There are two basic responses that can be made in opposition to end-of-life planning in government health care. The first, and (in my opinion) significantly weaker one is “This will turn into death panels and that isn’t right!”
The more important response is that something like this is inevitable when the government is expected to cover the health care costs of so many people.
The fundamental problems with government health care:
- Done on any scale larger than the community level it crowds out community (and affects other aspects of community)
- Done on large scale prevents opportunities to experiment and learn
- Calculation problem
- covering too many people requires cost containment. Given moral hazard problem and lack of monitoring (also due to not acting on community level), this can only be achieved by cutting doctor pay (creating more moral hazard), or by trying to convince patients to use less.
The end-of-life planning (in its most benign form) amounts to doctors asking patients nicely to weigh the expected gains of further treatment against the potential costs to taxpayers while they can still rationally think about the issues. It’s highly doubtful that the program would remain in that form, but if we grant them the benefit of the doubt we are left with a very strong argument against the status quo as well as planned expansions to it.