In the San Francisco Chronicle, one by your truly.

Those of us who propose market-oriented health-care reform need to spell out what this will mean for consumers — how it will increase their responsibility to study the costs and benefits of alternative treatments.

Those who favor universal government-provided health insurance also have an obligation to describe how health-care decisions will be made. If we cannot afford all the health-care services that everyone might want, then we are going to need policies for rationing health care.

My point is that we are not ready for radical reform of health care policy, because the would-be reformers are not being forthright about the consequences. It’s not a very sexy point to make, compared with saying, “We can have wonderful health care if we just do X,Y, and Z today!”

Meanwhile, Jo Ellen H. Ross writes,

A critical component for the future of health-care delivery is the adoption of health-information technology solutions that would allow individuals and their physicians to access vital health data when and where they need it.

My experience in the business world makes me skeptical. From a distance, information technology looks like magic fairy dust–just sprinkle it on, and productivity goes up. Up close, it turns out that in order to benefit from information technology, a business has to be organized to take advantage of it. I suspect that the practice of medicine needs to be standardized before information technology can have big impact. Whether standardization is desirable or feasible is an open question.