. . . An official of the Health Care Financing Administration offered this anecdote on the hard choices faced by health care policymakers in Washington: ''When I was working several years ago in a small rural clinic in Nepal, a man appeared one day carrying his 4-year-old son on his back. They had come from a village five days away and the boy was very sick. The only way to save him would be to radio for a plane to fly in to a dirt strip and take him out to a hospital in Katmandu. And even at that, I didn't think he had a very good chance of living.
Now, I had an annual budget for the whole clinic of about $20,000 and it would have cost me over $500 to fly the boy out. For $500 I could inoculate every child in four nearby valleys against diseases that would surely kifi hundreds of them. Now, what was I to do? [A famous organ-transplant surgeon said] ''Fly him out!''