The supporters of ObamaCare insist that government control of health care will not lead to rationing.  However, a report late last week from Bloomberg gives a clearer indication of the kind of power ObamaCare will put into the hands of bureaucrats, and how they will control access to health care through the government checkbook.  Medicare has cut $1.4 billion in payments to cardiologists and oncologists in order to ration resources towards family-practice physicians (via Doug Ross):

While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.

The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief. …

The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.

“A fair number of cardiologists are looking at the accounting and saying ‘we can’t afford it,’” Bove said in a telephone interview.

How will this affect costs for those who need oncological and cardio care?  It will force patients into hospitals rather than clinics:

Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.

That is exactly how rationing will take place in a government-run system.  Politicians will decide on priorities and adjust compensation to promote their engineering of the health-care sector.  Lower compensation will drive specialists out of the system, especially in disciplines not fortunate enough to have political support, just as happens in Oregon now.

What’s the result?  Fewer providers, higher costs, and more pressure on hospitals for treatment rather than clinics, where treatments are both more efficient and available.  We’re already seeing this in Medicare as providers stop taking new clients in the program.  The compensation supposedly controls costs, but it only controls pricing, and the costs of providing service outstrip the compensation.  Under those circumstances, providers have to either stop taking Medicare patients or fold.