Twelve years ago (BMJ 1996;312:1553-4) the BMJ argued that health systems needed to be explicit about rationing and published articles describing different ways of rationing fairly. Here a clinician (doi:10.1136/bmj.a1846), two ethicists (doi:10.1136/bmj.a1850), and four health economists discuss how their ideas have developed—and been put into practice—since then