[BusterBear]

Did anyone else hear this? Wouldn't this be age discrimination?

Yes, I heard about it. Betsy McCaughey had an article about it in yesterday's Wall Street Journal:

"What the Pelosi Health-Care Bill Really Says"
http://online.wsj.com/article/SB10001424052748704795604574519671055918380.html?mod=WSJ_hps_sections_opinion

"Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a 'medical home.'

"The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to 'disseminate this approach rapidly on a national basis.'

"A December 2008 Congressional Budget Office report noted that 'medical homes' were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority."

[kaila]

The gatekeeper concept is not going to work.
If you are a nurse practitioner( or a family physician), and you are seeing an elderly patient with complex problems- there is no way you are going to deny them specialty care.
NPs do not have the training to deal with these problems, and would likely face lawsuits if they did not refer out appropriately.
Family practice doctors have more training, but they would also face lawsuits if they took on a patient they could not handle.
What this will do is create more government layers which will accomplish nothing.
That is why the ins. companies dropped the gatekeeper model- too many complaints from physicians and patients with no cost control improvement.