The fear of government rationing is based on the premise that once government has such power, especially the ability to control what is covered by your private insurance policy, it also has the power to deny and restrict.

Those defending the House legislation claim rationing is not in any of its versions, and though that is technically true — no one wants rationing — the unprecedented power this legislation would grant to virtually unaccountable government agencies is all but certain to lead to rationing.

Consider Medicare, which is projected to go broke within the decade. As the baby-boom generation ages, it will put only more stress on the system. With more than 25% of all Medicare costs generated in the last two months of life, government already has the motive to ration care to the elderly. If the House legislation were to become law, these new government bureaucracies would then also potentially have the power. Are we supposed to trust that they won’t use it?

If such rationing occurs, rules will be needed to determine whether to spend federal healthcare dollars on a given individual. What might those rules look like? Dr. Ezekiel Emanuel is a key healthcare advisor to President Obama and the brother of White House Chief of Staff Rahm Emanuel. He co-wrote an academic article(09)60137- in January exploring the ethical challenges of valuing an individual’s life in the context of allocating medical resources that are very scarce, such as organs or vaccines.