Virtually every country in the world is currently attempting to find ways to ration health care services in order to control exploding health care costs. In some countries the courts play a role in overseeing the rationing of health care. This article examines the role that the courts play in the United States in health care rationing in various contexts and programs. It then goes on to present the German social courts as an alternative model for judicial oversight of health care rationing that is both responsive to the rights of health care consumers and professionals and sensitive to the need to contain health care costs.