Daniel Callahan's notable Taming the Beloved Beast: How Medical Technology Costs are Destroying Our Health Care System soon will be out. Here is his position:
I can sum up what I want to say in some simple propositions. First, ways must be found to return to more basic levels of medical care for ever more patients (e.g., to emphasize prevention and primary care) and to make it more difficult to receive medical care at the higher levels (e.g., advanced expensive cancer treatments or heart repairs). Second, the priorities for technologically oriented health care should begin with children, remain high with adults during their midlife, and then decline with the elderly. Third, if the medical care received during those first two stages of life is good, the elderly will have a high probability of a good old age even if advanced technologies are less available to them. Fourth, health care cannot be reformed, or costs controlled, without changing some deeply held underlying values, particularly those of unlimited medical progress and technological innovation.
Go read Tyler's short post. He makes a great point as to how the public realizes this thinking is common among the Democratic leadership. In this light, the outcry against health care reform really isn't all that surprising.
For my part, this is what scares me: A future where a bureaucratically imposed National Grandma Quotient is maintained, but individual grandmothers no longer matter.
Hell is the triumph of aggregates over individuals.