The equal treatment norm, strictly interpreted, is a significant constraint on policy choice. Suppose equal treatment is interpreted as requiring that a government service that is provided to some citizens shall be provided to all without discrimination against any group of citizens. Next imagine that the government proposes to provide health care coverage to all citizens and to ration coverage so as to maximize the number of quality-adjusted years of life (QALYs) secured by health care. Any scheme of this sort will recommend discrimination against disabled citizens, in the sense that the scheme will tend to recommend provision of treatment to an otherwise able person afflicted with some illness while recommending against treatment of a disabled person afflicted with a comparable case of the same illness (this recommendation occurs whenever this course of action is QALY-maximizing) (Brock 2000). Virtually any distributive norm that recommends raising or lowering the level of benefits to be provided for individuals depending on a comparison of costs of provision to well-being gains achieved for the recipient will conflict with equal treatment interpreted as requiring no discrimination among citizens on such a basis.