HEALTH CARE RATIONING PROVISIONS
The American Recovery and Reimbursement Act of 2009 (ARRA)

The structures for health care rationing needed to keep the Nation from being bankrupted by the overt generousity of The Patient Protection and Affordable Care Act are quietly secluded in the provisions of The American Recovery and Reimbursement Act of 2009 (ARRA)

The National Coordinator of Health Information Technology, is established to monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. Its goal is to reduce costs and "guide" your doctor's decisions. Doctors will have to give up autonomy and learn to operate less like solo practitioners.

Hospitals and doctors that are not “meaningful users" of the new system will face penalties. "Meaningful user" isn't defined in the bill. That will be left to the HHS secretary, who is empowered to impose more stringent measures of meaningful use over time.

Another new bureaucracy, the Federal Coordinating Council for Comparative Effectiveness Research, <http://www.hhs.gov/recovery/programs/os/cerbios.html> will determine the penalties needed to deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment. Its further goal is to slow the development and use of new medicines and technologies because they drive up costs. It chastises Americans for expecting results from our health care system.

Medicare now pays for treatments deemed safe and effective. The stimulus bill applies a cost effectiveness standard set by the Federal Coordinating Council . It will approve or reject treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. Expensive treatments for non-disabling conditions will be denied at some risk to the patient.

U.K. practice gives an example. In 2006, a U.K. health board decreed that elderly patients with wet macular degeneration had to wait until they went blind in one eye before they could get injections of a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.