afterward.  The Medicare Chief Actuary said that projection was nonsense, and the deficit commission goes further calling the promised savings

…phantom savings from scheduled Medicare reimbursement cuts that will never materialize and from a new long-term care program [the Community Living Assistance Services and Supports Act, or “CLASS Act] that is unsustainable (see page 16 of their report which is embedded below)

The commission’s plan called The Moment of Truth, keeps most of Obamacare, but repeals the long-term care program included in the legislation, calling it “financially unsound.”

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 The commission would gradually phase out the federal tax break for job-based health plans, a change that would force workers and their families to seek out cost-conscious insurance. (The recommendation probably forces commission members to seek out protection from AFL-CIO or SEIU hit squads).

And (Sara Palin detractors take note) they recommend that the federal government

For the first time, the government would set — and enforce — an overall budget for Medicare, Medicaid and other federal programs that cover more than 100 million people, from Alzheimer’s patients in nursing homes to premature babies in hospital intensive care.

Palin attracted wide attention by denouncing nonexistent “death panels” in Obama’s overhaul, but a fixed budget as the commissioners propose could lead to denial of payment for medical care in some circumstances.

Overall, the nation will spend about $2.6 trillion this year on health care, and some claim that a significant share of that is for procedures and tests that are of little benefit to patients like giving a pacemaker for a 100-year old woman for example. There would need to be a panel to make those decisions on a mass vs an individual patient basis. The methodology for those decisions is the Independent Payment Advisory Board (IPAB), which will recommend measures to reduce Medicare spending. Formally, the board is forbidden to make recommendations that ration care, increase revenues, or change Medicare beneficiaries’ benefits, cost-sharing, eligibility, or subsidies. For the board, reimbursement for doctors and other medical professionals seems the only target left. But by cutting payment they can effectively ration care.

The deficit commission recommends strengthening the IPAB it says on page 43:

To the extent health costs are projected to grow significantly faster than that pace, we recommend the consideration of structural reforms to the health care system. Commissioners have suggested various policy options, including: moving to a premium support system for Medicare; giving CMS authority to be a more active purchaser of health care services using coverage and reimbursement policy to encourage higher value services; expanding and strengthening the Independent Payment Advisory Board (IPAB) to allow it to make recommendations for cost-sharing and benefit design and to look beyond Medicare; adjusting the federal-state responsibility for Medicaid, such as block grants for acute or long-term care; establishing a robust public option in the health care exchanges; raising the Medicare retirement age; and moving toward some type of all-payer system.

Observers say that a stronger IPAB is not going to be a pretty sight

“Unless the economy turns around, these are the kinds of the proposals that are going to be debated,” added Ferguson, a professor at George Washington University. She called some “pretty Draconian.”

There are other recommendations which would cause seniors to pay more for their health care  revealing another Obamacare lie. The deficit commission found that Medicare’s co-payments are low in most cases, encouraging overtreatment and overuse. Revamping cost-sharing would raise $110 billion through 2020. In return, seniors would get an annual cost-sharing limit of $7,500, stop-loss protection that isn’t currently offered under traditional Medicare.

The AARP is surprisingly indignant because they helped to push the plan through.

“They are asking sick people to pay more in terms of cost-sharing,” said John Rother, AARP’s top health policy expert. “You are a Social Security beneficiary living on $15,000 a year, and they want you to pay up to $7,500? We are talking about bankrupting people. This doesn’t fly in the real world.”

Based on their record, what AARP is really upset about is the possible loss of licensing income from selling Medigaps plans.

Sadly while this report validates everything that was predicted by Obamacare’s naysayers, it is the American people, especially the seniors who were abandoned by AARP who will learn about the President’s lies first-hand and will suffer their consequences.