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

My point about Viagra is that it is presently funded both in private insurance (regulated by the states) and through direct state plans, cutting spending like that does not result in death. Thus spending cuts are not equal to death.

>>>All spending is about rationing. The argument boils down to who does the rationing? I say that's between the individual and their doctor.
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>That already happens, but doctors don't want to be society's executioners.

Did they consider themselves such prior to July 30, 1965?

>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.

The cultural shift we've made into the land of the lawsuit has certainly changed the equations, however, that is a seperate discussion about our cultural need to afix blame for the challenges and accidents of life. Introducing tort reforms like loser pays will go a long way towards rebalancing the risk-reward calculations.

>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.

Not just whether we want to fund it but how. Piggybacking on your point in another thread about the Super, I'd like to have a 401k type of account for health expenses. A pre-tax, matched by employer, privately managed investment account which can be accessed for health care expenses. Presently we have a very limited "flex" account for minor expenses, but if we expanded it, people could modify their coverage through time depending on their savings. I could also envision insurance rates dropping based upon account balances effectively leveraging my account to coverage. Plus, the account would be private property which I could pass on to my family.

Whew! Really went pie in the sky there. Gotta get back to reality. ;)