These are code words for the rationing the imbalance in supply and demand will cause. The panel will "encourage" doctors to adopt the "best practices" the panel recommends by limiting reimbursement rates or even banning alternatives. Likely guidelines will govern who can get elective surgery like hip replacements or new knees based on the number of QARYs "quality adjusted remaining years" the patient has.
For example, in Canada, the drug Avastin is barred by just such a panel despite its proven track record as the most effective anti-colon cancer drug on the market. The ban is not because of any safety concerns, but solely due to its $50,000 annual cost. As a direct result, 41% of Canadians with colon cancer die as opposed to 32% of Americans. It is just these kinds of "best practices" that the panel will have to impose to pay for Obama's plan.
The panel will likely recommend limits on testing and screening, worsening rather than improving preventative care. In Canada, for example, there is an eight month wait for colonoscopies which leads to a 25% higher incidence of colon cancer.
Together, these cuts in Medicare will pay for more than half of the subsidies in Obama's program. And what will the money be used for? To pay for medical coverage for people who are too young for Medicare, too wealthy for Medicaid, and too old for the Children's Health Insurance Program. The president claims that this coverage will be "affordable" for those now uninsured. But the guidelines in the bill indicate that a person making about $30,000 a year will have to pay approximately 8% of his income in premiums before the subsidies kick in -- $2400 a year. Many of those now uninsured will find this expenditure both onerous and unnecessary in view of their current youth and good health.
Obama claims that "our health care problem is our deficit problem. Nothing else even comes close." He's wrong. Medicare and Medicaid costs have risen by about 5% in the past year while the budget deficit has quadrupled. The deficit is caused by the massive overspending in the TARP program bailing out banks and the equally gargantuan stimulus package, throwing money - ineffectually - at the recession.
The president reports that "the reforms I'm proposing will not apply to those who are here illegally." This statement is also a half-truth. Illegal immigrants will be eligible to buy health insurance from the insurance exchange Obama creates, taking advantage of the lower rates he claims it will allow through bulk purchasing. And, without any effective provision for citizenship verification, will inevitably slip through the cracks and get subsidized coverage.
He boasts that "nothing in this plan will force you or your employer to change the coverage or the doctor you have." But the rationing his program will force will make those insurance companies and doctors impotent in the face of federal mandates for reduced care.
The president's plan is, essentially, a program to take medical care away from the elderly and give it to those who are not younger, healthier, and - in the main - richer.