State funded health care has always been and will always be rationed in one way or another. Explicitly or implicitly.

Rationing is also an area where there exist no perfect solutions or formula for how to make decisions. Careful balancing of different values and a continuos openness for reconsideration in the light of new evidence and arguments. Reasonable disagreements for when to ration care will always exist. Therefore it is self-defeating and unrealistic to strive toward consensus agreements on all issues at hand when dealing with health care rationing. Instead, the most promising way forward is to be explicit about reasonable disagreements that exist.

Some of my work might be useful.

Thesis The art of saying no – the economics and ethics of healthcar...

I don't know that starting from the concept of "rationing" is very useful. In allocating limited state funds for societal healthcare; "prioritizing" might be a more constructive perspective to utilize. Should children be given priority because they are the future of any society? Moreover, this is where the most preventative type of intervention can occur, thus avoiding higher health costs later on in treating adult ailments such as high blood pressure and smoking related illnesses. Vaccinations, dental care, health education classes aimed at preventing new smokers, or addiction to drugs or alcohol, or falling victim to sexually transmitted diseases, etc. Also wellness-related is investing in physical training and exercise facilities (outdoor space as well as indoor equipment) as early as elementary school to encourage active lifestyles that will ward off obesity, diabetes, high blood pressure and a host of other ailments that have been traced to inactive lifestyles and poor diet. This brings up the type of food made available to children in school cafeterias, which could also be thought of as a "wellness investment" in the young -- at a time when inexpensive health interventions are easier to come by than when adulthood has set in and bad lifestyle habits are harder to break. Of course, the implication is that lower priority would be given to aggressive treatment of end-of-life ailments or providing state funds for elective cosmetic surgeries, etc.

Gwen