>Mike,
>
>My advice: watch for inclusion of the phrase "within available resources" in the definition of quality. Quality has to mean what it says and society/policyholders and patients need to decide how much of it they are willing to pay for. Not easy to decide such things if decisionmakers can shroud rationing inside their definition of quality.
>
>FWIW, all healthcare systems exert rationing- otherwise healthcare could cheerfully consume the entire GDP.

Now if someone would kindly explain how is what HMO are doing is different from rationing, that would clear the waters of this discussion.