 At the level of meso-allocation—the distribution of health care resources across a single institution, such as a hospital or clinic—much of what is called “rationing at the bedside” is disguised as standard clinical practice (Ubel 2000). If a physician—whether motivated by pressures from hospital administrators, managed care organization or insurance company, or merely excising her or his professional expertise—decides to forego live-saving treatment for a patient on the grounds that the health benefits would not warrant the use of the resource, then the judgment clearly reflects, rough and ready, intuitive application of CEA. Or if a treatment is not provided because it is judged “medically futile”, that judgment is in effect a cost-benefit analysis. Treatments are said to be “futile” when in the physician’s judgment the expected health benefits do not sufficiently outweigh the costs of providing the care (Crossley 1995; Batavia 2002). Similarly, “Do Not Resuscitate” or DNR orders, while they may be equally motivated by futility or even compassion, are essentially CEA rationing techniques, although here the judgment is that the resource would have no benefit at all. 