>>You have created a logical fallacy. For example, if you cut spending in emergency heart surgery then some people will die. Thus all spending cuts equate to death. How about if we cut spending on Viagra?

Much of the healthcare spend goes on people in their last year/s of life, not on Viagra. QED.

>>All spending is about rationing. The argument boils down to who does the rationing? I say that's between the individual and their doctor.

That already happens, but doctors don't want to be society's executioners. Especially with hungry lawyers standing by talking to tearful Johnny and Barbara who thought mom was going to live forever until the naughty doctor did bad. What would really help would be frank public discussions about costly care and whether people want to fund it. but nobody will wear that- people talk about freedom to decide but what they really want is for somebody else to make all the tough decisions and then take the blame.