I'm getting the impression if an episode came out like this during the health care debates it would have been accused of being about Obamacare. It strikes me as a cynical vision of what might happen if control over health care were centralized, when you take control over resources away from doctors and patients and give it to a central 'Allocator'. It seems to be showing one extreme to be identical to the other extreme. Instead of several private insurance companies deciding who gets treated and who doesn't based on their income, one central insurance company decides who gets treated and who doesn't by some sabermetric algorithm. I don't think this is the implication the writers had in mind, rather it was probably meant to be about a cruelly inflexible medical institution. And ironically, getting somebody to manipulate the system, at gunpoint, in order to get a better share of rations for that particular hospital (At the expense of other hospitals) was their happy ending. It seems like a satirical ending to me. More like the ironic ending of a show like Yes Minister than the real ending of a Trek episode.