retired doc with more insight, as always:

Dr. Brett does not elaborate on what the process would be to decide which interventions are or are not effective but one can assume that would not be done by the individual physician in consultation with the individual patient.Those decisions would be made by committees appointed by the one party payer (which Dr. Brett favors) either directly or indirectly. Ironically, the egalitarian one tier patient system would establish a two tier physician system in which the higher tier would be the elite physicians who decide what should be “provided” and in the lower tier will be the rest of the physicians who will explain to patients what they will be not allowed to have.