On rationing in the new federal health plan

Private plans may "ration" care in the interests of profits without seeming to judge who is more worthy to live. But when the political community rations care it appears to make invidious distinctions.
For example, if a private plan charges a higher premium to include cardiac care for those over 65, those having to pay the higher premium will be unhappy but will probably understand that this is just a business judgment that young people have fewer heart problems and does not reflect any notion that older folks are less worthy to live.

By contrast, if the political community (in a government-supervised insurance plan) charges the old more than the young for the same benefit, this may well seem unfair and in fact may become a precedent for further unequal treatments of different ages.

In general, we rightly hold the body politic to different and higher standards, compared to private companies -- not only re health insurance but, e.g., re private vs. state action that discriminates on the basis of religion.