Proposals to ration health care in the United States meet a number of objections, symbolic and literal. Nonetheless, an acceptance of the idea of rationing is a necessary first step toward universal health insurance. It must be understood that universal health care requires an acceptance of rationing, and that such an acceptance must precede enactment of a program, if it is to be economically sound and politically feasible. Commentators have argued that reform of the health care system should come before any effort to ration. On the contrary, rationing and reform cannot be separated. The former is the key to the latter, just as rationing is the key to universal health insurance.

中文翻译：

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符号、理性和正义：配给医疗保健

在美国实行配给医疗保健的提议遭到了许多象征性和字面意义上的反对。尽管如此，接受配给的想法是迈向全民健康保险的必要的第一步。必须理解，全民医疗保健需要接受配给，如果要在经济上和政治上可行，这种接受必须先于计划的制定。评论员认为，医疗保健系统的改革应该先于任何配给的努力。相反，配给和改革是不能分开的。前者是后者的关键，正如配给是全民健康保险的关键。