Several years ago my parents were living in England, where my father worked for an American company. He needed some dental work but was told he was out of luck. Dad was over 55, and Great Britain's health-care system wouldn't cover that kind of dental work on a man his age.

In all the discussion about how to reform health care, both on the state level and in Washington, one thing needs to be clear. Mankind never has devised a system that is totally fair or universal.

You can trot out all the heartrending examples you want on either side of this debate. As in most theater, a skillful playwright can cast anyone in the robes of a villain. When it comes to using miracle drugs or surgeries to heal people, rationing never is a popular topic, but it can't be avoided.

In this country, we ration by the ability to pay, whether through an insurance provider or with cash. In countries with true socialized medicine — where the government pays for the health care of all citizens — care is rationed according to other factors, such as age or the expense of the procedure needed.

The difference is that in this country it is possible to find alternatives — raising money somehow or relying on charity — whereas many countries with socialized medicine leave no choice other than to fly here.

Which is what Dad did, going to a U.S. dentist during his annual home leave. That certainly isn't a unique option, for those who can afford it. For example, it's worth noting that the former prime minister of Italy, Silvio Berlusconi, flew all the way to Cleveland, Ohio, to have heart surgery. He didn't go to Cuba, where some have touted health care as one of Fidel Castro's triumphs. He didn't go to any socialized country.

Which brings me to the second thing that must be made clear. Medical care in this country is exceptionally good. I won't go as far as to say it's the best in the world, because I'm not sure how to measure that. But I believe it is. Take cancer survival rates, for instance. The Lancet, a British medical journal, found that 62.9 percent of men and 66.3 percent of women diagnosed with cancer in the United States live at least another five years. That's the best rate in the world.

That said, all is far from well with health care in the United States. A recent study by the CATO Institute, a free-market think tank in Washington, makes the point that the United States pays more for health care, as a percentage of gross domestic product, than any country on earth. Part of this may have to do with the relative wealth of Americans. But the average health-insurance bill for an American family is $12,106 per year, which is astounding.

Equally astounding is the number of uninsured Americans. Even CATO's conservative figures place that number at about 47 million.