According to a "60 minutes" segment entitled, The Cost of Dying (2009): "Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives -...

According to a "60 minutes" segment entitled, The Cost of Dying (2009): "Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives - that's more than the budget of the Department of Homeland Security or the Department of Education. And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked."

This makes you wonder if Healthcare rationing would be beneficial. There are two things that are certain in life: taxes and death. However, modern medicine has gotten so exceptional at prolonging life, even for the terminally ill where death is imminent, that it incurs huge costs associated with their treatment. Do you think it's ethically right to spend 60% of health care funding on those living out the last 6 months of their lives when there are children and younger adults who still have the majority of their lives left yet live without health coverage, thus impacting their overall health? CBS News. (2009). The Cost of Dying. Retrieved December 4, 2013 from http://www.cbsnews.com/stories/2009/11/19/60minutes/main5711689.shtml

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durbanville | High School Teacher | (Level 2) Educator Emeritus

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In healthcare, there are many ethical questions about spending and who and what to allocate funds to. Prolonging life is a noble thing and age is no longer the defined measure of wellness that it used to be. Many aging persons get sick but are strong and have the ability to recover and continue with meaningful lives. This is where the dilemma comes in because there cannot be a cut-off date or an objective measurement of worthiness when spending funds on the elderly or terminally ill. Much of the spending on the terminally ill is to ensure comfort not necessarily to cure and no one can deny a person's right to die comfortably. 

Healthcare rationing already exists in many countries and sectors as affordability defines what a person can afford in terms of comprehensive or more basic cover. A terminally ill patient with good cover can have his or her life prolonged whilst a young person, who cannot afford to even visit the doctor, must suffer in silence. There is no justification in that but there is also no easy solution. Healthcare reforms have become an explosive issue as they are so subjective and often cannot be felt until a person is himself in an impossible position with perhaps a dying relative. There is much rhetoric involved and there is a need to allocate funds better but how do you deny the very person who has worked all his life to ensure your freedom, safety and dynamic environment. It is almost tantamount to playing God. Hence, the Federal insurance for the over 65s. They no longer earn so need to be provided for. There should be a similar program for the under 25s but this is open to so much abuse it would have to be well-managed. The Medicaid program helps the needy and again has to be administered carefully. Unfortunately, that means administrative expenses are also high and less money is available for its real purpose. This creates a situation of under-insurance and those who need health coverage suffer. 

The situation is likely to worsen before it improves as more people outlive expectations. There is compromise in everything but begrudging the elderly after their contribution to the country as a whole is not the way forward. Better management and better systems are what are needed and the involvement of big corporate organizations in the management of healthcare. 

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