August 13th, 2009
12:41 PM ET

Limit on health care for elderly, terminally ill?

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/08/13/jchealthcare0813.jpg caption=" Should there be a limit on health care for elderly and terminally ill people?"]

FROM CNN's Jack Cafferty:

Medical care for the terminally ill is a controversial aspect of health care reform that hasn't gotten much attention yet.

Pres. Obama raised the issue in an April interview when talking about his grandmother's final days. He said his 86-year-old grandmother wound up having hip replacement surgery during the final weeks of her life, after already being diagnosed with terminal cancer.

The president said he didn't know how much the surgery cost, and that he would have paid it out of pocket because it was his grandmother. He also said that if someone had told him she couldn't have a hip replacement and had to suffer even more in the last days of her life "that would be pretty upsetting."

But, the president added that's where "you just get into some very difficult moral issues" when deciding what medical treatment to give to terminally ill patients. Pres. Obama suggested that the chronically ill and elderly account for as much as 80% of our health care costs.

It's certainly a tricky moral question to say the least. On an intellectual level, it may be one thing to say it doesn't make sense for the country to spend so much money on people who are dying. But on a personal level, when it's your loved one suffering, it's an entirely different issue.

SO HERE'S THE QUESTION: Should there be a limit on health care for elderly and terminally ill people?

Interested to know which ones made it on air?

I'm 48 years old, HIV+, and healthy, but I have given this a good deal of thought. My answer is "Yes". I don't understand all the money spent on the terminally ill. It appears to be primarily based on a fear of death. I've made my decision on this issue. My instructions for myself to my loved ones are: Provide necessary pain management, say "Good Bye", and allow me to die naturally (preferably at home or in a natural setting).

My mother had a hip replacement 13 months before she died from cancer. My father’s insurance covered it, fortunately. Because of this, my mother was able to have a higher quality of life during her last year. She was able to regain her driver’s license and play on the floor with her infant granddaughter. This was a tremendous benefit to her quality of life. While on paper it makes no sense to do this, it needs to be done because it is the compassionate thing to do.

I am a registered ICU nurse. Far too many times – I have seen the useless, invasive procedures and tests that we do on patients that make no difference in their outcomes… All of us as health care workers see their suffering and the staggering cost. There has to be a better way of letting patients die in dignity and peace. As human beings, one thing we are certain of is death. Letting your doctor talk to you and your family about your choices is a good way to start.

No, there should not be a limit. We define ourselves as a civilization by the care and compassion that we offer to the least among us. I happen to be one of those people suffering from a condition classified as "terminal". I'm in good health now and have a full-time job. I take great care of myself. However, if something were to happen to me (I'm 45), I would hope I would have the right to fight for my life with some form of available health care.

Life is a terminal condition. At what point do we say enough is enough? When a doctor says you only have 10 years, 5 years or just a few months?

Filed under: Health care
soundoff (250 Responses)
  1. Nancy A. Lawrence

    Yes, I believe health care should be limited for the elderly or terminally ill. We are based on capitalism and supply and demand. It is just not fair that a ninety year old would be using resources that perhaps would be redirected from a twenty year old.

    August 13, 2009 at 5:10 pm |
  2. Pat Shaw

    I think it is unbelievable that our country would hold back medical treatment from a senior who is terminally ill. Now we are talking about euthanasia. Would that be discussed if our government officials had the same health care they are trying to force on us?.

    August 13, 2009 at 5:10 pm |
  3. Wm in PA

    Ration care for seniors and terminally ill? We are all aging and none will get out alive, we are all terminal.
    We have trillions for war – deficits be damned!
    We have more than enough to pay for medical care for all!
    Lets get rational and demand a single payer option. It is past time that the citizens representatives quit representing just the millionaires and do what will save the citizens of the nation.

    August 13, 2009 at 5:10 pm |
  4. kelly lane

    As a nurse and a senoir citizen myself i feel as with all things common sense should be the rule. We cannot deny palliative care and quality care to anyone, yet when we deny young families of health services and spend hundreds of thousands of dollars on some one who is terminal whit no hope of saving theri lives it is a very poor choice. The young deserve healthcare as much as the old, and preventative care should be instituted at an early age. We all are going to die,,,give great palliative care and make their end of life one of peace ..

    August 13, 2009 at 5:11 pm |
  5. Bob George

    If there is no"Qualityof Life" for the patient, as determined by the patient/or decision maker, Hospice is available vice "Life Sustainment" care. This would greatly reduce costs for all concerned.

    August 13, 2009 at 5:11 pm |
  6. Karen

    Keep the government out of health care. I prefer to make my own decisions with my doctor...I will choose what I pay for and what I don't!!

    August 13, 2009 at 5:11 pm |
  7. LouAz

    We are all "terminally ill". Your question is nonsense. You must think of it in some defined TIME PERIOD. What time period ? Humans have been talking about that for hundreds of years. The US Government will not make any statement or take any position on this issue in this Century. Why ask Blue sky questions ?

    August 13, 2009 at 5:11 pm |
  8. Kevin Oertel

    if the elderly and terminally ill patients desire care, they should get said care. However the limitation should be focused on quality of life. If the patient is going to suffer in any event, then make them comfortable until they cease to be.

    On the flip, if the patient is generally a miserable person who makes it a point to bring misery to others, then give them the option of a psychotherapy rehab along with their requested care. Or simply let them cease to be.

    Misery loves company, but come on, quality of life for those around that miserable person? Really? Pull the plug.

    August 13, 2009 at 5:11 pm |
  9. Deb Currier, Rn

    Do you know the definition of palliative care? And the definition of Hospice Care? Please interview trained professionals that can explain management of a disease symptoms and explain management of end of life care. Death can be as special as birth. Please speak to the ones who have experience and want to share the information to help people make decisions before a traumtic end of life event. Thank you for your time. Deb, RN

    August 13, 2009 at 5:11 pm |
  10. Beverly

    Jack, here's where end-of-life counseling and living wills become so important. I know that I, for one, would opt to be made comfortable, but not kept alive by extraordinary (and unjustifiably costly) measures meant to add days or weeks of low-quality life.

    Just because we CAN doesn't mean we SHOULD. Everyone dies, and the quality of life you can lead, regardless of age, should be the controlling factor, and hopefully, controlled by the individual in question.

    Concord, MA

    August 13, 2009 at 5:11 pm |
  11. noreen pylatuk

    tHANK GOD I LIVE IN CANADA . We treat our seniors with a lot more care and love than i guess your gov. does.

    August 13, 2009 at 5:11 pm |
  12. Robert Warshaw (RETIRED!!!!)

    Absolutely NO LIMIT> Who is going to play GOD in these cases.
    It reminds me; What is the difference between a Depression and a RECESSION. The answer is: If I lose my job it is a DEPRESSION. If you lose your job it is a RECESSION. Apply this thought to the terminally ill. If it is your RELATIVE pay all. If it involves my relatives, have a cap and let them DIE !!!!

    August 13, 2009 at 5:11 pm |
  13. Tom


    Most of the people who are terminally ill are on medicare and have paid into it their whole life. Now they want to take that right away from everyone who needs it. They have paid for their health care up front so there are entitled to it. Its like paying into your 401 and not being able to use it because you are terminally ill.

    August 13, 2009 at 5:11 pm |
  14. Joan

    Seriously? Should we add in the developmentally challenged folks too? Oh yeah, and how about folks with birth defects and chronic debilitating illness? Get real, Jack.

    August 13, 2009 at 5:11 pm |
  15. kevin sparks

    I am a RN and work in hemodialysis. I see patients every day that don't need to be dialyzed becuase they are terminally ill. now why are we as a nation spending so much money on one person to keep them alive a few days longer? We as a nation have got to ask ourselves how much longer can we afford to do this? It is very expensive to do these things and on a personal level we have to learn to let go of our loved ones at some point.

    August 13, 2009 at 5:11 pm |
  16. Gini Worthen

    Jack, we are ALL "dying" – we start to die the day we are born. That's when we become "terminally ill" and the only question is when.

    If a procedure increases the well-being, or at least decreases the discomfort, of someone regardless of age and the liklihood of death in the near future, they should have the option of having the procedure if they wish it. If insurance covers it for anyone, it should cover it for everyone. There is no way to draw the line.

    Gini Worthen
    Westbrook, ME

    August 13, 2009 at 5:11 pm |
  17. R. K.

    Life is a terminal condition. At what point do we say enough is enough? When a doctor says you only have 10 years, 5 years or just a few months?

    August 13, 2009 at 5:11 pm |
  18. L W Randerson, Midland, TX

    Medical costs should be borne by the recipient. Each recipient should determine how much he wishes to spend for whatever medical costs are incurred.

    August 13, 2009 at 5:11 pm |
  19. David

    Only if the patient's name is Dick Cheney. Jack, maybe if most of these people had healthcare coverage when their illnesses were manageable, that 80 percent may not be so damn much. The Government should stick with the current plan: provide health insurance and not get involved in physician/family patient care decisions. An ounce of prevention is worth a POUND of cure (at least in the UK).

    August 13, 2009 at 5:11 pm |
  20. Scott Hines; Janesville WI

    How typical of this country, that we'd spend decades persecuting (and prosecuiting) cases of assisted suicide which only help to provide dignity and control to suffering people in the last phase of their life; and then turn around and waste so much time and energy to actually debate the extent of care we'd provide the terminally ill. It would be laughable if it wasn't so sad.

    So we deny people the choice of ending their own lives when they need help, and then turn around and deny them certain kinds or levels of care because of how sick they are. Too sick to live, too sick to die. Could we be any more cruel? As if being terminally ill wasn't awful enough. God help us all.

    August 13, 2009 at 5:11 pm |
  21. conniesz

    It's limited already – so why are people suddenly noticing? You will always get what you pay for – and that will remain true even if the government is collecting the money. We cannot afford unlimited care for all – the rich will always have better, and more, care than the poor. What we're trying to do here is to bring the bottom level up a little without forcing anyone else to move down in their care coverage. If you have standard insurance from you employer and no pension (most of us), by the time you are elderly you will most likely be on medicare with whatever supplemental insurance you can afford. It is that supplemental insurance that will determine just how much beyond basic care you get – not the government option, which already rations care – a lot.

    August 13, 2009 at 5:11 pm |
  22. Sharon

    Federal funding does not equal rationing. We need to educate ourselves on all the options the elderly and terminally I'll have- it is always the patient's choice of treatment, regardless of the funding source.

    August 13, 2009 at 5:11 pm |
  23. renee

    If a person is close to dying and nothing can really be done to prolong their life with some quality, pain management would be the way I would expect the decisions to go.

    August 13, 2009 at 5:11 pm |
  24. Sara; Everett, WA

    Of course not.

    August 13, 2009 at 5:11 pm |
  25. lisa

    Perhaps we should ask Ted Kennedy.
    I truly think this a decision between doctor & patient–however, we NEED tort reform to make sure doctors are not sued by the survors.

    August 13, 2009 at 5:11 pm |
  26. Janet Weiblen

    I am a pastor so I have considerable concern for those who are dying; I often sit with families in hospice or share last moments with a loved one. In today's world where pallative care has advanced considerably from years past, there seems little reason to offer surgeries for those who are dying–unless there is a strong reason to believe that the surgery might prevent death.
    Perhaps the only reason to suggest such surgeries is to provide additional revenue to hospitals and doctors. In my opinion, that is totally irresponsible.

    August 13, 2009 at 5:11 pm |
  27. Gerald

    Ezekiel Emanuel, a top health-care adviser to President Barack Obama advocates withholding healthcare from the elderly.

    Can't trust the government no matter how they sugar coat it.

    Can't "Spend to Save"

    August 13, 2009 at 5:11 pm |
  28. Laura

    Hi Jack,

    We are all terminal. If people are in pain, they should be able to get treatment. It shouldn't matter if they are old or young.


    August 13, 2009 at 5:11 pm |
  29. Jonesey

    What would the answer to this question be in all industrialized countries, with the exception of the United States? You KNOW a health care system is completely broken when this issue needs to be addressed in the first place.

    August 13, 2009 at 5:11 pm |
  30. Karin Willison

    I believe that we sometimes over-treat elderly and terminally ill people, and that it often leads to more suffering, not less. We need to look at the benefit vs. the suffering caused by providing a specific treatment in order to make these decisions. Just because we CAN do something, should we? That is not a decision insurance companies or the government can or should be making. It should be in the hands of the doctor and patient/family. I trust the government more than I trust for-profit insurance companies, but I trust my family and my doctor most of all. They are the only ones who should be deciding who needs treatment and how much to administer. It's then up to whomever is paying to accept the word of the experts, and cover the costs.

    PS. Perhaps if we spent less money killing people in other countries, we wouldn't be struggling and arguing about how to pay to care for our own citizens.

    August 13, 2009 at 5:11 pm |
  31. Andrew Swaine

    When you dog is terminally ill you do the humane thing and put it down. When Grandma is terminally ill you hook up every machine and tube you can to keep her alive, Why? Is not the humane thing to let her die in dignity??
    Boston Ma.

    August 13, 2009 at 5:11 pm |
  32. Charlie

    This is what scares people – someone might deny care to a parent who will most likely die soon. No one outside a family should be able to make this kind of decision. End of life counseling is so valuable, as it was for three of my own family. It described options open to the family in ways that made decisions better informed. No one led us to make specific decisions, and no one urged pulling the plug. That was, and should always be, the family's decision. Living wills, informed by the patient himself were very helpful because they let us know what the patient wanted. Obama's plan does not suggest anything except getting information regarding the options.

    August 13, 2009 at 5:12 pm |
  33. Debra Comstock

    That is where an end of life consultation is important. My mother who died of Alzheimers refused to eat during the last few weeks of her life. Would it have been better to put in a feeding tube into a 91 year old woman so she could eventually die of something else? That would have been selfish and would have prolonged her life for what? There was no quality of life. A lot of these needless end of life medical expenditures are approved by the loved ones who aren't ready to let the dying
    go quietly and with dignity.

    August 13, 2009 at 5:12 pm |
  34. John

    Dumbest thing I've read or ever have read Cafferty ,limit health care for the terminally ill deserve the same or better health care than anyone else.You must belong to the obama network in thinking he is god but he isn't.I say limit health care to the wealthy and to the people who have never worked a day in their life and living off taxpayers.This health care obama and the democrats came up with is a joke all because you democrats have elected a president that has no idea what he is doing.One term president

    August 13, 2009 at 5:12 pm |
  35. Robert O'Grady

    Let me see if I got this right.

    The problem is we spend too much money on healthcare. Then wouldn't the solution be to spend less?

    And who is going to choose on what or for whom we spend less on. That's the question no one wants to answer.

    Never forget the road to hell is paved with good intentions.

    Fort Myers, Florida

    August 13, 2009 at 5:12 pm |
  36. Julie Austin, TX

    Whether healthcare reform is passed or not, there will have to be a limit for all groups of people who depend on the government for their access to healthcare. There is not enough money for new coverage or even many programs currently in place. Rationing is inevitable. I do not know how long it will take but there will come a time when the government will be called on to repay its debts.

    August 13, 2009 at 5:12 pm |
  37. Sharon

    Are you Kidding? Unless there is a Living Will, there should NOT be a limit on health care for the elderly and terminally ill. They should have the same health care as the young terminally ill. It is not our decision when someones life ends. You know, there are miracles until that last breath is taken. I am appauled that this should even be a question!

    August 13, 2009 at 5:12 pm |
  38. Richaerd Huff

    Yes. Under a living will.

    August 13, 2009 at 5:12 pm |
  39. Josh Molongia


    We don't want to spend money on those who are dying (Or are just very Ill) But we don however want to go out and bid on a glove that was worn by Micheal Jackson, I don't know I just see a problem with how people are thinking.

    Josh Molongia


    August 13, 2009 at 5:12 pm |
  40. deb

    Elderly got to be elderly because of good health care.. so no limit on the elderly.... terminal.... KEEP THEM COMFORTABLE !

    August 13, 2009 at 5:12 pm |
  41. Charlotte Araki

    My father, at 96, had a polyp removed and they made a hole in his intestine. Until then he was going great. He is of the age to take a doctor's word as God. He has steadily gone down hill mentally and physically since then. I have a living will. I want quality not quantity, I think assisted suicide should be a choice. I wouldn't let my dog suffer the way most people believe humans should. Isn't it all religion based?

    August 13, 2009 at 5:12 pm |
  42. Nell, Clemson, South Carolina

    Some treatments do not make sense for terminally ill people. Sometimes, it is better to keep a person comfortable than to put them through surgery that will not relieve suffering or prolong life.

    August 13, 2009 at 5:12 pm |
  43. Anthony

    No, Healthcare should not be limited for the terminally ill and elderly. Life is about quality of life and while they are alive, they deserve as good a life as the rest of us (In principle).America has gone too far, freedom and the pursuit of happiness have turned into every man for himself and stepping on one another. The elite in society reap the fruits of the labour of the less fortunate. People are now viewed as capital rather than people. So profit is privatised while the costs of business are made public. Have Americans gotten to the point where they truly gotten to the point where you lack empathy for one another??. Healthcare should be a right not a commodity.This was not the American Dream. But what do I know....i’m just a socialist Canadian, because we aren’t free up here...right.

    August 13, 2009 at 5:12 pm |
  44. Jack Brennan

    At the end of my dad's life at age 79 he was in intensive care. He wanted to live if he could be healed and the family was concerned that we were putting him through "too much". I wise physician told my sister regarding the decision to try one final procedure to isolate the microbe that was causing his phneumonia the following. "Do everything there is to do until there is nothing left to do." The decision must be between the patient, the family, and the physician. I think the President is probably inexperienced and not close enough to the issue of treatment for the elderly. Not to worry he will get his turn. We almost all do.

    August 13, 2009 at 5:12 pm |
  45. Bill

    Jack, I don't believe there needs to be a limit for terminally ill or elderly people. While it's true they may die soon; they just as easily might have many more years. Denying health care to them because somebody says they will die soon is wrong – and I certainly don't want to have to make that call. I'm sure others don't either.

    August 13, 2009 at 5:12 pm |
  46. TJB

    In a private system ... no. In a government run system there has to be. This is the conundrum those supporting nationalized healthcare face. They want to establish healthcare as a "right". Freedom of speech is a right. Freedom of religion is a right. Freedom from oppressive and tyrannical governments is a right. A right has no bounds, no monetary limit, no equitable burden on society as a whole. In other words, you don't say "Freedom of speech is a right ... as long as you don't use up more then $50 of my time.... when you hit $50.00 then you have to stop talking". The house bill under consideration establishes healthcare as a "right", so illegal aliens are entitled. However, the basic coverage has limits of $5000/year/person or $10,000/year/family. That's not a right, that's a ration – and a very small one at that. There is no "moral issue" with a private system. You get what you can afford, or what charity is willing to put forward. Placing the responsibility of deciding who or what gets covered on society imparts the moral issue. So under nationalized healthcare each time a person is denied coverage for any reason, each and every one of the 300 million or so Americans is 1/300,000,000th responsible for that decision. Nobody wants to deny granny or anyone else healthcare, however it is not moral to lay the burden of those inevitable denials on the population in general nor is it moral to put such decisions in the hands of an emotionally devoid third party with a vested interest in the least expensive outcome. Just remember ... we are all terminally ill – some of us just have more time then others.

    August 13, 2009 at 5:12 pm |
  47. Paul

    I have already told my family that if I am terminally ill and only have a certain amount of time left to live that I would not want to be kept alive indefinitely. I would love to have the option of assisted euthanasia.

    August 13, 2009 at 5:12 pm |
  48. Connie

    Hello, this is Connie in New York City.

    Medical Care available to every citizen including the elderly, the homeless, the terminally ill, AIDS patients, even drug addicts, is to me, the hallmark of a truly advanced, healthy society; a society that accepts the mutual responsibility of taking care of each other and a society I’d be very proud to be a part of. And yes, I’d be willing to pay higher taxes to achieve this (even though I’m in the under $100,000 per year category). I understand, however, that the cost for this would be very high and for the benefit of the whole I would put limits on treatment for the terminally ill. I would say that only if a procedure had life-saving potential should it be performed in the case of the terminally ill. I would leave this determination up to the judgment of doctors who have taken their oaths regarding the health and well-being of their patients. Perhaps a consensus of 3 doctors could be required to make a final decision, but something like a hip-replacement surgery 2 or 3 weeks before passing doesn’t make a lot of sense. My intuition tells me the operation itself would bring a lot of pain to bear when someone is already very weak.

    August 13, 2009 at 5:12 pm |
  49. Jason

    At a certain point a realization has to be made that people are going to pass on and we need to stop excessive medical care. Ease their pain but when we somebody else is paying for it, limits need to be placed. A hip replacement for a terminally ill patient seems to be excessive

    August 13, 2009 at 5:12 pm |
  50. carolo

    No doctor should be doing surgery or other procedures on a person unless it will better their life. To simply do unnecessary procedures to pack their wallet and add more suffering for the patient should not be allowed.

    People need Living Wills. It's silly to lay for years in nursing homes on life support.

    August 13, 2009 at 5:12 pm |
  51. Patrick

    No there should not be a limit for health care for the elderly. In fact, we should show more compassion and understanding and make their remaining years on Earth as comfortable as possible.

    August 13, 2009 at 5:12 pm |
  52. Karen

    Is the hip replacement for a terminally ill patient supposed to relieve suffering? I guess that will have to be decided by the someone else if the patient neglected to have an advanced directive.

    August 13, 2009 at 5:12 pm |
  53. Pat in Georgia

    The issue isn't as simple as a "yes or no" answer might suggest. Pain reduction, health maintenance and quality of life procedures should never be denied, regardless of the patient's age or prognosis. What's not so clear is whether optional treatments should be performed just because a patient can pay for them. The reality is that poor people have limits placed on their health care right now.

    August 13, 2009 at 5:13 pm |
  54. nancy


    It should be up to the family and the patient. What are we becoming;
    A country of uncaring people?

    There is too much in the "bill" at the moment. Slow down ...read....think

    America needs our prayers....badly!!!

    August 13, 2009 at 5:13 pm |
  55. Andrew

    This is a very tough issue. Unfortunately with the way these town halls are going I dread the day they try to have a national discussion about this. There won't be any nuance allowed by these town hall 2 year olds because the second you try to have a honest discussion about terminal illness these people will let their emotions control the flow of conversation, and not cold hard facts. Right now if you are terminally ill and insurance won't cover something, and you can't afford it, you die without it. So why is anyone worried about "death panels" when we already have them with private insurance and none of these right wing 2 year olds seemed to mind until now?

    August 13, 2009 at 5:13 pm |
  56. Adam

    Absolutely not. Putting a limit on the terminally ill and elderly sends a message that says "Those people do not have much longer so who cares". It is absurd and of low moral character to just cast these people off to the side when it comes to treatment. It is your right as an American citizen to remain as comfortable and painless as possible during an illness until your last breath.

    August 13, 2009 at 5:13 pm |
  57. Pete Chamings

    Jack..we're all terminally ill in that we're all dying from the moment we were born..some sooner than others..illness and death don't discriminate with age or circumstance..all life is sacred and should not have a monetery value put on it

    August 13, 2009 at 5:13 pm |
  58. Marsha from Kansas

    Elderly people and even terminally ill should have whatever medical help they need. But it would not be terrible to to lay it on the line with them regarding how much help the medical intervention will be. If an elderly person is honestly told that a hip replacement will not make them totally mobile again and will be painful and involve a long therapy program he or she might decide against it. As it is now they will be provided the treatment whether it will ever improve their situation. I know of a lady who just passed away in a nursing home who had a knee replacement that she never had the strength to use. She could at least walk before but never got out of the wheel chair after. Sad situation.

    August 13, 2009 at 5:13 pm |
  59. EbonyW

    There should be a limit on ALL government-sponsored healthcare benefits. If patients wish to bill over the government limit, then they should pay out of pocket. Healthcare is a human right but we must be financially responsible.

    Ebony W.
    Washington, DC

    August 13, 2009 at 5:13 pm |
  60. David P Vernon

    Tucson, AZ – Yes, but not a dollar based one. Too much of the care given the terminally ill merely postpones death but does not improve their quality of life. Heroic, invasive, and intensive care was intended to keep people alive while they heal, not keep them breathing so that they take longer to die. The limit to care should be based on prognosis – my question is how long the Obama grandmother enjoyed that new hip before the cancer killed her. If it was several months, that might have been worth it. For less than amonht, it would not have been. There are now transplant committes the dole out organs to those who will benefit most. Intensive end-of-life care is probably not worth it for anyone.

    August 13, 2009 at 5:13 pm |
  61. Bob - Pittsburgh Pa

    If you are terminally Ill with Cancer and the Doctors say you have maybe a year to live, but with this treatment, you might get 2 or more years. To you life is precious and another year is a good thing.

    In this Plan, the Government can decide No, it is not a cost effective course of action and you just get pain pills and death. You have no recourse, the "Commissioners" decision is final and cannot be challenged, even in court.

    I thought we all were striving to live in a humane country, not an Ant Colony.

    August 13, 2009 at 5:13 pm |
  62. haeli

    Im not prod to be an american. Are we really suggesting our parents and grandparent life simply cost too much? So should we just let them die? Private jets for gov.officals, huge oil profits, corporate takeover.. Who needs the elderly? They only birthed, raised and taught us? Their comfort should be a priority. When I have children I will not raise them here.. Im not proud to be an american anymore

    August 13, 2009 at 5:13 pm |
  63. Angela

    "NO" on limiting healthcare for chronically ill and "Possibly " for limiting heathcare to terminally ill. The chronically ill may come out of whatever the cause of their illness is and deserve to be treated as if they will be cured, but the terminally ill will not. Now, that doesn't mean that they should not receive reasonable, compansionate and affordable care. Everyone should be entitled to whatever level of care is reasonable for their particular situation. Now, should Pres. Obama's grandmother have gone through hip-replacement as a terminally ill patient? Well, that depends on the term portion of the diagnosis (how long was she expected to live), but I suspect ...not. That's a LOT of pain and discomfort to go through and when the prognosis was fixed anyway....for MYSELF I would say..'why bother' Let me tell you: I had an aunt who got a physical exam before she was scheduled to move to CA to be with a sister. She was diagnosed with terminal cancer. She didn't go to CA and refused all unnecessary medical treatment. We've always admired her for facing her reality with such brovado!

    August 13, 2009 at 5:13 pm |
  64. Maria Beaton

    My husband IS terminally ill and we have stopped trying to find a treatment for him, instead, carrying out his wishes that we keep him comfortable and treat the coming pain.
    Had he wished for aggressive but futile treatment, we would have done everything we could.
    There should be no one stop solution for anyone. it should be left up to the individual.

    August 13, 2009 at 5:13 pm |
  65. Lora - PA

    If I'm terminally ill or just old and sick I should be able to choose euthanasia. Besides being humane and allowing people to choose to die with dignity, it would be a big step in saving money on medical care that's given just for the sake of keeping people alive until the last possible minute.

    August 13, 2009 at 5:13 pm |
  66. richard jaffee

    I've been waiting for this key issue to be brought into the healthcare debate. In a word...YES. A rules-bases system that limits spending on the terminally ill or elderly. It must cover paliative care, but not the very costly treatments that only add weeks or months to someone's life. It is the only way our overall system can be kept financially sound. Painful, but necessary choice for all.

    August 13, 2009 at 5:13 pm |
  67. DeeDee

    This question may be the most gut wrenching question I've ever seen on the Cafferty file. It gives me a headache and a stomach ache just to think about it. How can we not do everything in our power to help another human being and yet is it cruel to perform surgery on people who have already been given a death sentence? This seems like a question for God. We mere mortals don't have the capacity to figure this out.

    August 13, 2009 at 5:13 pm |
  68. Elizabeth A Keep

    The only limit should be to avoid any treatments that do not add to the comfort of a terminally ill patient. As for chronically ill, there should be no limits because the person doing the limiting forgets that they are one diagnosis away from joining the chronically ill themselves. As mu Mother used to say about aging " As you are now, so once was I. As I am now, so will you be someday"

    And where would it stop? There are no limits suggested on the 100s of thousands of dollars spent on infertility treatments and the millions spent on disabled children who will never be anything but a drain on society. No health care for anybody below a certain IQ level? Denying care to one group starts society down a slippery slope on which we do not want to travel!

    August 13, 2009 at 5:13 pm |
  69. Frank Stacey

    I believe there should be limits to health care coverage for terminally ill patients regarding further elective surgery, but I don't think hospice coverage should be eliminated. Elderly patients should receive at least the same care provided to them now under Medicare.

    I think we should fix the health plan we have now and not try to reinvent the wheel. Allow menu choices that would eliminate unneeded benefits. Some people don't need or want maternity, drug and alcohol, chiropractic, holistic healing, or dental coverages, but we require health companies to include them, thus raising premiums for individuals. We need a serious dose of common sense and patience. I am not at all comfortable with Pres. Obama's rush to implement a new and untried health care systems which is riddled with layers of bureaucracy.

    August 13, 2009 at 5:13 pm |
  70. Sherry Flynn

    Who are we to play God? This country was founded for freedom, for equality. Illness, unfortunately exists. People deserve the dignity and compassion of others when dying, or living with a chronic illness. It is our responsibilty and moral obligation to take care of our fellow countrymen. If money is to be saved, bring our troops home. Curtail space exploration until our budget allows it. We are talking about human beings. This is unbelievable. What has our country come to?

    August 13, 2009 at 5:13 pm |
  71. Carlito Nicolas

    insurance companies get $ 177 billion of taxpayer money to provide service to Medicare for the elderly patients,
    there is no such thing; limit on helath care for the elderly in the bill.
    The Administration anticipates saving hundreds of billions of dollars by reforming the current Health Care system, and extends coverage to 50 million uninsured Americans. Through this process, they will increase the efficiency of medical care by better connecting payments to health outcomes, and discouraging doctors from performing unnecessary tests and procedures, no such thing as putting a limit on health care for the elderly,

    August 13, 2009 at 5:13 pm |
  72. Brandon - Alaska


    How can someone who knows they are going to die within a matter of days/weeks be selfish enough to waste so much resources so they can stare at a hospital ceiling for a little while longer. Life ends. Say your good-byes, pull the plug. Cold-hearted? Close-minded? Rediculous? Call it what you will, I'm just being realistic.

    August 13, 2009 at 5:13 pm |
  73. Mich

    their should be know limit on health care at any age. Even though the people who give obama advice have written in the past about systems of health care that would give better treatment to younger people then the elderly. I'm not sure what's going on with this issue. No one will let anything happen to grandmom like they say. Yet some of the people advising Obama have a different way of looking at the country and issues like this. It just makes it hard to trust them in anything they say.

    August 13, 2009 at 5:13 pm |
  74. janice jones

    What a moral dilemma who gets to play God and decide who receives care and who doesn't . My father was 98 when he had a bad fall and broke his collarbone in Australia he received outstanding medical attention and lived to his 10lst birthday. I can say it was an honour and a priviledge to have spent the last years of his life with him and we were still going out for happy hours to various clubs, lunches and family outings until two weeks prior to his passing.
    Imagine if a decision had been made not to have healed his body when his mind was so wonderful.and
    active. I pray for the US that the right decisions are made regarding your health care.

    August 13, 2009 at 5:13 pm |
  75. John Tollett

    Jack, i think thats up to the family to decide whether to pursue treatment. I think the medicare should stand behind whatever decision the family makes.

    August 13, 2009 at 5:13 pm |
  76. Roberta

    No there should not be a limit on health care for the elderly and terminally ill. Perhaps to help fund health care for these groups money spent on the incarcerated could be pulled away from the prison system and given to those not living out life sentences. Often prisoners are better cared for than most working poor or even more and more of the middle class. ;(

    August 13, 2009 at 5:13 pm |
  77. Sarah

    A nation must decide how to allocate limited resources to provide healthcare for the population. If the same proportion (the 80% used up by the elderly and terminally ill) were being allocated to another population such female minorities just to use an example, the rest of the nation would be in an uproar. Unlimited high quality healthcare is no longer viable. We need to focus and incentivise wellcare and heath maintenance. Difficult decisions must be made in order to maintain its future viability.
    Port Ewen,NY

    August 13, 2009 at 5:13 pm |
  78. Bruce

    Dear Jack,

    Why should the taxpayers pay for medical care for someone who is going to die anyway. I know it may sound cruel but it is the reality of the situation.

    August 13, 2009 at 5:13 pm |
  79. Carol Creamer

    Dear Mr. Cafferty,
    What we are hearing and seeing enacted before our collective socio-political eyes is an applied ethical dialogue regarding each individual's right to life. This is, of course, one of the fundamental platforms of our Constitutional "sui generis," the others being the rights to liberty, and the right to the pursuit of happiness. May I point our that it is impossible to have liberty or to pursue happiness if one is deprived of existence? Terminating health care for the chronically or gravely ill, which would suggest an implicit termination of life, is in fact a violation of our civil rights.

    August 13, 2009 at 5:13 pm |
  80. Billy Wheeler

    All moral questions are "tricky" until they become personal. The only moral answer is...There should be no limits on health care, not for the elderly or young, not for the terminally ill or healthy, not for Christian, Jew, or Muslim, not for liberal or conservative.

    The interesting philosophical question is not should we limit health care, but who will make the decision to limit heath care, the government, the insurance company, the doctor, the family, or the patient? I once knew how Americans would answer that question. Now, I'm not sure and that is what scares me.

    August 13, 2009 at 5:13 pm |
  81. Carolyn T.

    The answer is a resounding NO! Why are we even asking these questions when the presidential campaigns of both Obama and Mccain cost in excess of 500 million dollars. Amounts that would well have covered the healthcare reform that we so greatly need in this country. We have to get back to believing that PEOPLE MATTER!

    August 13, 2009 at 5:13 pm |
  82. birdy

    of course it does not make sense for a very old person with a terminal illness to have hip replacement surgery as the surgery itself and its aftermath can cause just as much pain as never having the surgery. the point of the surgery is to heal and recover so that one can live a fruitful life. if it does neither, then it is a completely pointless surgery indeed. why suffer the pain of surgery when already suffering. it makes absolutely no sense.

    August 13, 2009 at 5:14 pm |
  83. Keith Brooks

    I am so glad that the government is willing to make the tough decisions for us. In President Obama's case, I am also glad he has the money to override those decisions for his family. I wish I had his kind of money so I can override government decisions for my family, however I don't.

    August 13, 2009 at 5:14 pm |
  84. Brady in Winchester, VA

    Yes there should be. What you asked is sort of extreme but doctors should be required to do what is necessary to keep a patient comfortable but I cannot see where surgeries as such should be an option. On the other hand, a doctor should prescribe enough pain 'management' that a patient is not miserable. But is it ethical to allow a patient to become addicted to drugs? I personally believe you do what is necessary, whether ethical or not. After after all, they are dying!!

    August 13, 2009 at 5:14 pm |
  85. John in Salt Lake City

    Yes, there should be limits from a public option plan. Private insurance can pay according to policy or as an supplemental. The Presidents grandmother or not there simply is no utility in it. It isn't mean or unkind, we just can't go bankrupt fixing people with a few months to live anyway, that's for Hospice Care. As a Registered Nurse I have rarely seen advanced elderly do well with any kind of surgery. We love our Grandmas, we just cant afford to throw away resources that could be used on patients that can make a difference, like a 30 something with breast cancer.

    August 13, 2009 at 5:14 pm |
  86. Anne Wild

    Who are we to answer this question? Especially as a blanket statement for all. I do not see anything in the Constitution that gives anyone the power to choose when care is appropriate or not appropriate.

    If individuals/groups purchase policies that cover certain treatment, it should be covered. The same goes for routine (preventative) care, dental, x-rays, etc.

    Maybe the real question is how to sell/choose "basic" insurance that people can purchase for certain services that is not tied to state/federal mandates. Then, determine pricing for "add ons" for those who want to pay.

    August 13, 2009 at 5:14 pm |
  87. fideauxdon

    It depends on how you define the issue. Obama is dead right in adding counseling to his health care bill. We don't want anyone playing God, but realize that most people, when they approach their final year of life, don't know what a Living Will or a Health Care Surrogate is. By just explaining this to people, I'm sure that the majority of them, as they approach death, would opt out of high-cost procedures which do nothing but prolong their agony. When my Mother approached the end of her life, with her mind and body seriously slowing down, her greedy dentist talked her into the need for serious dental work, despite the fact that osteoporosis had pretty much destroyed the facial structure needed to hold her teeth in place. Potentially, counseling would have prevented this.

    August 13, 2009 at 5:14 pm |
  88. Kent Crombie

    It's a very difficult issue. 2 years ago we faced the decision with my 87 year old mother who had a very severe stroke. The doctors told us that we could only keep her alive with a feeding tube and respirator and that she would need full time care for the rest of her life. Mom would never be able to eat or breath on her own. She had made it very clear numerous times to our family and her friends that she didn't want to live on machines. She was even able to communicate that to the doctor and I at the hospital. As an only child, the final decision was mine and I decided to honor her wishes. Some days I feel that I absolutely made the right decision for her; on other days I feel very guilty.

    August 13, 2009 at 5:14 pm |
  89. Stuart Washington

    Hey, Caff. That's not part of Obama's program. It's a fine question but aren't you just feeding into the propaganda that these "birthers" and "deathers" want us to? Nobody wants to leave the terminally ill to die. Yes, it would be immoral but it also wouldn't be part of the health care debate if it weren't for Sarah Palin's twisted imagination.

    August 13, 2009 at 5:14 pm |
  90. Veronica McNamara

    As a person who has worked as a nurse both in England and the US, including care of many terminally ill patients, certain procedures which common sense dictates will not prolong a quality life should not be instigated. Remember, we are using the word 'terminally'. The important thing is to keep terminally ill people comfortable and pain free while caring for them respectfully and honoring their wishes. We put our animals 'out of their misery' people should have the same OPTION. Thse who disagree, should, perhaps, volunteer for hospice work and get their eyes opened.

    August 13, 2009 at 5:14 pm |
  91. AJ

    The type and extent of care we will receive when we are terminally ill is an individual decision, within reason . Unfortunately very few patients are in control of their mental faculties when the time comes to actually implement these decisions, thus leaving their families, loved ones and healthcare providers guessing what their wishes were, after-the -fact.
    This debate underscores the importance of advance end-of-life planning: sitting down with your loved ones, drafting a living will and designating a health care proxy is the best way to minimize the moral diffculties, conflict, heartache and unnecesary suffering that too often dominate these situations when they arise.

    Yuma, AZ

    August 13, 2009 at 5:14 pm |
  92. Amy

    The elderly are covered under medicare so I don't even know why this is coming up. The revisionsto the health care system are targeted at working people & the poor who can't get health insurance or who get dropped.

    August 13, 2009 at 5:14 pm |
  93. Jennifer

    While I think providing extensive surgeries and advanced medical care to terminally ill patients is a futile effort and I would not advocate it for myself or my family, I don't think the government should play ANY role in determining the care I choose for myself or my family. This is a matter of personal and family decision. I am a huge proponent of palliative and hospice care. By the way, I am a surgeon.

    August 13, 2009 at 5:14 pm |
  94. s b s

    Where does it stop?

    We start with the elderly, then the terminally ill, next the obese people, then the gays, the blacks, hispanics, Republicans, etc.......

    And before you know it, we have Obama / Pelosi making the choices, not unlike Hitler.

    So if it was wrong for Hilter to decide who lives and who dies, what makes it right for Obama / Pelosi to make those decisions?

    August 13, 2009 at 5:14 pm |
  95. Maria Wilkes

    No, there should never be a limit on health care for elderly or terminally ill people. When it comes to health care, money should never be an issue. The main priority should be to do all one can to improve a persons life at that moment without "time" or "money" being an issue. Every person in this country deserves the same Civil Rights, equally, and if certain rights are granted to some yet denied to another due to age or illness then any politician that advocates this should be immediately impeached for not upholding the constitution....Senator or President, it doesn't matter, impeachment is the ONLY option.
    Maria Wilkes
    Rockledge GA

    August 13, 2009 at 5:14 pm |
  96. sally

    The very people who are using the most money for healthcare are the same who fought WW2, Korea, Viet Nam. Spouses staying home and raised their families and worked. WW2 and Korean War the women were working in Civil Defense, Douglas Aircraft, North American Aviation, Pratt and Whitney, etc. Now we are supposed to say, "you don't pay taxes anymore, therefore you are of no importance and therefore you will die, either in agony or with the help of Morphine and Ativan (shuts down the respiratory system).????????

    August 13, 2009 at 5:14 pm |
  97. Taylor from San Franicisco, CA

    I think terminally ill people should be allowed access to health care but after a certain point I think they should cover costs out of pocket or at least pay more into the national plan. But another question arises: What do we do with people diagnosed with terminal cancer who have survived long past their doctors' expectations?

    August 13, 2009 at 5:14 pm |
  98. Mike

    Really, what was the point of a hip replacement during a terminal illness? If the goal is to "have a hip replaced" then it worked....but to what end? Just to say that it was done? Great.
    Rather, attention should have been paid to the comfort of the patient. Ask anyone that had had a hip replaced, there is no comfort in the time just after surgery. Additionally, there is a rehabilitation time that must be spent. Was Obama's grandmother really better off as she lay on her death-bed with a new hip....I would say that that piece of titanium went to waste and should have been implanted in someone who would have used it to it's fullest extent.
    We must focus on quality of life, not on a menu of procedures that can be performed just to get them performed. This is not rationing. It is called good medicine as defined by every major physician association.

    August 13, 2009 at 5:14 pm |
  99. Candy Wilson

    I feel I have a right to comment on 2 folds..#1. I was a practicing RN in Critical Care for over 30 yrs.. I also worked in the nursing home setting the last 5.. I now also have a disabling disease.. I have end-stage COPD which requires Lung Tranplant to repair. This disease was also I must add brought about by my smoking.. At present I am managed by pulm rehab and meds I manage to work (volunteer) in my church on Fri's.. So should I lose my healthcare.. I surely hope not.. In fact I campaighned for Sen Obama because I am in favor in Universal Care.. And now he is doing something to make this transplant possible by passing law which will close the donut hole in meds which has beeen the stopping point of my being able to proceed.. So I hope I am not one of what Sarah Palin calls death panel candidates.. As a nurse, the panel is exactly what we need.. TOO many times the ems unit goes out on a call and the patient dies enroute to hosp.. there is nothing on the patient to determine their wishes so therefore the team works to save their life which includes intubating and putting on a breathing machine... then the family comes and says oh they didn't want that! Look at the waste in time money and equipment...the panel would alleviate that.. and as far as hospice... ask anyone hospice is the greatest care for the terminally ill to allow them to die with dignity.... and above all, alleviate pain.. I am on Medicare and I am fine with a panel discussing my case; I applaud it... Also I am fine with being evaluated every 5 yrs... From what I saw of Gov. Palin's parents, I don't think she has a problem. They looked very heathy to me....And if she would check the gentleman advising the pres. on this(Down Syndrome) issue has a handicapped child also...So I don't think she has anything to worry over in regard to her son either....thankyou for allowing me this time

    August 13, 2009 at 5:14 pm |
  100. Cindy in Texas

    "Elderly" and "terminally ill" are two different matters. They should not be combined in the question. Being "elderly" at 78 years of age but in good health, does not compare with someone who is "78" years of age and terminally ill. Do we also stop treatment on someone 35 years old because they are terminally ill? Of course not. So why should it even be a question. When my otherwise healthy 92 year old father had a stroke and was "terminally ill" they asked if we wanted to insert a feeding tube. I asked the doctor if putting a feeding tube in him would allow him to get up and go home, the doctor stared at me and said, "well, no." So I told him, then don't insert one. My dad died peacefully and in dignity, 4 days later.

    August 13, 2009 at 5:14 pm |
  101. Dick Lepre

    You have made a massive mistake. You state, "SO HERE’S THE QUESTION: Should there be a limit on health care for elderly and terminally ill people".

    That should not be one question but two. What level of mindlessness confuses "elderly" with "terminally ill"?

    August 13, 2009 at 5:14 pm |
  102. Anne Coleman

    People! Old, Young or Terminal should be allowed to die with dignity. If that means an expensive procedure, then so be it! Whatever it takes to make the last days tolerable and comfortable. The procedures that should be questioned are those that allow prolonged suffering... such as weekly blood transfusions when we know survival is not possible. This may help the family have a bit more time, but the patient is suffering in many of these cases.

    August 13, 2009 at 5:14 pm |
  103. John Ebin

    Jack; Nonsense!!!!! Even after all of the compassionate issues are to be overlooked by the Obama Gang, how about the fact that these Seniors have paid in to Medicare System all of their lives and they now are to be denied coverage because they maybe elderly or terminally ill!!! Many of the terminally ill and elderly make miraculous recoveries and/or live on for years--IN PAIN?????

    Sarasota, Florida

    August 13, 2009 at 5:14 pm |
  104. Mike from Indiana

    Get the facts straight. The two biggest hits on our health care system come from premature infants and in the last week of life.

    Thre should be no limit on health care for the elderly or otherwise terminally ill patients until the last week of life.

    When I'm down to my last few days, stop intervention and just give me one IV of heroin that I can control.

    August 13, 2009 at 5:14 pm |
  105. Adam

    This is why the counseling and living wills are so important. We cast blanket ethics on these kinds of ideas- we make up anecdotes about dying old people- and then we get angry at our stories and throw the baby out the proverbial window.

    If I'm old and dying, I probably don't want hip surgery. If I do, I pay for it. How is this rationing? It's not like I won't get care- I just have to pay for it.

    August 13, 2009 at 5:15 pm |
  106. Michael

    There are already limits placed on healthe care. Americans have been led done this path by our leaders not being able to discuss the hard truths. Nothing is free and we can't have everything because we don't have the money to pay for it.

    August 13, 2009 at 5:15 pm |
  107. Stephen Bleetstein

    I think those people who want limits on health care for the chronically and trerminally ill should sign a declaration that they themselves will decine this care, and allow the rest of us to get the care we seek and desire.

    August 13, 2009 at 5:15 pm |
  108. shirley sherbahn

    If I am terminal, and there isn't a possibility that I can survive the disease, then I would rather just have the pain meds and be made comfortable until the end. Sometimes the treatment makes the quality of life a lot worse, especially with chemotherapy.

    Prescott Valley AZ

    August 13, 2009 at 5:15 pm |
  109. Donna Shea

    My mother is 93 and has been in a nursing home for 5 years. She and her roommate and several of her dinning table mates comment on the fact that they just want to die and get it over with. I think Living Wills should be more detailed outlining many more procedures that patients can choose to opt out of. I definitely think that hip or knee replacements for patients who are already wheelchair bound due to other health issues do not make any sense. Another instance where doctors did not use common sense involved by 96 year old friend who had been in a nursing home because of a broken hip. She was clearly dying from congestive heart failure–struggling for every breath when her orthopedic surgeon wanted to have her taken to the local hospital for an x-ray on her hip to determine whether she would walk again. I would not allow them to take her out of her warm room in the middle of winter to ride in a cold ambulance and sit in a hallway at the hospital to be x-rayed when she was barely conscious. I certainly feel that health should be limited when the outcome does not justify the procedure.

    August 13, 2009 at 5:15 pm |
  110. C. Clinton Hourani

    Limited Heath care to the elderly? Haven't they suffered enough? Seems like they are treated like a burden here in America. It's a shame you would even ask such a question. Hold on Jack your one step from "elderly" are you not going to need health care too?
    We are all Americans weather we are young.old,dying,black,native,or white we deserve to be treated equall!!
    Cathina Clinton Hourani

    August 13, 2009 at 5:15 pm |
  111. Josh

    It's not a yes-no question and attempts to boil it down to that are just partisan politics.

    August 13, 2009 at 5:15 pm |
  112. Dj

    Private health-care can be included in offering additional payment for health service. This way, everyone can receive a large amount of health-care regardless if they are in the lower income bracket in their elder or limited years.
    Set a limit for government funded health-care. This will create more jobs in many health working fields and it will not interfere with private and additional health-care.

    I don`t see what the problem is??..

    August 13, 2009 at 5:15 pm |
  113. Robert Mattnies, M.D.

    I'm a family practice physician in Prescott, AZ, and have dealt with this type of matter repeatedly. My quick response is, "That's the wrong question". The more appropriate and ethical question is, "What would the patient want if capable to understand the situation?". When asked that way, the answer often(NOT always , though), is "Just let me go, I'm ready". Allowing a natural death is not at all the same as causing a death. I explain how we can easily keep the person comfortable, and that artificial means of survival, i.e., feeding tubes and IV's, may cause MORE discomfort than simply offering if wanted. As far as "playing God" is concerned about withdrawal of life support, my response is that we "play God" when we initiate life support. This is a complex issue in some ways, yet most people, patients and families, are grateful to have this conversation, to relieve guilt and blame, and act respectfully. In fact, I was just able to help a wife with this matter at a meeting I attended this afternoon.

    August 13, 2009 at 5:15 pm |
  114. Pat, Ohio

    Every is concerened about how they are going the get their slice of the healthcare pie. What about the doctors who are going to provide this care? Are they going to get their slice of the pie or are they going to end up getting the crumbs?

    August 13, 2009 at 5:15 pm |
  115. Frederick Welsh

    There should be a limit on health care for the terminally ill. Again and again, we hear of cases where tens to hundreds of thousands of dollars are spent on people with less than a week to live. Many terminally ill patients are living in prolonged agony thanks to the additional, but futile care.

    August 13, 2009 at 5:15 pm |
  116. Tom Looze

    Absolutely not!! The very idea is abhorrent to anyone who has any respect for human life. That is a decision to be made by the individual in consultation with his/her doctor and family, and in no way should the government have any say whatsoever.

    This notion of cost-effective health care sends shivers down my spine. What chance would people like Franklin Roosevelt, Helen Keller, Christopher Reeve or Stephen Hawking have in Obama's brave new world?

    Tom from Roselle, IL

    August 13, 2009 at 5:15 pm |
  117. Stephen

    As a nurse i think no patient should have care rationed or restricted. We give care were care is needed, and we can afford to do so if we cut waste and fraud. Thanks for educating and clarifying.

    August 13, 2009 at 5:15 pm |
  118. Nicole Rose Galvan

    A patient is a patient until the day they expire. My grandmother had catarac surgery just 6 weeks before she passed away and her last few weeks were wonderful for her! She could see so much better! but most of all her balance had improved dramatically and she was able to get around and live her life! To deny someone terminally ill the right to care that would otherwise be given to anyone else is to de-humanize them. I believe that medical professionals have a duty to ease suffering, and treat disease under any circumstance. One should be shown the same respect, dignity, and care that anyone else would receive, ESPECIALLY at the end of life. There should not be a price tag for quality of life, even at its end.
    Tempe, Arizona

    August 13, 2009 at 5:15 pm |
  119. Bert Clanton

    My logical mind says that spending a great deal of money to give a lot of medical care to people who will soon die doesn't make sense.My heart says that forcing people who are already suffering to undergo additional suffering at the end of their lives doesn't make sense. My heart wins.

    August 13, 2009 at 5:15 pm |
  120. Michael, New Orleans

    There should be limits on terminally ill patients, with a focus on comfort care and pain management. Reforms are needed badly because most terminally ill people with good insurance become jackpots for the doctors and hospitals.

    August 13, 2009 at 5:15 pm |
  121. Adam, Seattle WA

    Why don't we just let their families and doctors decide?

    August 13, 2009 at 5:15 pm |
  122. Bill in Colorado Springs


    What a set up for a sucker question. You know this is a catch 22. You are damned if you do and damned if you don't. If you withold needed care, then you just made Sarah Palin's claims of "death panels" true. If you give all the treatments that the terminally ill person "needs" then you are truely throwing good money after bad. In reality this topic is best debatted by the medical ethicists much in the same way as the statement from the Ethics Professor that stated that the life of a 17 year old was more important then that of an 85 year old.

    August 13, 2009 at 5:15 pm |
  123. Mirjam

    No. Have dignity and respect for the elderly and terminally ill. That is how you want to be treated yourself when your time has come. However, if we all just respect illness and death being part of life and come to terms with death, maybe "quality of life" decisions will be made more often and unnecessary costs could be avoided.

    August 13, 2009 at 5:15 pm |
  124. Nancy A. Lawrence

    Yes, I believe health care should be limited for the elderly or terminally ill. We are based on capitalism and supply and demand. It is just not fair that a ninety year old would be using resources that perhaps would be redirected from a twenty year old.
    Nancy Lawrence, Toms River, NJ

    August 13, 2009 at 5:15 pm |
  125. Matt in Denver

    It would be nice if SOMEONE could stand up for the terminally ill. Under the current system, insurance companies deny care to chronically ill and terminally ill patients with a remarkably cavalier attitude. These people, who have families and loved ones, are merely an obstacle to the bottom line in the eyes of these enormous for-profit health rackets we call insurance companies.

    August 13, 2009 at 5:15 pm |
  126. DJ in Denver

    Hi Jack, love your part of the show. In a word NO. I think we might have two parts of this reform one for regular types of health problems and one for catastrophic health problems but we never should have our doctors decide when you die based on economy. Sick people always have and always well cost more than healthy people and it should not be an option to say no to these sick people. Not having insurance companies shut people down because they are sick is part of this reform. What was the question? Should we kill people at will? NO!!!

    August 13, 2009 at 5:15 pm |
  127. Evelyn McLain, Livingston, TX

    What makes people think there's not already a limit by the insurance companies. My sister, a terminally ill patient, died two years ago and all we did was fight Blue Cross for treatment for nine months. It was a battle from the insurance company every time there was a suggestion for treatment. I'm not so sure many of the treatments and surgeries that the doctors insisted upon were always necessary, but they were trying to save the life of their patient and isn't that what doctors are supposed to do instead of having to fight the greedy insurance companies.

    August 13, 2009 at 5:16 pm |
  128. H Cooper

    NO. The elderly should be allowed to live their final days as comfortable & happily as possible. If the person needs pain killers, oxygen, etc. they should get it. Euthanasia is a whole other question that needs to be addressed. If I'm dying and miserable, or even before, I should be allowed to choose an honerable and respectful death if that is what I want. Rather than lying in my own fecal matter, unable to hold my food down, I should be allowed to die comfortably at the time and place of my own choosing. THAT is what the dying – elderly or not – need to be able to decide for themselves.

    August 13, 2009 at 5:16 pm |
  129. Rachel Sue Ritz, RN

    As a Hospice Nurse, the question is not about whether or not to pay for the elderly or terminally ill. The question is what does the patient and family want. Often they are not given the proper information to make appropriate decisions. Doctors, patients and families need to have discussions about what are the treatment options, will the treatment prolong their lives and what will the quality of that life be like.
    Only then can people make decisions reflecting their want,s needs and desires.

    Allentown, PA

    August 13, 2009 at 5:16 pm |
  130. Dan from New City, NY

    Should there be a limit on health care for anyone? Isn't that the purpose of the health care bill? This is a bad talking point for the Democrats; half the country thinks the current health care bill has provisions to kill the elderly because of questions like this! The better question is, should there be a limit on health care in the wealthiest, most industrialized, most advanced nation in the world?

    August 13, 2009 at 5:16 pm |
  131. Annie, Atlanta

    This is stepping into “Soilent Green” territory, Jack. That’s a place only some of our "esteemed" elected officials feel comfortable going, and some of your respondents, apparently. Wow.

    August 13, 2009 at 5:16 pm |
  132. sonny chapman

    The greatest health care system in the world can prevent the inevitability of death. All of mankind seems to be able to accept that except spoiled Americans. For a self-proclaimed Christian Nation there's a lot of fear of returning to the Father as Jesus spoke of in John 14,1.

    August 13, 2009 at 5:16 pm |
  133. charles c. pease

    I am surprised that anyone would even ask that question. Anyone that would ask that question must be a left over from the 1930s Nazi regime.

    August 13, 2009 at 5:16 pm |
  134. blewis

    The most neglected group of Americans are the Veterans. The Health care for them shoud be the Gold Standard. As for the uninvited guests that are border hopping by the millions they need to be deported or bill their countries for the upkeep and cost of them being here. Mexico is the wealthiest country on the planet in natural resources-Gold, Oil, Silver, Zinc, Copper, and the illegal drugs need to be nuked out. A death penalty should be imposed in this country for illegal drug dealing. That wont solve all of our health care cost but a mojor portion!!

    August 13, 2009 at 5:16 pm |
  135. Sharon, Hospice nurse from California

    Federal funding does not equal rationing. We need to educate ourselves on all the options the elderly and terminally ill have. It is always the patient's choice of treatment, regardless of the funding source.

    August 13, 2009 at 5:16 pm |
  136. Mark

    I would start by counseling the terminally ill and helping them make the best choices for their lives. That would probably have a dramatic effect on cutting out aggressive surgeries/treatments.

    Mark in Chicago

    August 13, 2009 at 5:16 pm |
  137. Jennifer Smith

    It is a difficult moral and ethical issue. But such painful decisions should be made by the patient and the patient's family in consultation with their doctors purely on the basis of medical and quality of life considerations. Money shouldn't even be an issue. Ever. The fact that you're even talking in those terms shows just how wrongheaded your profit-driven health care system is.

    – Jennifer Smith
    Milton, Ontario, Canada

    August 13, 2009 at 5:16 pm |
  138. lella dougherty

    First, I am dying, as we all are from birth; secondly, I have diabetes. I suppose I could be marked for termination. I teach at-risk students. I wonder how long it will be before their value to society is in question, too. What about people who could be considered by someone mentally or physically "inferior"? I am not willing to give even more power to make these decisions to government or health care industry officials who have proven that their only criterion is thier own best interest. I am sure they would have easily justified "deleting' Einstein and Hawking and many more, much less famous, valuable people.

    August 13, 2009 at 5:16 pm |
  139. Maurice Salem

    Yes, but there must be a clear standard set that most people will accept. Using President Obama’s Grandmother as an example; if she was so ill where she could not get out of bed and the doctors believe she had a week or two to live, then she should not have hip surgery.
    The criterion can be: 1) the individual is unable to get out of bed, 2) the illness is terminal, 3) the doctors expect the individual to live for a certain short period of time.
    The individual does not necessarily have to be elderly. If I had a terminal illness where I had a short period of time to live and I needed hip surgery, I would not do it.

    August 13, 2009 at 5:17 pm |
  140. Matt


    I'm all for palliative care and providing pain relief to those who are very sick and dying of things like metaststic cancer, but let's be realisiic. Providing expensive treatments and therapies for people with terminal diseases which haven't been proven to cure of extend life for a significant amount of time (years, not weeks or months) is ludicrous. It's always easier to spend other peoples money, but folks need to either buck up with the money to pay for these things themelves or throw in the towel. People die, it's the way it is. Spending tons of money on this sort of thing with no regard for how it's being paid for is exactly what's breaking the system. I often see people advocating for single payer systems like in England. Well, in england, if grandma who's 85 has cancer, grandma will get pain relief and thats it. The patients and families understand thats how it goes. Folks in this country have this totally unrealistic expectation that nobody can die. It's time to get real.

    August 13, 2009 at 5:17 pm |
  141. pierce

    The moral questions should not be settled by accountants or bureaucrats.

    Let those decisions be arrived at the 1. the doctor 2. the patient. If a dying person wants continued treatment, why not?
    Better to relieve the suffering for a couple of weeks of the person's life than to throw it away in the 10 minutes that it takes for Air Force 1 to fly to New Yor for a night on the town or for one bomb to destroy a shepherd's hut in Afghanistan.

    August 13, 2009 at 5:17 pm |
  142. Scarlett

    If you have health insurance, you should be able to choose and pay for whatever treatment you want, no matter how old you are. The government should have no place in that decision. If you have no insurance, go to a county hospital. NO to Obamacare, NO to Pelosicare, NO to Socialized medicine, NO to House Bill 3200.

    August 13, 2009 at 5:17 pm |
  143. The Vicar

    I have two words for any doctor who would perform a hip replacement for a terminally ill patient – In. Sane. Why not give her a face lift and some botox injections? A subscription to Match.com? Making the terminally ill comfortable and helping ease their passage through the last few moments of life is fine and noble, but performing pointless and futile expensive surgeries is neither of those things, it's wasteful and you know that someone, soomewhere, is using this procedure to line their pockets. It always comes down to that, does it not? Greed. Stupidity. Mostly greed.

    August 13, 2009 at 5:17 pm |
  144. Patrick

    I have always adhered to the belief that the moral standing of a community should be judged by how it treats the least of its people. That is true for the poor, and it should also be true for the sick and elderly. While I applaud President Obama for his tireless efforts to provide quality medical care for ALL of our nation's people (and not just those who can afford it), I would most certainly hope that success in that regard is not achieved at the expense of our terminally ill. My God bless and watch over our nation's leaders as they meet this challenge.

    August 13, 2009 at 5:17 pm |
  145. Ricky King

    We need to care for our elderly. They deserve health care as much as anyone else. Our country as shown a willingness to provide free health care, education, and assistance to illegal aliens but not willing to care for our own. How sad is that!!!!

    Wichita Falls, Texas

    August 13, 2009 at 5:17 pm |
  146. Dave

    Well in a perfect world that had no religion or morals putting terminally ill people down would make sense. However we have no gotten the point where we would fathom not giving a person care because the pronosis is grim. Its a slippery slope but the Democrats are for killing the unborn and protecting late term abortions which is infanticide so its not out of the relm of possibility that the terminally ill or old would be deemed by them as not worthy of treatment and left to die. The left trys to make everyone believe that they are for the common man and has their supporters fooled they are a danger to the very people they claim to represent.

    August 13, 2009 at 5:17 pm |
  147. Steve

    Unfortunately, the example used here is the wrong one, in that it is remotely possible that the hip replacement reduced her suffering. The real issue is that an astonishing amount of money is spent in the last 6-months of life and studies have shown (e.g. Elliot Fisher, Dartmouth) that this results neither in longer nor better lives for these people. People who live in parts of the country where huge amounts of money are spent in the last 6 months of life are no better off (and probably worse off, for the degree of suffering), than those who live in areas where much less is spent. So the right way to frame this is whether it is possible for the medical and social culture in the high-spending regions to change to that of the lower-spending regions, with people probably being better off for it. In most cases, it is not a matter of saving money by NOT improving end-of-life, but rather saving money AND improving it. Seems like a win-win to me!

    August 13, 2009 at 5:17 pm |
  148. Robert Warshaw (RETIRED!!!!)

    Has anyone noticed how much drug prices have increased recently. What goes here? Are they raising prices now, knowing that they may have to lower them later. Maybe to the level that pricves are right now!


    August 13, 2009 at 5:17 pm |
  149. Eric Dillon

    This is a truly difficult question because your answer above is spot on. From an intellectual point of view the care should be withheld while from the point of view of a loved one you want to ensure they have a fighting chance of having a decent life should they live longer, and doctors aren't always right, sometimes people live for years past what their doctor tells them to expect. That puts you in a very difficult position.

    The other side of this argument is what level of life saving health care do we give to someone on death row? Is it truly cruel and unusual punishment to withhold life saving treatment from someone who is already scheduled to die, or is it cruel and unusual punishment for the family of the victim to see their tax money used to pay for the treatment?

    There are going to be no easy answers in this discussion but it still needs to happen.

    August 13, 2009 at 5:17 pm |
  150. Gary Knudson

    Of course there should be limits. There are already limits that are hidden in the protocols of health insurers. What we need is a serious, concerted effort to develop sensible and human protocols put together by doctors, ethecists and medical researchers that address this increasingly important issue. As medical research discovers treatments in exponential relationship to societies ability to pay for them, the appropriate use of medical care will be an ever more complex question.

    August 13, 2009 at 5:17 pm |
  151. cassie

    I live in Canada. Debates like this one would never be open for discussion. Everyone is taken of, the elderly, dying and young. The U.S. is walking on sacred ground when it comes to health care. Thank goodness for Canada's healthcare that is open to everyone.

    August 13, 2009 at 5:17 pm |
  152. Jim Mayfield

    I can't imagine many terminally ill patients with only weeks to live wanting to spend their last days recovering from elective surgury for which they will never benefit. It is an interesting ethical dilema, but not something that cannot be cured by a system that ensures compationate, palative care in a dignified setting, where patients make there own decisions about how to spend their last days.

    August 13, 2009 at 5:17 pm |
  153. Harold Watkins

    My preference if I become terminally ill is to limit treatment to alleviate pain and suffering. If I become comotose turn up the morphine and let me die in peace and dignity. My life-My death-My choice.

    August 13, 2009 at 5:17 pm |
  154. jess

    How about your loved one dying of mesothelomia from asbestos exposure ....my brother just wanted to die at home and could not since he would have needed a nurse full time around the clock...four years after he died , the insurance company acknowledged his claim.

    August 13, 2009 at 5:17 pm |
  155. Justin Smith

    It is always a difficult choice, The question is what would these patients benefit from. I believe there needs to be some limitations. would giving new dentures to a ding elderly person be beatifically ..no, would giving that patient medication to ease their pain yes. Its all about common sense.

    August 13, 2009 at 5:17 pm |
  156. Robert Chicago


    I didn't realize that people came with expiration dates.

    August 13, 2009 at 5:18 pm |
  157. walt Utah

    Since 1973 this country has accepted the tearing out and destroying of a future life from a mother's womb through the "politically correct" process of abortion. When this "process" became law, I wondered how long it would take before we as a country started contemplating prematurely ending the lives of the terminally ill or elderly. It appears that the time is approaching
    I don't agree with abortion or euthanasia

    August 13, 2009 at 5:18 pm |
  158. Jeffery, Toledo, Ohio

    I'm not sure about the idea of placing limits on terminal care, but I would welcome a revisitation of the debate over euthenasia and assisted suicide. Were I to become terminally ill, all I would want is to be sped along on my way, with enough care to keep me comfortable. We all have both the right to live, and the right to die–with dignity.

    August 13, 2009 at 5:18 pm |
  159. Dick Elewaut

    Dear Jack,
    Why can't we have a system with opt-in national insurance that also offers a supplemental health plan for the elderly either paid by them or their family. A person no matter what age could then decide if the extensive care they require would be right for them without bankrupting the system for everyone else.
    You're right – this moral, ethical and emotional decision (if not handled compassionately) will rip this nation apart. My statement is also an endorsement for a mandatory living will for everyone that qualifies by age for medicare.

    August 13, 2009 at 5:18 pm |
  160. Jennifer Ripplinger

    It is a matter of personal responsibility. Demanding expensive treatment and surgery when you are terminally ill or quite elderly is irresponsible. Stop blaming the government, it is the individuals who are at fault.

    August 13, 2009 at 5:18 pm |
  161. Debbie Houghton

    People are given the right to choose what life saving measures they are willing to have performed if they are unable to communicate by having a Do Not Resucitate (DNR) in their medical file. They should be able to make the same choice about how much care they wish to receive in the case of a terminal disease. This should be done before a person has an actual diagnosis as the emotional impact of such a diagnosis could effect their choice. The same can be said about elder care. We should be responsible for making plans on how to spend our final years if we can't take care of ourselves. I don't believe it is the governments responsibility to make such life choices. We make plans all of our lives, so why stop when we get sick or old?
    Debbie Houghton
    Ephrata Washington

    August 13, 2009 at 5:18 pm |
  162. Gary Soper

    Jack what the hell kind of question is that, I am starting to feel like living in the United states is more like living on the island in Bless the Beasts and the Children.

    August 13, 2009 at 5:18 pm |
  163. Carl in Topeka Ks.

    Of course not.Can you say "death panels"? Greedy HMO's deny needed medical procedures for sick Americans all the time in order to pad their own pockets. Why aren't the folks at townhall meetings furious about that?

    August 13, 2009 at 5:18 pm |
  164. Sandra

    These decisions are made everyday by doctors and families. It just makes sense that everyone should be as informed as possible and that really involves the doctors taking the time to discuss these issues. Unfortunately, since they took the counseling option out of the health care bill now they are not required to this and if they do they won't get paid for it.

    August 13, 2009 at 5:18 pm |
  165. Cookie Cutter

    The best resource a country can have is a healthy population.
    Only misinformed, greedy and stupid Americans with preconceived ideas would go on a rampage against health care for all. You would think that before acting like a bunch of morons they would try to get the facts and find out what’s in the plan before coming out like a pack of ignorant idiots shouting and disrupting the town meetings. It smells like another ploy orchestrated by the Republican machine.

    August 13, 2009 at 5:18 pm |
  166. Jane Goodwin

    When my father was dying of AIDS in 1998, he was accidentally offered dialysis for his failing kidneys, which he accepted. The doctors then had to tell him that he actually wasn't eligible for dialysis because it was a "limited resource" not available to terminally ill patients. He was crushed. My dad believed until the day he died that "they" might find a cure to AIDS at any moment. He insisted on dialysis and they offered him peritoneal dialysis as an alternative. Three weeks later he died from an infection caused by the foreign body required for this type of dialysis. At the time (I was exhausted), I was furious to learn that the hospital could make a mistake in the services offered and give my father such a sense of false hope. But it's been ten years, and I still question what was right and if there would be a right answer. The fact is that until we know what it is like to be terminally ill, not giving up hope of a miracle, we will never be able to make a fair assessment. But I do feel that most family members would make the most logical decisions for their loved ones. This is not something that can or should be regulated by laws and policies – it's far too personal.

    August 13, 2009 at 5:18 pm |
  167. Marion Jones

    No there shouldn't be a limit on any health care or for eldely and terminally ill people it doesn't make sense

    August 13, 2009 at 5:18 pm |
  168. sally

    HR 3200 Healthcare Bill is nothing more than a TABLE OF CONTENTs, when you turn the page there is nothing on that page, it is a blank page, and Obama wants the US to sign onto blank pages?
    Who are the people writing up our Insurance Plan?????? I want to know who they are and their backgrounds, and I don't mean what college they graduated from either.

    August 13, 2009 at 5:18 pm |
  169. James Norwag

    I guess it depends on why we are talking about a Federal Health Care system. If we are doing this to provide care, then there should be no limit. If we limit the terminally ill, should we limit health care for those who partake in dangerous activities? A thrill seeking 25 year old may not be a good investment of health care dollars.

    Now if we are talking health care to lower costs and maybe make some money, then the decisions are no longer about health, they are about profit. The question would be, how much more can we expect the patient to give back to the system? Is this more or less then we need to spend?

    Either let the private industry determine cost or have the government take care of all with no regard to cost.

    August 13, 2009 at 5:18 pm |
  170. Vanessa

    Jack, I'm glad you asked this question. I'm a nurse and have worked geriatrics for 15 years. The answer to the question is YES JACK! There should be a limit if its paid for by medicare. There are some people out there that will place a feeding tube in a dead person. If grandma or granddad will never sit around the dinner table, or lie in bed and hold a conversation again, why put them through the turmoil. I have actually wittness patients taking a turn for the worse after the surgery.Jack what sense do it make to prescribe an anti-depressant to a comatose patient. I have been actually asked to do that by a family member.

    August 13, 2009 at 5:18 pm |
  171. Les Rivkin

    There is a world of difference between being elderly and being at life's end. Many of the so called elderly live active vibrant lives into their late 80s and 90s. You can be terminally ill at any age. Rational choice and rational options are needed. Access to life end information and planning would be a boon for those who cannot afford it.

    August 13, 2009 at 5:18 pm |
  172. bob

    "But, the president added that’s where “you just get into some very difficult moral issues” when deciding what medical treatment to give to terminally ill patients. Pres. Obama suggested that the chronically ill and elderly account for as much as 80% of our health care costs."

    It's very simple really. You give them the care they want and ask for. If they want to try to live as long as they can no doctor or government official should have the power to say no, you can't. And then there is the issue that even if the government refuses to pay for it, it governemnt dominates the system, they may prevent you from seeking treatment anyway even with your own money because that might be seen as "unfair" to those who might not be able to afford it.
    So basically, they could have the power to end your life if we are not clear and demand that there are protections built into any new system.

    August 13, 2009 at 5:18 pm |
  173. Avie

    Hi Jack,

    The terminally ill and the elderly are still living, breathing human beings. Why should we curtail their quality of life? Yes, we CAN treat someone, without spending an exorbitant amount of money. Really, there are alternatives to surgeries. The more important issue is: we need to teach Americans how to maintain a health lifestyle. This is America; I think we can handle the challenges ahead of us.

    August 13, 2009 at 5:18 pm |
  174. Dave

    My wife and I witness the health care system being abused nearly everyday. No, we don't work at a hospital....
    My mother in-law, now 84 years old, has my wife or friend taking her to the doctor so often our heads are spinning. To what end? Her health is not better and as far as we know they haven't cure old age yet. Almost all of her visits to the doctor or ER end the same...lots of money being spent on tests and nothing being found wrong. We don't contend that her access to care be denied, but how this care is administered needs to be addressed. Doctors are worried about denying care even when they know nothing is wrong – so they prescribe and send her off to other specialists, who are also making money on these 'frequent fliers' (this is the term the medical personnel call this type patient). How do we fix this?
    Dave and Debra

    August 13, 2009 at 5:18 pm |
  175. BJ

    Wasn't this tried back in the 1940's under the Hitler and Nazi regime? Their one question, then sparked another, then sparked another...where did it stop, it didn't. Even they didn't know at what point a human became of value of saving as they turned on their own. If we as a society follow that same route, what nation is going to step in and save the world this time?

    Funny how history has a way of repeating it's self.

    August 13, 2009 at 5:18 pm |
  176. Dianne Lee

    The proposal is that the individual would be able to make those choices for themselves.
    But, this is all going to work out so everyone wins.
    The Democrats control Washington, so they are going to pass a law they like, so they will be happy.
    However, that law will not have "death panels" or any of the other things the right wing is screaming about. Since the law doesn't have these things, they will declare victory and be proud and happy. That is because they are sincerely unaware that those things are Right Wing Nut inventions and were never under consideration in the first place.

    August 13, 2009 at 5:18 pm |
  177. Jerry Sanders

    My wife is terminaly ill with cancer. She will die, we both know that. We both agree that the only treatmant she should recieve is pain control. It is a hard situaton, but each person who is terminaly ill has to make that decision by themselves. No one else is wanking in their shoes.

    August 13, 2009 at 5:18 pm |
  178. Sampath Parthasarathy

    I favor the limit on coverage. The basic coverage should be for prophylactic preventive strategies, therapies based on currently accepted practices, quality of life after treatment, etc. Of course, morally no one would like their loved ones to suffer. That is where optional or additional coverages are needed, apart from basic coverage. I also feel that it should be left to the petient to decide.
    I suggest an age based coverage with a three tier system. Below 21, mid level and child bearing age, senior citizens and chronic illness coverage. All of them should be covered for preventive health, vaccines, acute and unanticipated health emergencies, fracture, pregnancy children associated conditions etc. Optional coverages (heart diseases and associated risk factors, cancer and non malignant growth, rare and uncommon genetic diseases, etccould cover most people.

    August 13, 2009 at 5:19 pm |
  179. Beverly

    NO! It should be left to the " Sick " person. That is what this "Death Panel" thing is all about. BTW when I checked in to the hospital for knee replacement surgery, I was asked if I had a DNR (do not resesitate),a Living Will and a Medical power of attorney.. I did and I do. This End of Life Advice proposal would enlighten alot of people as well as seniors and give them input they may not currently have.
    Gold Canyon,Arizona

    August 13, 2009 at 5:19 pm |
  180. Ely Q. Abellera, Fayetteville. Ga.

    No Jack, there should be no limit to the care of an elderly terminally ill patient. However, it should be left to the family and the patient. This will brings us to the need for advance directives as part of the end of life counselling which I fully endorsed. Too often without a living will, families feel guilty making those kind of decisions consequently suffering instead of life is unduly prolonged.

    August 13, 2009 at 5:19 pm |
  181. Mike C

    Hi Jack. These are both social and personal issues. How about we split it logically down those lines? Life-threatening issues (cancer) should be covered by health care, while quality-of-life issues (hip replacement) can be either subsidized, covered by a premium plan that costs the individual a higher premium, or be an out of pocket expense. It's not ideal, but it's still better than what most people have today.

    August 13, 2009 at 5:19 pm |
  182. ksvb3

    As a senior I've been paying and have paid taxes,so why should I be limited on my health care? Can I get a refund? And if health care is limited...will the government pay for the funeral?

    August 13, 2009 at 5:19 pm |
  183. Mario

    Absolutely...there should be.
    Abuse of the law is what kills our medical system when compared to other countries'.
    Unlimited malpractice suits, and insurance fraud cases which would be thrown out of court in other first world nations are heard on our dime by what appears to be corrrupt judges.
    Caring for the terminally ill must not divert resources that should be used on the young who have not even had a chance to live.

    August 13, 2009 at 5:19 pm |
  184. Mike

    The question exists because the math doesn't work to care for everyone on an infinite timeline. If you look at any country with welfare you find there are decisions they have to make in order to make the math work.

    August 13, 2009 at 5:19 pm |
  185. krhodes

    In certain circumstances healthcare should be limited in the elderly and terminally ill, if the persons are alcoholics, drug addicts or obese and have done nothing to help themselves. If they desrve care then I deserve reimbursement for all the money I spend trying to stay healthly AND my time spent doing so. example personal trainer , gym membership etc.

    August 13, 2009 at 5:19 pm |
  186. John-Smithfield, UT

    My Mother was living alone and she went to Urgent Care or a Hospital ER for everything. Her visits also often coincided with Holidays because she was not near family and needed attention and caring people around her at those times. She was at, or in, a hospital 8 times the last year she lived alone. Those visits cost Medicare thousands of dollars and she was physically healthy. When I finally convinced her to move into Assisted Living near my home it all stopped. She hasn't been in a hospital in 16 months, her general health has improved, and she is having fun again at 86 years old. Much of the cost of Medicare is due to inappropriate use of the system through ignorance and unintended abuse (such as hers). Routine counseling for the elderly, the obese, and routine care for the mentally ill will result in lower costs over the long haul. Ignorance creates cost and the system we have does not deal with educating the public and presenting options. People should "READ" this bill before commenting. I have and I am amazed at the ignorance evidenced by Politicians and the Media over its content.

    August 13, 2009 at 5:19 pm |
  187. Ken

    No there should not be a limit, i'm when it's you or your family member you will want to everything in your power to help them. When you give the goverment control of your health care, then they have control of you.
    If they are so concerned about the so called 47 million w/o insurance, which 10 million are illegal and another 6-8 million are legal workers but not US Citizens. Of course there are another 8-10 million that have the money don't want to pay for it. So in reality your going to change an entire country's system because 10 million people can't afford health insurance ...that makes great sense...not Just create a fund for these people.

    August 13, 2009 at 5:19 pm |
  188. mary harrell

    no, i do not think healthcare for the chronically ill and terminally ill should be limited. my husband is chronacally ill with a few medical problems. but with his medications, hes able to live with them.
    as for the terminally ill, everyday that you get to live is a gift from god. so let it be.
    the lord giveth and the lord taketh away.
    thank you
    Mary Harrell..somerville new jersey

    August 13, 2009 at 5:19 pm |
  189. Peggy, FL

    My mother has advanced C.O.P.D. and was on home hospice care for a while. She has since "graduated" because her C.O.P.D has stabilized. While she was on hospice, she had to go into the hospital for an unrelated problem, and I was very surprised how poorly she was treated. During previous visits, I was happy with her care, but this last time, she received no visits from specialists, and she was kept doped up to the point she had to spend 25 days in rehab relearning how to walk. The fact is, my mother wasn't really terminal in the strictest since of the word, but her treatment seemed to me to be limited.

    August 13, 2009 at 5:19 pm |
  190. jack

    I think this is the main issue which the media has missed. Who wants to spend excessive monies on a dead horse.
    People with aids and other terminal conditions should live a comfortable but REASONABLE life. This is an area where our Congress and Court has failed WE THE PEOPLE by putting a few peoples needs above the MAJORITY of our society.
    What great nation has ever remained great by taking care of the oldest member of the society? None.
    Nations remain great by caring for its youth and families.
    Thanks Jack.

    August 13, 2009 at 5:19 pm |
  191. harry

    In his interview with the Pope, Obama said he wanted to reduce abortions. Then he proposes a medical "reform" bill which has at least the potential to expand abortion facilities. Apparently moral choices are a difficult area for someone who attempts to convey the idea through his speechifying that he is some kind of great thinker.

    August 13, 2009 at 5:19 pm |
  192. Doran

    If you put a limit on health care for the elderly and termainally ill then there should also be limits on health care provided for premature babies. No one seems to have any issue when millions of dollars are spend to save the life of one premature baby. Spending priority should be equal across the board.

    August 13, 2009 at 5:19 pm |
  193. mick, florida

    NO, NO, NO!!! This is a decision that should be between the patient, their family and the patient's doctor! NO ONE ELSE.

    Years ago, my friend's elderly father who had many chronic health problems, had a heart attack and was told he needed open heart surgery. The hospital he was in refused to do it, because of his poor health, but Johns Hopkins was willing to do it. The surgery was a success, but the family was told it would only extend his life 5 more years, if he was lucky. HE LIVED 16 MORE YEARS. If this were your father, would you want to give up however many more years he was given? I know I wouldn't.

    If the patient is willing to go through the pain of the surgery, he/she should have it. Apparently, Obama's mother wanted the surgery, or she wouldn't have had it. Would he take it away from her?

    I don't think there is a difficult moral question here at all. To not allow a patient to have a treatment or surgery, because they are chronically ill, terminally ill, or elderly, is discrimination against those groups of people.

    August 13, 2009 at 5:19 pm |
  194. Calvin King

    Families need to prepare a living will expressing what the dying person wishes from the health care profession. if they would normally die without life support, and the life support does not permit the person to engage in life in any meaningful way, we should allow that person to choose not to be comatose for the last months or even years at the end of life. But making a choice about the end of life must be made before hand and be signed by witnesses. I want to be in charge of my own life, and that includes the end of my life.–Calvin King

    August 13, 2009 at 5:19 pm |
  195. Paul L. Ransom

    No limit whatsoever.......... everyday we hear stories of "you have 3 months to live" and the person ends up living 6 years. We have to do everything that is humanly possible to keep people alive (if they want that) period. End of story.

    I think that's what we will get, but who knows with all the lobbiest money floating around the halls of congress.

    August 13, 2009 at 5:20 pm |
  196. carolo

    Pat Shaw....No one is discussing euthanasia here. We are talking about expensive surgeries on a person who is already dying. If you're full of cancer and been given 3 months to live, why have your gall bladder removed?

    August 13, 2009 at 5:20 pm |
  197. margaret

    The decision for care should be between a physician and patient.It is best discussed before the individual is seriously ill.Some people will always want everything done,but many people would choose comfort and compassion when they are terminally ill.If people are able to have a physician that knows them and their values and beliefs these decisions will be made not finacial reasons but for an individuals reasons. Often it is the family that is not able to step back and decide what their loved ones would want.They would feel guilt for not doing everything.As a physician I often explain that I can not prolong life but I can prolong dying.

    August 13, 2009 at 5:20 pm |
  198. C Spurgeon

    I think its a sad day in this country when this is what we are talking about. I am 67 years old, pretty healthy and have wotked fror 40 years and paid my taxes and withholding always at the max. I am tired of every tv station, politician and President referring to us as Grandma and geezers. I am only Grandma to my own Grandchildren and think some of this whole problem is caused by the lack of respect for seniors or even for eay other for that matter. I have heard Grandma and Geezer so many times this week and I see the news covering all these screaming banshees. Of course the health system needs reform and the insurance companies are disgraceful but if it can't be done civilly and respectively then maybe we need to look at ourselves..not seniors but young ,middleaged, rich ,poor and middle class and yes seniors. We are all americans in the best country in the world. It just doesn't look like that anymore.

    August 13, 2009 at 5:20 pm |
  199. Jaye T. Swoboda, MD

    I am a family physician in Questa (rural and northern) New Mexico. I love practicing with this community full of beautiful people who have lived their lives and had their children here and who seem to accept death as comfortably as they hold onto the joy of each day they awaken. There isn't a one of them I talk to, and I ask them about it, that would want to live to bankrupt their family if they couldn't have the quality of life they have now. This desperate clinging to life (as manifest by the presence of vital signs) has been crammed down our throats by mis-applied technologies in a culture at times seemingly bereft of ethical or moral standards. Our quality of health care will never be determined by how aggressively we defy death but rather by our peacefully and kindly we live each day and treat each other and selves. My experience is that a vast majority of people have a much better sense of what they value than all the politicians and reactionary town-hall resisters of change ever will combined.

    August 13, 2009 at 5:20 pm |
  200. Michael

    We spend far too much keeping the terminally ill alive in their last few weeks. Currently insurance pays for the care everyone thinks they are entitled to and that drives up medical costs, inflation and the budget deficit. If people had to pay a fair share of their medical care, then costs would drop dramatically as they would realise that they couldn't afford it.

    People need to accept responsibility for their "rights". That means work hard, save your money responsibly and pay for the things you want. You are not entitled to free everything just because you live in America.

    The US government cannot continue printing borrowing money and bankrupting the future generations. That is self centered and evil.

    August 13, 2009 at 5:20 pm |
  201. Ron T

    Yes, and no. Yes, there should be a limit on what the government will pay. No, there should not be a limit in that if the person wants to pay for it out of pocket, why not. Too often I have heard of elderly people going for expensive procedures Medicare covers, while they are concerned about leaving money to their grandchildren.

    August 13, 2009 at 5:20 pm |
  202. kelly

    It is a tricky question, yes, but really it comes down to, something beyond morality. The question becomes or will become eventually, when the money starts running out, do we pay for terminally ill grandmother's hip replacement or 2 year old Johnny's stomach surgery, or appendectomy. And then it comes down to the same old dilemma, Who is willing to make the tough decisions? In the end, I doubt much will be done in the way of this decision anytime soon, as it's something that can be put off until later. And we Americans have been too eager to take that easy road too often.

    August 13, 2009 at 5:20 pm |
  203. Justin from Milwaukee

    This is a classic case of the good of the whole vs. an individual's benefit. Although it may seem heartless, and one's viewpoint could change if a loved one fell chronically ill, objectively it only makes sense to have certain limits on health care for elderly suffering from debilitating chronic diseases and those who are terminally ill. These individuals simply become a true burden on everyone.

    August 13, 2009 at 5:20 pm |
  204. Patrick Callahan

    Will someone tell these people too quit being a bunch of tigjht wads and just provide the medical care wearther the person is dying or not !!!!!!!!!!!!!!!!!!!!!!! Buhl, Idaho thank you

    August 13, 2009 at 5:20 pm |
  205. John

    My question is: Why, if many people are sooooooo religious and believe in an after-life, do they, and we, try to keep them alive AS LONG AS POSSIBLE?? Seems like they would be only too glad to move along to their great reward in the sky – and save a LOT of money in doing so at the same time.

    August 13, 2009 at 5:20 pm |
  206. Katie, St. Paul, MN

    Jack, the terminally ill and elderly are humans just as much as you and I and our children are. Nobody can say that it's not worth it to care for somebody because they have only 3 months to live instead of 30 years. The term "universal" means that it should be available to everyone. Let's not start to pick and choose here.

    August 13, 2009 at 5:20 pm |
  207. Dick Martin

    This is a decision that should be made by the patient and family.
    There is no need to include this as a requirement on the new health bill. It is causing an unnecessary problem in passing the much needed health bill. What is important to seniors is the cost of prescription drugs, the ability of medicare to go out for competitive bids and for seniors to be able to buy lower cost Canadian drugs.
    These p;oisstive steps would reduce the questions seniiors now have about reducing cost of health care and our national debt.

    August 13, 2009 at 5:20 pm |
  208. Tracy C

    I understand the financial rammifications. However, we have a responsibility as a nation of conscience and compassion to prevent the suffering of the chronically or terminally ill as much as possible. Anything less is inhumane

    August 13, 2009 at 5:20 pm |
  209. Steven

    Why is it that in a Christian nation we are so afraid of dying and letting other people die with dignity? Death is the natural consequence of life. Letting people go is not only more responsible but also more ethical. Obviously we shouldnt kill off grandma, but nor she we waste resources. Making a terminally ill patient go through more surgery that will not extend their life or substantially improve their pain, is in itself cruel. We should use common sense.

    August 13, 2009 at 5:21 pm |
  210. calvin hicks

    jack,in answer to your question,dare i say that many people w/a terminal illness might opt for euthanasia if that option were available thereby solving a major part of the problem!!!

    August 13, 2009 at 5:21 pm |
  211. Lou in Illinois

    Jack - It does make sense to limit care for the elderly and terminally ill. Nobody lives forever. The important thing is to keep people comfortable in their final days; not to do every last thing that might add a day or a week to their lives, at huge expense. Intensive healthcare at the end of life often decreases the quality of the life that it prolongs. The only problem is that limiting care makes family members angry, and angry families file lawsuits against healthcare providers. This is why we need tort reform. Without tort reform that will allow healthcare providers to provide reasonable care based on actual medical need, the only way to cut healthcare costs will be to ration care based on bureaucratic fiat.

    August 13, 2009 at 5:21 pm |
  212. Kim Leathers

    Morally and ethically, our hearts say that everything possible should be done for the elderly or terminally ill. But having just been through this with both my parents, I've come to the realization that there is a limit. My mother was diagnosed with two brain tumors, and for the next eleven months, I held out hope against hope. We tried cyberknife radiation - at a cost of over $41,000 for two treatments, paid for by Medicare and private insurance (BC/BS) - and for a time, it worked. But due to the other ailments and age, it was too risky to do a biopsy to see what was really wrong and pinpoint the tumors.

    The doctors were very helpful and encouraging, but honest about her prognosis from day one. The day after my father died, I admitted her to a nursing home with a feeding tube, which she repeatedly tried to pull out. Even though her physical abilities had declined, she wanted to keep her dignity and a semblance of control over her destiny. I continue to wonder whether I made the right decision to have the feeding tube placed in the first place.

    As difficult as it was to face the terminal illnesses of my parents at the same time, I gradually came to the realization that, regardless of what I wanted, they were tired and had lived their lives, and wanted to leave this world with dignity. And they finally did. In the end, they both died at home, where they wanted to be.

    August 13, 2009 at 5:21 pm |
  213. Keith .... from Oregon

    That's a topic for a person and their doctor and if they choose to include them...their family.

    There is no place for government in the process....not even to discuss it.

    August 13, 2009 at 5:21 pm |
  214. Ann

    If, as a nation, we decide to limit care to the elderly and the terminally ill, then is the next step to also limit care to the very premature and sick babies who also require a tremendous amount of medical resources?

    August 13, 2009 at 5:21 pm |
  215. Heidi Vornholt

    My dad was diagnosed with inoperable, incurable lung cancer at age 85. His oncologist said on a regular basis that chemotherapy would not cure the cancer, only keep it at bay. The chemo did not keep it at bay and the cancer spread to Dad's spine–he was in terrible pain. Less than a year later, Dad died. The chemo didn't make any difference, other than make Dad sick, fatigued and tired of living. I will add that the doctor never gave Dad the option of NOT treating the cancer. I think Dad would have opted out. I certainly would.

    That said, I don't understand the thousands of dollars spent keeping Dad alive a month or x months longer, and in pain, when he was going to die anyway because the cancer was incurable. What's the sense in that?

    By the way, I am a breast cancer survivor (12+ years). If/when it comes back, I will think long and hard about having it treated.

    As an aside, I haven't read anywhere about people being concerned that health care may be denied to children born very prematurely and with myriad health problems. If the elderly or terminally ill would be denied health care, wouldn't these preemie or extremely ill babies be in the same position?

    August 13, 2009 at 5:21 pm |
  216. Aaron @ Austin, TX

    Each of us deserves a heatly & long life, who are we to discriminate based on age and/or health status? There are laws currently in effect to protect these classes (age, gender, race, etc) for employment, loans, etc... Why would we make special laws to not protect those same average Americans when it comes to Health Care?

    August 13, 2009 at 5:21 pm |
  217. Leslie Brown

    This is a very difficult moral issue and is difficult to define boundaries of care. I believe certain insurance paid procedures should be limited. It doesn't make sense to do a hip or knee replacement on an individual who has terminal cancer or is 90 years old. I do believe that there should be provisions allowing for people to pay for these out of pocket if they chose to do so and it is approved by a physician.

    August 13, 2009 at 5:21 pm |
  218. B Ries

    Holding back any sort of necessary care for a terminally ill person is inhuman.
    Yet I also believe that it is time to seriously look at allowing those who wish to end their lives with dignity to have that option.

    August 13, 2009 at 5:21 pm |
  219. Bernice

    We are all terminal from the start of birth. Who decides this, the insurance co?? They do now. the individual person should make that decision though a living well or family. We better watch our step on this one, there is a fine line here between a limit on health care
    and euthanasia. The main point here may be in keeping the quality and dignity of life till death.

    August 13, 2009 at 5:21 pm |
  220. C. B. - AZ

    My sister was diagnosed with a 'terminal' illness. Her and her doctor decided to go down fighting. Her insurance company paid for most of the treatments. She is still alive 4 years later. She works full time and has an active and full life.

    I would hate to think that medical care would have been limited somehow because her illness was considered terminal. Instead of calling her on the phone, I would be visiting a grave site.

    Keep the government out of these decisions.

    August 13, 2009 at 5:21 pm |
  221. Griffin

    Nope. I think that the decision should be between the patient/patient's family and the doctor. I like the idea of insurance companies not having a say.

    August 13, 2009 at 5:21 pm |
  222. Ken in NC

    The question should not be if there should be limits. The question should be if there were limits, would you be able to find an idiot brave (DUMB) enough to tell family members they have to take their elderly or terminally ill mother out of the hospital to die because she has reached her limit. I don’t think so.

    August 13, 2009 at 5:21 pm |
  223. Andy

    Jack – as a person with 20 years experience in health care, and MPH in Health Management and Policy, someone who worked for an insurer and is now part of a health care start-up I can second much of what has been said above. People – slow down, take a deep breath. Health care is already rationed today and it is rationed poorly. To the person that said we need to look at each case – certainly. Are there times when care should be rationally not performed – certainly. That is not the same as euthanasia and shouldn't be construed as such. When a person is actively dying of cancer we should attempt to treat the cancer with as much vigor as the person desires. When that same person is also hard of hearing – do we need to do $50,000 cochlear implants so they can hear more clearly in their last 3 months? Maybe not – but it happens today. Every case is different, but not all health care is about saving life and not all health care denied at the end of life is euthanasia.

    August 13, 2009 at 5:21 pm |
  224. sheilah anderson

    absolutely not, and the bills does not have that clause in it.
    it is the left wing conservatives that have dramatized this- what else will they stoop to..... anything to make oboma look bad i am in an office

    of 16 with only 3 having insurance. it is scary. something has to be done......obama is trying his best .... gop did nothing for 8 years. give
    this administration a chance... stop the scare tactics you say it cost
    trilllion so do the folks going to emergy rooms with no insurance...

    August 13, 2009 at 5:21 pm |
  225. Sharon Peyton

    There should not be a specific number of dollars but individual case basis to maintain quality of life or freedom from pain as long as possible. When my father was obviously close to dying from congestive heart failure, I believe the doctors went overboard with tests and procedures to satisfy their scientific curiosity about his condition. All they did was discomfort him and waste money.

    August 13, 2009 at 5:21 pm |
  226. Ralph Spyer chicago Il

    We are all terminally ill the only question is the exact date. So do you want to decay on a hospital bed or on vacation.I will take the good life or no life

    August 13, 2009 at 5:21 pm |
  227. John

    There should be absolutely NO limit on health care for the terminally ill and elderly. If you really want to save money on health care, try placing limits on malpractice insurance and get those rates down. Then the cost savings would be passed on to the consumer.

    August 13, 2009 at 5:21 pm |
  228. Karen in Cortland, Ohio

    Jack, I'm 59, permanently disabled and slowly dying. I want to be able to make intelligent decisions about my medical care and to be able to have frank discussions with my doctors. I believe that the proposed health insurance legislation promotes that.

    I'd consider it downright immoral for someone as sick as I am to use up precious resources such as a donor organ, even though some of my organs are beginning to fail.

    Palliative care and hospice care for terminally ill individuals and long-term disabled individuals for whom no cure exists needs to be better understood, and more adequately provided.

    Currently, our system pays doctors to do things that patients such as myself may not want, or need. Providing end of life counseling to terminally ill patients is logical, intelligent and caring. I applaud the concept and support President Obama's health care goals.

    In addition, everyone needs a living will to make sure that their wishes are followed.

    Keep up the good work Jack!!

    August 13, 2009 at 5:21 pm |
  229. Theresa Matt - Athens, GA

    Of COURSE the chronically ill and elderly account for 80% of health care costs! Can anyone visualize a situation where the well population would use 50 or 80 percent of health care resources? It doesn't make sense. We must take the best possible care of those in the most need. Surely, difficult decisions must be made, as in the case of hip replacements for the dying, but those decisions are not the * government's * decision to make! That's why government-run health care is a bad idea. Limits on health care for the elderly? Another word for rationing!!! And it will get more and more stringent as taxes go up and up.

    August 13, 2009 at 5:21 pm |
  230. Ralph Nelson

    As the AARP says: Medicare only covers 70% of an elderly person's health, so buy subimental insurance. One gets to a point where one wishes to escape a worn out body and move on to another life in the world of dreams. We are all made out of carbon (ashes) and life is eternal because we are made of energy within that carbon and energy is the one thing that is eternal, it simply changes shape. Ralph, Yakima, Wa.

    August 13, 2009 at 5:21 pm |
  231. Denise Hillsboro, OR

    No. But that doesn't mean doctors, patients and their family members shouldn't use common sense in making decisions about their care. Obama is right. Hip replacement surgery when someone only has weeks to live makes no sense and could not have been any benefit to his grandmother. It would have taken weeks to months for her to recover from that. Major surgery is so stressful on the body even when the patient is healthy. Money was wasted on that hip replacement surgery his grandmother got for nothing. Care for someone else was probably denied so she could have that surgery she was never able to benefit from.

    August 13, 2009 at 5:21 pm |
  232. Richard

    Why should we ration health care for the elderly who cannot help getting sick in order to give it away to people who abuse their bodies and make themselves sick?

    August 13, 2009 at 5:21 pm |
  233. Christine M.

    I am a 54 year old woman with terminal metastatic breast cancer. I received extensive treatment in 1996 and was cancer free for 9 years when it appeared again in my bones. This treatment has lasted for the past 4 years and I may have many more years under this "maintenance" plan. Who is to say when a medical procedure that makes my life easier or more comfortable is no longer an option for me? Will someone one day tell me that I can no longer have chemotherapy because I'm going to die anyway so why spend the money? I am shocked at the idea.

    August 13, 2009 at 5:22 pm |
  234. Akintunde Richmond Va

    Nobody wants to take the plug off seniors that are terminally ill. But the reality should be "what are the options available?." Nobody wants to be in situation of either doing a surgery that will bankrupt the entire extended family today and still die two weeks later.

    August 13, 2009 at 5:22 pm |
  235. Ashley

    I wonder if we had started this 30 years ago, would we have the medical advances we have today? Each time a person is diagnosed with cancer or any other terminal condition, their physician uses it as an opportunity to learn how to better treat the next person. Would we really want to stiffle these brilliant minds from finding cures? No. This is how you solve a problem, it's not by giving up. Sure there's a cost to treating these patients but imagine what the benefit would be to the economy if we have healthy citizens who contribute? A potential short term cost coupled with a few brilliant minds equals a bigger bottom line. Money is what this whole issue is about, so let's look at treating the terminally ill as an investment rather than a cost.

    August 13, 2009 at 5:22 pm |
  236. James In Idaho

    Let's put that question to Ted Kennedy, The Parents of Terry Schiavo and Maria Schriver. My cousin Jessica Ann Mayhall died of Leukemia at age 11, and I couldn't remotely fathom the point of limiting her chances of living longer nor presenting that as a viable option to her mom and dad.

    August 13, 2009 at 5:22 pm |
  237. Nancy B

    We as a country  already have such poor resources for and attitudes towards the elderly and terminally ill. The better question would be not what if it were a loved one, but what if it were you at the mercy of others in your last days and incapable of advocating for yourself?  Would you want people to give up on you? Would you want them to have limitations on alleviating your pain and suffering. I wouldn't.

    August 13, 2009 at 5:22 pm |
  238. Tommy

    Well, it is definitely a complicated issue...80% of the cost. I think there are some underlying issues, (such as the role and influence of pharmaceutical companies and the excessive cost of treatments) that should be assessed before people simply start to make decisions about this part of the plan that are based on emotion and the "Obama wants me to let my grandmother die!" mentality. Unfortunately, a not so insignificant amount of people will react in just this way, probably the same people who think Sarah Palin isn't evil.

    August 13, 2009 at 5:22 pm |
  239. Dolores Young

    Jack, most people will find at some time that they should think about and make plans ahead for end-life. It's called having living-will" so one's wishes will be honored. I had to fight with a Emergency Room not to put a loved one on a respirator which would have been against his request in the living will that we both had drawn up years ahead. Good thing I had my power of attorney and living will with me as our falmily doctor had advised. Those people who stick their heads in the sand and ignore these discussions and plan will just be leaving a mess for others to sort out.. planning for any stage of one's life is just good sense. thanks for letting me blow off steam .dee

    August 13, 2009 at 5:22 pm |
  240. mike Losos RN

    Myexperience is that if you are in a system and acutely ill, the sky is the limit. Insurance or not. That is often because it is easier not to deal with the complex ethical questions. It does mean that someone else will not be getting care.
    We cannot resolve any of this with the current tone of health care debates. Ironically there are pts. who would decline these services near the end of life, but the discussion itself has been twisted into "Obama's death boards." If we don't start to change healthcare now, we'll limit healthcare for everyone in the future.

    August 13, 2009 at 5:22 pm |
  241. ken

    We already limit treatment on the terminally ill. Once a person is near the end, they are 'kept comfortable' with pain medication and fluids.
    We have so many pharmaceuticals now prolonging life with diminished quality as we age.
    First we need to address childhood nutrition and obesity. We're paying at the end of life through insurance and doctor bills for the bad behavior we learn at the beginning.

    August 13, 2009 at 5:22 pm |
  242. Eric in Madison, WI


    No one wants to talk about it, but everybody dies. Those facing death should have at least three rights:
    #1 The right to the best care available to extend life.
    #2 The right to discuss with their doctor how they wish to be treated in cases of life or death medical decisions (also known as an advanced directive).
    #3 The right to doctor assisted suicide if they so choose.

    Plenty of people in terminal cases may choose options #1, #2 or even #3 to end their suffering.. and they should not have that right taken away from the government, insurance companies or well-meaning family members.

    August 13, 2009 at 5:22 pm |
  243. John

    This is basically the same issue Palin brought up, and the media (and Obama) tried to make her look like a lunatic for even implying the government might have a part in hastening someone's death. Many others have the same concerns as Palin, so I am glad that you, Jack, are presenting it as a real issue.

    August 13, 2009 at 5:22 pm |
  244. Dorothy Shackleton

    Given what happened to my dad at the age of 74, I saw my attorney to establish a durable power of attorney for health care at the age of 50. My dad suffered a ruptured aortic aneurysm and spent 5 months on dialysis incoherent and confined to a hospital bed. My mother asked the doctors twice to take him off life support when it was apparent that he was not going to recover from the devastating loss of blood.
    I made a decision how I want to live and die. I willingly made the decision so as not to leave that burden to my college age child. The question for us is asked and answered.

    August 13, 2009 at 5:22 pm |
  245. Perry Vale

    So, I have ALS (Lou Gehrig's Disease). I'm 54 yrs old, and when diagnosed at this age, life expectancy is 3-5 yrs. Does this mean that once diagnosed, I'm just out? I am not on disability or medicare yet, but soon will be. So, I should just go over in the corner and die, and get out of everyone's way? I could only be lucky if I had a fatal heart attack, or get alshiemers, otherwise I'm going to be aware and cognizant all the way through this. If you know or know of Stephen Hawking, that's my fate in a couple of years. If I am abandoned by the health care system, I'll probably only live another couple of years at the most. I will need medical intervention to eat and breathe. I think you have a very nasty fight on your hands from the older generation. Good luck with that.

    Perry L. Vale
    Washington, MO

    August 13, 2009 at 5:22 pm |
  246. karen harrison, Minneapolis, MN

    No, but physicians should absolutely be paid by Medicare to have conversations with their patients about end of life issues. As a retired Hospice Administrator and Registered Nurse, I believe patients need to ask specific questions and be given honest information ie," how likely is this treatment to improve my condition?" and " you say it will work, what exactly does that mean?" " Will I live longer but be in more pain?"–"and what are the implications of no treatment for my condition?"

    August 13, 2009 at 5:22 pm |
  247. Joyce Drapeau, Murrieta, CA

    It is appalling that we ,as Americans who have fought so hard for our freedoms, are handing over control to the government on such personal issues as health care for the elderly and terminally ill. We need LESS government control, not more! I do not want any part of a government controlled society that can dictate the care of my loved ones in their final days. Where do we draw the line? If the goverm=nment deems it is too costly to provide services to teh terminally ill, when will they decide it is also to costly to provide services to the physically handicapped, or mentally disabled, or teh weaker of the species? Are we returning to the Hitler era of only the strong, cream of the crop survive and are worth investing in and all other weaker species should be destroyed?? Our freedopms are slipping away a little at a time, WE are giving them away to the government. WAKE UP AMERICA before it is too late and we have no freedoms left to protect!!!

    August 13, 2009 at 5:22 pm |
  248. Cimaron

    Absolutely NOT. Who do we think we are dictating how people, human beings, should live out their final days. We are taking away what dignity and respect they have left. That's sick. They just get the news they are dying from cancer, or alzheimers and now they are no longer useful to society so we're cutting their benefits? What if it's a terminally ill child – who is going to tell the family that their health care is limited because they are going to die anyway? This is morally wrong and scarey to me. It's emotionally draining to watch a loved one waste away and the guilt of not being able to do anything about it because of Uncle Sam is pathetic. We are a country where young and beautiful is best – stupid.

    August 13, 2009 at 5:22 pm |
  249. chuck ratermann

    Yes, it should be limited for the terminally ill. the greater good. that should be the main consideration. today, medicare and medicaid spend huge sums of money to prolong lives for very short periods . this is not sensible. these funds could be used to educate people not to smoke, not to overeat, to exercise, etc., etc., etc. In that manner, we will be doing far more good, extending lives much much more, than we do now with those same monies.

    August 13, 2009 at 5:22 pm |
  250. Bob

    Unless I am missing something, there are only three people qualified to make these decisions. The patient, the doctor and God. Based on the type of legislation being introduced by our politicians, would you trust them to make that decision? Based on what? Their judgement? What a joke? Reform is not about limiting access. Let the private sector work on this reform. We don't need government in this area.

    August 13, 2009 at 5:22 pm |