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By Ira Sharkansky
 JERUSALEM—There is much to criticize in Barack Obama's presidency. I have joined the chorus of naysayers, but I would still support his election, given the option of someone who chose what's her name as his running mate.
Here I offer my wee small voice against those working so hard to keep him from bringing America's health care into the 20th century.
I know it is already nine years into the 21st century, but America has a lot of catching up to do.
What attracts me currently is that aspect of the campaign that attacks the president for wanting to ration health care. One can also ridicule the claim that he wants to appoint death committees, and limit choice for a population that--thanks to insurance companies and HMOs--has virtually none.
Know-nothings treat rationing as the political equivalent of a four letter word.
Rationing is the essence of civilization. Without it we'd be person against person, each using tooth and claw to get the most for immediate consumption.
Economists have long taught the importance of rationing. Persons cannot acquire all they want.
One of the first things parents should teach their children is, "You can't have everything."
Governments cannot tax and spend enough to provide the best of every imaginable public service.
We ration all the time when we decide to buy X instead of Y, or 3 Xs and 1 Y rather than 4 Xs, or decide to forego both Xs and Ys because we don't have enough money or choose to use our money for a Z.
Health care is always rationed. If there is no government and no insurance, patients ration their choices to buy the treatments they can afford in order to alleviate what pains them most.
Insurance companies and HMOs ration. They pressure care givers to limit the time spent with each patient, they monitor
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physicians' requests for tests or treatments, and reject many of them. Governments also ration when they subsidize some facilities and treatments, but not others. Not every town gets a major hospital.
Rationing occurs here, in this socialist paradise, where a government committee rations each year when it decides how to spend the annual increase in money to be provided in the government budget. It rations by adding some new medications and treatments in the "basket" of what is subsidized, and not others.
Patients suffering from serious diseases protest if the new additions to the basket are not what they want. They claim that bureaucrats are sentencing them to death.
Guess who organizes the protests and pays for the buses to bring unhappy people to demonstrate?
The companies who make the medications being considered for addition to the basket.
People in the fields of health who have to decide what will be added to the basket explain that the most difficult cases are for expensive and new medications that will not save lives, but may prolong lives, and only for a minority of the patients who receive them.
There is insurance available that will cover items not in the basket. People without that insurance, who are disappointed by decisions about what is in the public basket can buy the treatment privately, or ask relatives and friends to help. People go door to door, with a file of medical opinions, which they summarize by saying that they need something not in the basket. Some people contribute, some do not.
On one occasion we prepared our checkbook to help a youngster in our neighborhood who needed the equivalent of $250,000 for a national survey to find a suitable donor of bone marrow. Then we heard that the company employing her mother picked up the bill.
There is room in socialized medicine for compassion, perhaps more than in a system run by insurance companies. Democracies are open to pressure for more services and lower fees. No program--public or private--will provide everyone with everything they want, or even with everything that a physician says might help them.
It can be awkward to be asked for help by a stranger for a treatment that one does not fully understand. However, most people get most of what they need, routinely, from the public program.
"Rationing" is not a dirty word. It is inevitable.
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