Chuck Lane offers some calm thoughts on Medicare and living wills and the extraordinary costs of end-of-life care. What's new in the current proposals in the Congress is encouraging doctors to talk with elderly patients about drawing up powers of attorney and the like to govern end-of-life medical decisions. As long as there is no coercion involved and this is a totally voluntary process - with time for a patient to decide to forgo such measures if he or she wishes - I find this a sensible measure to tackle the huge percentage of medical costs that occur to extend life for a few days. This isn't a death panel, as Chuck concedes. But I disagree with him on whether this measure goes too far - simply because the fiscal crisis is so grave.


Technology - wonderful, amazing technology that has saved my life - is one root cause of the cost escalation. But it can do things no one would have have dreamed of when Medicare was first set up. We should be very, very, very careful to avoid any infringement on everyone's right to determine their own end-of-life treatment in advance. But a nudge from the government to get you to consider your options seems perfectly responsible to me.

Again: my starting point is that the status quo will bankrupt us all - private industry and public finances. I'd rather not do this at all. But we have to make decisions at some point to live within our high-tech means.

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