Much of the dicussion of rationing health care has focused on end of life issues. We currently spend a good chunk of health spending in the last few months of life. Hence, the argument goes, we are being unreasonable, making heroic efforts to save and prolong life, when they, as a rule, have little prospect of doing much good, particularly in comparison with what the same money could do elsewhere. Perhaps we might also look at beginning of life issues. If we have bureaucrats deciding how to allocate money, might they decide that fertility treatments for women over 40 or so simply are not a good use of scarce resources? Such treatments are not inexpensive, and as women age, the odds of having babies that cost more to raise than the average baby rises. (I also fear that there would be subtle, and perhaps not so subtle, pressure to abort children who are likely to have problems.) Rationing such treatment would be a tragic cost of the centralization of health care. If this bill passes, I hope that such choices are not taken away from us.