Our politicians cannot come up with a health care solution because there is an elephant in the room they are not willing to speak of. It's the problem of Science Progress creating more and more possibilities for medical analysis and treatment. Soon, if not already, the nation's budget would be spent many times over giving everything to everyone. If they won't COME UP WITH A SYSTEM OF RATIONING, they'll just have to go on hiding the need for it.

In a world run by engineers instead of humanitarians and diplomats, a solution would be worked out roughly like this: First the president would announce we need to have a sense of our nation's ethical sensitivities. We need to know how people feel about some tough questions, and finding out how they feel, we need to come up with some kind of consensus. Engineers and statisticians know how to do this. The kinds of tough questions we need to ask are: What proportion of our health dollars should we spend for the young versus the old? For convicted criminals versus working citizens? For those contributing financially to the health care system and those who are not? Who is more worthy for a heart and lung replacement, the one who will benefit the most? or the one who has been waiting the longest?

Besides (1) data on the moral sensitivities of our population, we need (2) cost effectiveness estimates of medical procedures. This is not rocket science, but many practitioners, drug companies, etc will not agree with the effectiveness estimates. Last is the process of "modeling". Scientists, engineers, and statisticians do this all the time. A health care system model can be assembled that best matches the data of (1) and (2).

We don't need to abandon our system of political fights among lobbied elected representatives. We simply need to define the SYSTEM OF RATIONING and then let the voters choose between that and what our politicians come up with.