huge role in health care. can tell people that they will not get certain procedures. you said the anti-rationing language is completely toothless. how can this board tell seniors that they are not going to get a procedure because some board says no. >> well with, the way i-pad works is it comes up with proposals. unless congress knocks them down and to block a proposal you need 60 vote nts the senate. those proposals become law. the secretary of health and human services has to implement them. there is a prohibition on rationing in the law. it says ipad cannot ration. what if i pad says we'll do it anyway? we'll define rationing ourselves to mean if we deny care for a cost ineffective service or they come up with a definition. >> they have a definition for rationing. >> and they say we'll deny the treatments and it doesn't count