Rationing, in the economic sense, of any scarce and therefore valuable resource is inevitable under any economic system.
We presently have health care rationing. Some is done by government agencies, which limit payments to providers and thereby restrict availability of services. Other rationing is done by insurance companies, who exclude certain treatments from reimbursement and impose other restrictions.
Some rationing is provided by the market, most notably by those without insurance being unable to pay.
The issue is not one of whether rationing will be performed. It is one of "who decides?"
Under almost any possible American system, those with money will be able to get whatever care they're able and willing to pay for. The question of "who gets what" is pretty much limited to the lower and middle classes.
The most likely outcome of increasing government control of healthcare is:
15% at the top continue to get whatever they want, as they always have.
Health care will improve for the 25% at the bottom.
Quality and availability will decline to some extent for the 60% in the middle.
(Percentages are approximate.)
I should also have pointed out that Canada, UK and lots of other European countries “ration” health care via time, or by waiting list. Some percentage of those needing the procedure die before their number comes up.
“15% at the top continue to get whatever they want, as they always have.”
Wrong. If a free market does not exist, then what is the motivation for private companies in the health care industry to develop innovation? The wealthiest only have access to the products that are being offered. If a company can only freely service 15% of a market, their motivation dissappears.
“Health care will improve for the 25% at the bottom.”
Wrong again. The government must cap prices to claim cost reduction. When prices are capped, in any commodity, that commodity faces shortages. If health service providers are faced with caps on reimbursements, they are not motivated to work more (add resources) in order to meet the need of the expanded market. The result will be shortages which will be evident with long lines (wait time increases) for what should be basic services.
“Quality and availability will decline to some extent for the 60% in the middle.”
Wrong again, but really only by the degree of your reduction forecast and the size of the population affected. It will decline by huge margins for all. This has been proven every time any government moves to centralized planning. In the centralized planning governments, the only commodity that sees sharp increases in effectiveness and a broader market reach is brute force by those carrying government guns.
Don’t be fooled by those telling you differently.