When a government panel released new guidelines increasing the recommended age for mammography screening earlier this month, it highlighted the volatile topic in the world of health care reform: health care rationing, the Detroit Free Press reported over the weekend.

"If Americans want a preview of what federal health care rationing is, this is a preview," Rep. David Camp, R-Midland, was quoted as saying. The Obama administration has said rationing is already occurring when insurance companies deny coverage.

The piece looks at how big of an issue rationing has become and how it is already being used in the U.S. health care system. University of Michigan physician and health policy specialist A. Mark Fendrick said in the article that rationing should be based on clinical benefits of a treatment and not whether a person can afford to pay.

"There are 40-plus-million Americans with no insurance who certainly do not get the same level of care as those who have insurance," he told the Detroit Free Press. "This is rationing by one's ability to pay for services."

Meanwhile, University of Michigan surgeon John Birkmeyer said there could be significant push back among Americans if the government tries to push reforms too far.

Tina Reed covers health and the environment for AnnArbor.com. You can reach her at tinareed@annarbor.com, call her at 734-623-2535 or find her on Twitter @TreedinAA.