But we do ration healthcare indirectly, in two ways:

First, we ration health insurance. We make affordable insurance available to some people but not to others.

Second, our insurers — insurance companies or the government, if you’re on Medicare or Medicaid — ration what they’ll pay for. They’ll reimburse some costs but not others…

The Democrats’ proposals would make affordable insurance available to millions more people, if not to everyone. So one major form of rationing — the rationing of health insurance — would be relieved.

As for making decisions about what care is paid for, and at what price — the indirect form of rationing Kyl warned about — that’s a stickier point. The Democrats mostly kick the can down the road. Their bills set up a council on “comparative effectiveness research” to study which forms of care are cost-effective and which are wasteful, but they insist the board won’t have power to deny payment for inefficient practices — at least, not now. Republicans are right to warn that the board might grow teeth: If it finds that a treatment produces negligible results at high cost, it will push to stop paying for it.

You’d think that’s a concept fiscal conservatives would applaud, but they’re more intent on blocking any expansion of the federal role in healthcare — and on thwarting President Obama.