The standard case for a single-payer health insurance system is pretty well known. Anyone can get care without courting financial ruin. Monumental personal decisions, like when to have a child or whether to leave or take a job, no longer hinge on the whims of an employer or the dysfunctions of the private insurance market. Surprise hospital bills, endless phone calls with insurance companies, juggling premiums, copays, and deductibles — all will be things of the past.

The case against single-payer often boils down to a single word: rationing. When critics peddle scare stories about Canadian or British “waiting lists,” they’re trying to conjure images of scarcity and austerity — the social-democratic equivalent of Soviet bread lines.

The truth, of course, is that you only have to look around to see that health care in America is already rationed. Try finding an in-demand specialist willing to take your “bronze-tier” insurance plan, or paying for high-priced specialty prescriptions out of pocket. Health care rationing is a fact of life in this country.