Death Panels.
HR3200 dictates that after the fifth year, the Secretary sets prices and content of all insurance, government and private. Since he will have a strong desire to gather the premiums of the participants in private plans, it is obvious to most the private plans will simply be driven out of the market. The "public option" will become single payer. When that happens the committee that gathers to set policy on what will be paid and what won't could also be known as a death panel. There is no provision in HR3200 for a "death panel" per se, but that policy setting committee (a responsiblity specifically assigned to the Secretary in HR3200 and probably delegated to the committee) will set prices and coverage.

An 88 year old man who has paid in to the single payer system for 60 years and contracts cancer will look to his insurance policy for coverage for chemotherapy. Will he get it? Is it likely the Secretary will think it economic to pay for chemotherapy for an 88 year old man? What if all he needs is a hip replacement? Would he get that? What if he were 98?

Somewhere in all this the Secretary will be saying "We aren't going to pay for your medical needs." The reason this is a Death Panel is because

a. If the 88 year old man doesn't get chemotherapy he dies
b. Government forced him to join government plan. If he didn't join he would suffer an 8% tax penalty.
c. Secretary says he doesn't get chemotherapy and man has no appeal. Secretary is beyond judicial review (HR3200).

It is (b) and (c) that distinguishes the Governement death panels from the private death panels. The man has a choice of what to buy from private insurance companies. Also, with private insurance if he doesn't like the decision he can appeal the the state insurance commissioner.

Compulsory end-of-life counciling isn't a death panel. The Secretary is. Think about it.

There are arguments to avoid this.

If you're poor, you die. you won't have enough money to pay for the chemo. The Secretary is a "Death Panel".

If you're middle class, you will have to do what the liberals and HR3200 purport to avoid -- bankrupt yourself to pay for chemo. Alternatively, like in Canada, you can buy supplemental insurance, thus paying for your insurance twice. This is just a tax though it doesn't look like one.

If you're rich, you'll write a check and pray the chemo is successful.

HR3200 removes for all time, any possibility the poor could get expensive care at end of life.

Finally, since the Secretary is beyond judicial review, he could decide not to give heroic treatement for cancer after a person reaches 75 years of age. There's nothing you could do about it. Then, when Ted Kennedy discovers his cancer, the Secretary can make an arbitrary exception and there's nothing you could do about it. Remember, he is beyond judical review.

HR3200 is such a bad law that if everyone read it and understood it and thought for a while about how it might be implemented and operate over the next 10 years almost everyone would vote no. High costs are one of the motivations for HR3200 but costs are not addressed to any significance. To keep costs down, the Secretary will start with price controls. Price controls always lead to shortages (e.g. Canada has 2.2 doctors/1000 people - almost the bottom of US+Europe). The bill itself will be challenged in the courts and major parts of it could be wiped out [e.g. can the Federal government force me to buy insurance and if I don't tax only me because I didn't buy insurance -- where is that in the Constitution?]

Finally, the CBO estimate of cost over 10 years is $1T. However, most of the $1T is spent in the final 6 years AND the CBO said that its estimate was only for the parts of HR3200 that were complete enought to estimate. The CBO is not famous for accurate predictions of future costs, so the $1T is unlikely to be lower, but has a good chance of being higher. Medicare will be bankrupt in 2017. HR3200 is significanly larger in scope and price than Medicare and so far, there is no plan to keep Medicare from going bankrupt. I fail to see how HR3200 will produce anything better that Bankruptcy of the entire country sooner rather than later.