There was a chilling column in the March 26 Boston Globe by health-care economist Uwe Reinhardt chilling if you aren’t rich and/or fear for the long-term prosperity and stability of the United States.

Professor Reinhardt, who teaches at Princeton, discusses the rise of “boutique medicine,” in which your access to health care, or at least top-quality health care, depends almost entirely on your ability to pay. He notes that it’s the same sort of thing that increasingly applies in American education.

Of course, the quality of one’s health care and education has long depended heavily on one’s family income. But the purveyors of “boutique education” and “boutique health care” want to make the role of personal wealth even more important. Given the frustrations of managed care and the apparent inability of many public schools to improve, the desire to opt out and buy fancy private services is understandable. But this tendency can get very damaging to the country.

State and federal tax and other policies have, in recent years, increasingly shifted resources to higher-income students, in response to political pressure from the affluent. And, contrary to the P.R. stuff out of Ivy League and other elite colleges, these colleges, though very rich with potential scholarship money, are overwhelmingly camps for the well-heeled. They seem likely to become even more so, thus threatening to solidify the U.S. class system which we aren’t supposed to say anything about.

As for “boutique health care,” some economists, Professor Reinhardt notes, think that it’s just ducky: After all, they assert, the rich “contribute” more to society than do the poor through the multiplier effect of their spending and investments. So, the argument goes that they deserve better health care. How even an economist could confidently make such value judgments about something as qualitatively and quantitatively complex as humans eludes me, though of course they do it all the time. (No wonder economists’ forecasts are so often wrong.)

But let’s just keep this practical.

Capitalism and a stable democracy depend on most of the population believing that everyone has a shot at success and prosperity, that this is really a land of opportunity for most folks. Key to this is that such basics as quality medical care and education are available to everyone. And yet these things are increasingly allocated on the basis of a person’s money (much of it from choosing the right parents).

As this develops, the understanding that permits America to function without serious social unrest falls apart and the nation becomes a much more difficult place to do business.

Eventually, even the rich, insulated with their state-of-the-art medical care and their kids in fancy private schools, will find America a dangerous place to live in if the sense of a rough equality of opportunity is destroyed by the class-privileged health-care and medical system we are now building to the cheers of the beneficiaries.

Of course, we must encourage wealth accumulation wealth is a powerful prod to innovation in many things, and so toward building a better society. But to undermine the belief that there is at least a very rough equality of opportunity in America by increasingly allocating basic services by income threatens the whole American project.

Let the rich have their luxuries, but don’t poison the well we all draw from by letting the phrase “equality of opportunity” become empty. The argument, usually presented by the already comfortable, that this is a boundless land of opportunity, and that achievement in life is not to a large extent determined by class, has some big holes in it, and they’re getting bigger.