The slippery slope of health-care rationing, fueled by a gaping budget shortfall, is now an issue at the Veterans' Administration. 

Last year, long waits and allegedly fraudulent practices that misrepresented the number of vets actually served in VA hospitals prompted calls for a top-down reform of the federal agency.

But a year later, as those same hospitals scramble to facilitate a surge in demand for medical services, we learn that a looming budget crisis and rising costs for an expensive Hepatitis C treatment, has  prompted administrators to consider rationing the treatment, which doesn't only alleviate symptoms of the disease, but can actually cure it. The New York Times provided this update:

One year after outrage about long waiting lists for health care shook the Department of Veterans Affairs, the agency is facing a new crisis: The number of veterans on waiting lists of one month or more is now 50 percent higher than it was during the height of last year’s problems, department officials say. The department is also facing a nearly $3 billion budget shortfall, which could affect care for many veterans.

UVA administrators have pressed Congress to address the budget shortfall. Meanwhile, the Times reports, the federal agency has quietly initiated a debate on one partial solution to the spike in treatment costs:

"A proposal to address a shortage of funds for one drug — a new, more effective but more costly Hepatitis C treatment — by possibly rationing new treatments among veterans and excluding certain patients who have advanced terminal diseases or suffer from a 'persistent vegetative state or advanced dementia' is stirring bitter debate inside the department."

The Times offered scant details on why such a debate might be "bitter." But a 2014 Washington Post story noted the high price tag for new drugs that treat this disease, and anticipated an intense debate about whether U.S. taxpayers should foot the bill for patients who lack private insurance.

"If all 3 million people estimated to be infected with the virus in the United States were treated with the drugs, at an average cost of $100,000 per person, the amount spent for all prescription drugs in the country would double, from about $300 billion in a year to more than $600 billion," the Post reported.

There may be good medical reasons why physicians won't prescribe this drug for every vet with Hepatitis C. But we also know that a proposal to withhold treatment from a class of vulnerable patients has alarmed some VA personnel, and we, too, should be concerned.

We need to keep a close watch on this debate, not only to carefully evaluate the arguments used to justify a denial of treatment, but also to discourage any future attempts to cut costs by excluding patients who can't advocate for themselves.

Last year, when news of healthcare rationing at the VA first came to light, a column in the Daily Caller argued that such rationing was an inevitable feature of any single-payer system that excluded choices.

"The VA is but a smaller version of the sort of government-run, single-payer health care with which the political left is so enamored," contended Elizabeth Foley, a Florida law professor. "When government has a monopoly on the provision of health care, patients lose. They lose because they cannot escape. They have no viable alternative choice."

Point taken. But that does not let U.S. lawmakers on both sides of the aisle off the hook.They should finish the job of reforming the VA, and secure adequate funding for medical services our veterans need and deserve.