Rationing has long been a dirty word in the health care reform debate. HMOs [health maintenance organizations] hotly deny that they are engaged in rationing. Politicians decry rationing, whether it is inflicted directly by HMOs or indirectly by lack of insurance. Polls consistently indicate that a large majority of Americans oppose rationing as a means to reduce health care spending.

The Rationing Argument

The call for rationing first became audible in the late 1980s as health care inflation worsened. It got louder in the early 1990s as universal health insurance rose to the top of the nation's agenda. It has grown louder…