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Megan
McArdle blows me away with her essay on rationing by fiat v. rationing
by price, a concept, evidently, as elusive to statists as free markets
and national defense. "
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But
there is also a real difference between having something rationed by a
process and having it rationed by a person. That is, in fact, why
progressives are so fond of rules. They don't want to tell
grandma to take morphine instead of getting a pacemaker.
It's much nicer if you create a mathematical formula that makes
some doctor tell grandma to take morphine instead of getting a  pacemaker.
Then the doctor can disclaim responsibility too, because after all, no
one really has any agency here--we're all just in the grips of an
impersonal force.
But this won't do. If you design a formula to deny granny a
pacemaker, knowing that this is the intent of the formula, then you've
killed granny just as surely as if you'd ordered the doctor to do it
directly. That's the intuition behind the conservative resistance to
switching from price rationing to fiat rationing. Using the
government's coercive power to decide the price of something, or who
ought to get it, is qualitatively different from the same outcome
arising out of voluntary actions in the marketplace. Even if you
don't share the value judgement, it's not irrational, except in the
sense that all human decisions have an element of intuition and emotion
baked into them.
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