My aunt and I both have pacemakers. I'm almost 60 and she is
80. At some point, our pacemakers, like any other electronic device, will need to be replaced. As of now, if either of us needs a pacemaker, we get it — no fuss, no muss. However, under Obamacare, the replacement procedure will have to be approved by a bureaucrat or a panel of bureaucrats. The decision to replace the pacemaker will be made based, not on medical and health need, but rather, whether the procedure will be cost effective. My aunt may be deemed too old (she will probably die soon, so why waste money on her) and the money for a new pacemaker can be better spent elsewhere (like for some chippy's abortion). Never mind that if the old pacemaker quits, my aunt will be dead.
Me? I might be placed on a waiting list or I might be prescribed medication. Problem is, I did try medication to fix my problem and the result was a cardiac arrest. So without a new pacemaker, I will be dead too.
No wonder the new law is called Death Care
Cost effectiveness will likely be determined by estimating the present value of the future taxes you will pay or, ir you will not be paying in, the present value of the future benefits you will receive. Compared to the cost of the specific care/procedure needed. Those with net tax payments will receive priority care over those who cannot or will not be paying any more in IMHO.