How would you ration health care

In a comment on another blog, talking about my favorite subject, something brilliant was said:

A hypothesis:

If you ask: should medical services be rationed by the a government board, or be left to consumer choice? More people will pick the latter.

But if you ask: should medical services be rationed by medical need as judged by a government board, or by the market? More people will pick the former.

These two are for practical purposes identical, of course. It's all in the phrasing.

Rationing is coming. We simply cannot afford the healthcare system that we have now, especially Medicare and Medicaid. How should health care be rationed?

My preferred plan (taxing employer paid health insurance premiums and Medicare as income, promoting high deductible catastrophic health insurance) uses the free market to ration care. Individuals spending their own money largely determine what they are willing to pay for themselves. Only on the high end, for very sick people with very severe illnesses, would we have to rely on "experts" to determine care.

In almost every other case, Obamacare will need to become an HMO on sterioids in order to ration care. I don't think that that will fly in America, and instead health care will continue on the road to bankruptcy.