In the fall, I was for a time among the 300,000 Utahns without health insurance. Did that make me long for government health insurance? Not at all. If anything, it increased my dread at the prospect of Big Brother turning into Big Doctor.

Letting you and me manage our own medical issues will be, in the long run, the most efficient and compassionate way to run health care. To understand why, let's look at what I might do about a sore knee. As a young man, I dislocated each knee twice. They feel OK now, but it would be no surprise if they started aching tomorrow.

Advocates of government-dominated health usually focus on expenses and pain. It costs too much to treat that knee! they exclaim. We have to keep people from suffering! they cry. But their sympathy for their ailing is too narrowly confined, their concerns about finances too narrow.

Here's the key question: Who decides what to do about those painful knees and how to pay for them? If my employer picks up most of the tab, I would just whip out my Blue Cross card and say, "Doc, fix the knee, and don't skimp on anything." That's one reason why costs are rising so fast. Right now, for most of us, getting medical care is like going to a buffet restaurant: you've already paid, so you might as well consume all you can.

With many classic government-run plans, the same attitude holds, multiplied many times over. I have heard backers of Sens. Hillary Clinton and Barack Obama say their health plans will cut costs. Baloney. Politicians can't say no. They'll cover more and more, and costs will run amok.

But liberals will ask, Can a price tag be put on suffering? The question is not whether we put a price on it -- price is an inescapable reality. The only question is how we assess it. And to do that, we have to widen the scope of our sympathy, to comprehend all the suffering involved, not just what is easily seen.

Let's say there's a government-run health plan that covers all knee problems. That's great if you have bad knees. But all resources have limits. If a society puts a huge amount of resources into knees, it must take them from somewhere else.

That's why government-run health programs in other nations must ration care. Rationing may not be easy to see, but it's there. A plan may provide prompt knee replacement, but then have a five-year wait for a balloon in a clogged artery. Alternatively, knee replacement may be banned after age 70. Or knee replacement may get in line behind the repair of potholes outside the hospital.

The point is that health care is always rationed. The only questions are who does the rationing and how.

It's better if we're rationing care for ourselves. In fact, I'm doing self-rationing now. I just enrolled in a high-deductible plan with one of the health savings accounts backed by President Bush. I'll confess that, though I approve of this idea in theory, actually doing it makes me a bit anxious. In any case, I now have to think about what care I get.

Say my knees do get sore. I may have to decide to ignore them, ice them, or find an exercise regimen that will help them. Maybe I'd have to give up a vacation one year to pay for surgery. The choices could be very difficult. But the person making them would be me.

And that's why I'm rooting for idea of a consumer-based, market-driven health plan for Utah, which is now being studied by the state's political and business leaders. I'd love to see such a plan succeed, in the hopes that you and me and all Utahns wouldn't be at the mercy of a corporation or the government, but would be in charge of our own medical insurance and care.

That would be best for our health and our pocketbooks. And if it gives us the best possible care, it would also be the most compassionate.

I don't know if it will happen. The Democrats running for the White House have their plans for government-run care at the federal level. That I dread most of all. If you don't like your health choices now, just wait to see what they're like when run by a huge Washington agency.

I've got my fingers crossed that Republicans can get their act together and create a viable free-market plan, whether here in Utah or nationally, before the Democrats can inflict their idea on us.

In the meantime, I'm working out on the Nordic track whenever I can. You never know when those knees might start acting up.

Jim Tynen is the Daily Herald's editorial page editor.