He notes the following about IPAB (the Independent Payment Advisory Board authorized to cut Medicare spending):
Health and Human Services Secretary Kathleen Sebelius has been quoted as saying that the majority of IPAB members must not be medical practitioners. Though some doctors may be represented, it is unlikely that they will be actively practicing clinicians who care for patients directly. Instead, the board will be populated by economists and other bureaucrats - "bean counters" - who will be given the responsibility of deciding how doctors caring for Medicare patients will get paid. It is anticipated that IPAB will drive payments so low that many doctors will be unable to offer certain services to patients, resulting in rationing of health care, which the administration fervently denies....(Read the full text of "A Trojan horse named IPAB".)
IPAB has almost limitless power over Medicare spending. Written into the Affordable Care Act are provisions that essentially make its decisions exempt from congressional oversight and impervious to administrative or judicial review. It is a nearly autonomous agency operating as an arm of the executive branch. Conveniently, this does not occur until after the 2012 elections.
As if this weren't pernicious enough, President Obama thinks IPAB should have even more power -- that of "automatic sequester," which means it would be able to prevent Congress from appropriating any additional money for Medicare outside of its purview.
Dr. Scherz also notes that many want to expand this government control from just Medicare to all nominally private health insurance.
In other words, unelected bureaucrats will make medical payment decisions that de facto limit services that doctors are able to offer to their patients. But we're not supposed to call it "rationing".