My biggest concern is that Obama plans to gut Medicare by rationing and exclusion for certain high cost medical proceduresThe mechanism is certainly in place for doing so, starting in 2014. It's called the the Independent Payment Advisory Board, a panel of unelected bureaucrats that will have dictatorial powers over what gets reimbursed and what doesn't.http://www.washingtonpost.com/opinions/george-f-will-romneys...Beginning in 2014, IPAB would consist of 15 unelected technocrats whose recommendations for reducing Medicare costs must be enacted by Congress by Aug. 15 of each year. If Congress does not enact them, or other measures achieving the same level of cost containment, IPAB's proposals automatically are transformed from recommendations into law. Without being approved by Congress. Without being signed by the president.These facts refute Obama's assurance that IPAB "can't make decisions about what treatments are given." It can and will by controlling payments to doctors and hospitals. Hence the emptiness of Obamacare's language that IPAB's proposals "shall not include any recommendation to ration health care."By Obamacare's terms, Congress can repeal IPAB only during a seven-month window in 2017, and then only by three-fifths majorities in both chambers. After that, the law precludes Congress from ever altering IPAB proposals. Because IPAB effectively makes law, thereby traducing the separation of powers, and entrenches IPAB in a manner that derogates the powers of future Congresses, it has been well described as "the most anti-constitutional measure ever to pass Congress."_____________________It would behoove all of us to have foreign medical facilities lined up as a precautionary measure for when the IPAB says nyet. When it decides, for example, that it's too expensive to provide us with hip replacements because we're over 72 and that we should just learn to live with the pain and disability, it would be good to have someplace else to go get one that will cost less than paying US prices out of pocket. --fleg
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