Editor's note. This is taken from NRLC's Robert Powell Center for Medical Ethics blog --http://powellcenterformedicalethics.blogspot.com.

On Wednesday, Senate sources again confirmed that there might be a merged bill this week. Once a merged bill is revealed, the Congressional Budget Office would likely release a score very quickly. At that point, Democrats hope to keep debate to two weeks.

On a separate but related front, Senate Majority Leader Harry Reid (D-Nev.) has delayed action on a "multi-year" Medicare physician payment proposal (docfix), with a pledge to work on it after action on broader health reform. The pledge followed a failed vote to end debate. No Republican voted for, and 12 Democrats opposed the measure, largely due to the failure to provide a way of paying for the expensive measure.

Prior to the vote on Tuesday, a reporter asked Sen. Reid whether Democrats could "still say health-care reform is paid for if you pass a quarter-trillion-dollar doc fix and don't pay for it." And when inadequate financing is present, coupled with the mechanisms present in the Senate bill, rationing becomes a very real threat.

The Senate Finance Committee product contains: (1) cuts to Medicare, (2) the dangerous "Death Spiral" provision, (3) a grant of nearly unlimited power to the Medicare Commission to reduce Medicare payments to fit with the limits on growth, and (4) verbal promises to consider price controls.

The Senate HELP Committee [Health, Education, Labor and Pensions Committee] product's rationing concerns can be found at www.nrlc.org/HealthCareRationing/HELPbill.html.

Part One