There is a strange kind of schizophrenia in the arguments about rationing. One part holds that funding for the NHS is adequate and likely to be so for the foreseeable future2; another holds that rationing takes place in the NHS and always will, because rationing is inevitable.3 Yet these two central themes of policy are not joined. Surely the amount and kind of rationing, affects perceptions of the adequacy of funding. If it does not, then “rationing is inevitable” can be a paternalistic justification for playing Scrooge. It can justify as low a level of funding and supply of doctors and nurses as those in power want. If we conclude from the start that we can never adequately meet all needs, why bother trying to meet them as inadequately as we do already? Why not cut the NHS budget by 10% or 20%?