There are continual "crises" in health care systems worldwide as producer a
nd patient groups unify and decry the "underfunding" of health care. Someti
mes this cacophony is the self interest of profit seeking producers and oft
en it is advocacy of unproven therapies. Such pressure is to be expected an
d needs careful management by explicit rationing criteria which determine w
ho gets access to what health care. Science and rationality, however, are u
nfortunately, rarely the rules of conduct in the medical market place.