The following appears on the invaluable http://powellcenterformedicalethics.blogspot.com.

The Obama health care proposal issued this morning would take away from America's senior citizens their current right to add their own money on top of the government Medicare contribution to get health insurance less likely to deny treatment through tightly controlled managed care. (See http://www.nrlc.org/MedEthics/PLPositionMedicare.html ). It would do so even as it cuts the government contribution to Medicare by hundreds of billions of dollars.

Under "Title III . . . Guaranteeing Benefits for Seniors by Ending Overpayments to Insurance Companies," the Obama proposal states that Medicare Advantage plans-- the alternative that now allows older Americans, if they wish, to pay more to get insurance less likely to ration treatment--will "be prohibited from charging seniors more than they would pay for services delivered under the traditional Medicare program."

Thus, older Americans would be prohibited by law from making up the Medicare shortfall by using their own money to save their own lives. (See http://www.nrlc.org/MedEthics/JusticeArgument.html )

This means that, even as more and more doctors and other health care providers are leaving the Medicare program because of low government reimbursement rates – rates that under the Obama bill will decline still more in comparison to medical inflation– senior citizens will have nowhere to turn. Their only option will be tightly managed plans that provide less and less treatment.

In a case of genuine chutzpah, the Obama proposal then goes on to claim that "all ideas that ration care . . . will be banned"--even as it imposes what will be ever-increasing rationing on senior citizens.

Part One
Part Two