Or the threat of rationing. One of the most powerful arguments against proposals for an expanded government control of the U.S. health care system. Critics of such expanded control – which might take the form of a public plan or public option – argue that in order to control costs in a revamped system, the government would have to restrict (or ration) care, by refusing to pay for certain procedures or medication or by putting limits on care for the elderly or terminally ill. Some proponents of increased government control argue that health care is already, in effect, rationed in the United States, as consumers are limited in their ability to get adequate health insurance – and health care – by rapidly climbing health care costs.