 Scarcity entails that health resource demands will always overwhelm supply, which in turn entails that some method of constrained allocation must take place. Rationing is the generic name for this and it comes in many forms: implicit or explicit, case-by-case or systematic, rational and fair or the opposite, overt, transparent and professionally-sanctioned, or hidden, unexamined and rationalized as something other than rationing. The key point is that rationing is unavoidable and always occurs. As health economists insist, since rationing of health care resources is inevitable, best it be open, transparently justified and understandable, based on good evidence and argument (Ubel 2000). The ethicist agrees, but adds the consideration of fairness.