Forbes has an interesting article about the health care implications of end-of-life care and how you may be affected. Obamacare's so-called 'death panels' are, of course, a reality, no matter what name you use for them, just as similar decisions will be made on your behalf by any socialized medicine scheme. The article offers useful perspectives. Here's an excerpt.
Any government-funded health care system must necessarily set limits on medical spending. No government can issue a blank check for unlimited medical care for everyone. The only issue is where and how it draws that line.
This is an inherent part of any socialized medical system, such as in Canada or the UK. Put simply, if you expect “somebody else” to pay for your health care, then “somebody else” will ultimately decide what care you may (or may not) receive.
. . .
... the US debate over end-of-life decision making has been reignited by a 500-page report from the Institute of Medicine (IOM) urging drastic overhauls in the end-of-life care system in the US as well as by a recent proposal by the American Medical Association for the government to start paying physicians for end-of-life consultations with Medicare patients. (Currently, doctors can’t bill Medicare for this service, so many must do so on their own time, putting even more pressure on their already overloaded schedules.)
. . .
However, commentators ... warn of a potential dark side to government-funded end-of-life counseling — namely that it might be a vehicle for future covert rationing of medical services.
End-of-life counseling per se is not synonymous with “death panels.” However, this can become a problem if doctors are also under hidden incentives to limit care in the name of “cost effectiveness.” Doctors are increasingly being rewarded (or punished) for their adherence to “appropriate care” guidelines — with “appropriate” defined by government entities. (For example, in my own field of radiology, reimbursement from Medicare will be linked to adhering to “appropriateness criteria” starting in 2017.)
When a doctor advises a patient (and their family) against further care, are they giving their best unbiased advice? Or are they being inappropriately swayed by incentives to save money? As of 2011, 28% of Medicare’s $550 billion budget was spent on the last 6 months of patients’ lives. Hence, this is literally a $170 billion dollar question.
There's more at the link.
The real kicker is going to come in the form of decisions as to which lives are "worth saving". I'm sure you're going to find this utilitarian justification creeping into end-of-life decisions. If a limited amount of medical resources are available, should they be spent on someone who's nearing the end of their natural lifespan, or on someone who still has many productive years ahead of them? Who's more important to society - a plumber who fixes things, or an author who writes things? (And what if it's the doctor's favorite plumber? Or his wife's favorite author?)
I'm afraid we're going to see a lot more of this sort of dilemma as we increasingly lean on Big Brother to pay for our medical care. I think the only way out of it is to revert to a user-pays system . . . and even there, medical insurers are going to want input into such decisions so that their economic interests are taken into account.
(I note that other countries are reacting differently to the same problem. Switzerland, for example, has just rejected socialized medicine, opting in a referendum to retain a private-insurance system.)