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because he’s 77 years old, would not be treated the way it’s treated in the United States. In other words, they say, well, he doesn’t have long to live, even if he’d live another four or five years. They’d say, well, we’ve got to spend the money on people that have more, can contribute more to the economy.” That earned a rebuttal from Ara Darzi, Britain’s ambassador for health and life sciences. “Well, I’m sorry to say that’s the most ludicrous thing I’ve heard,” he told National Public Radio (where I work). He went on to say it’s not just false — “these are lies which have been used to set fear against reform.” He added that life expectancy in the UK is longer than it is in the US. As the flap unfolded, the National Health Service found friends and supporters on both sides of the Atlantic. “For the first couple of years I lived in Britain, I was an illegal immigrant from the United States, visaless with an expired passport and looking over my shoulder all the time,” wrote Clancy Sigal in the Los Angeles Times. “Even so, from the very first day I arrived at Victoria Station in London, suffering from bronchitis, I was accepted in the NHS — the national health scheme, we called it — no questions asked and no ID required.” For three decades, he used the free medical system, “and that single-payer, socialistic, government-run, bureaucratized, heavily used, nationalized health system served me — and 50 million others — very well.” More visible – and vociferous — was the defence from the UK, from the likes of Prime Minister Gordon Brown and Conservative Party leader David Cameron. The latter sent out a widely quoted email proclaiming national pride in the NHS. “One of the wonderful things about living in this country is that the moment you’re injured or fall ill — no matter who you are, where you are from, or how much money you’ve got — you know that the NHS will look after you.” Of course, many misrepresentations are built on a grain of truth. And in this case, the truth is that health care is not a limitless resource — to make it affordable, the NHS does set limits about what it will cover. That doesn’t mean snuffing out the Ted Kennedys and Stephen Hawkings of the world, but it does mean reining in expenses. So, when the British medical review institution — National Institute for Health and Clinical Excellence — concluded that controlled studies of cortisone for non-specific lower back pain showed that the shots don’t seem to work, it decided to recommend against them in that context. In the UK as well as the US, this was an outrage. “Specialists fear tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 each for private treatment,” the Telegraph warned. Sean Hannity on Fox News waved around that article as proof that America is heading toward a world of medical rationing and agony that would no doubt result from putting a price tag on human life and suffering. The truth is, we already do, wrote Peter Singer in the New York Times magazine. “Health care is a scarce resource, and all scarce resources are rationed in one way or another.” The real question — not currently up for debate — is whether to be honest and direct about what’s already happening.