An internist who works in the hospital acknowledges that Medicare is unsustainable and lists various forms of rationing. He advocates "lifestyle rationing":
If you smoke, be prepared to be denied access. If you do crack, be prepared to be denied coverage.
If you fail to join lifestyle modification classes or fail to show improvement in basic exercise tolerance tests, be prepared to be denied coverage or pay more for lifestyle associated disease process. Rationing of resources will be made. Be prepared for this possibility. We already deny liver transplants to those actively drinking. Scarcity of resources we say. Of course the [Medicare] is a scarce resource already, we simply chose to look the other way. At some point we will have to look back and stare rationing down right between the eyes and deny coverage for poor lifestyle choices.