To: Brian Sullivan who wrote (19067 ) 7/4/2012 10:49:11 AM From: Bread Upon The Water Read Replies (1) | Respond to of 85487 Instead we know that the cabinet secretary SebelIus is able to issue whatever decrees she likes without any oversight from Congress. So when the time comes to ration Medicare due to the expulsion in costs that we will face by the doubling of the number of patients then we will get the "directives" issued by her that direct providers not to perform certain operations on the older patients. You should have put quotes around your first paragraph to establish that was the test's answer and separate from that part about Sebellus issuing directives as it makes it seem that the second paragraph (block quoted above) was part of the test's official answer (which was your first paragraph) instead of an editorializing assumption on your part. No Cabinet Secretary is going to unilaterally make such a politically charged decision like that all by his or herself IMHO no matter who is in the WH--which is also, I grant, an assumption on my part. Having said that, do I think Medicare will ration care for elders. Yes, I do. I personally believe we will as a nation, collectively come to the conclusion that we can't both support the medical resources for both the productive and the retired to the fullest extent. And this is a conversation we need to have in the ongoing budget debates that are to come no matter who occupies the WH. We probably need a panel of Drs, Lawyers, Hospice and Hospital Administrators, Scientists, Religious/Ethicists, social workers, and leading lay people of all political stripes to see if some kind of broad guide lines can be established. In nations that have national health care this is already in place. If you're over a certain age you are not eligible for certain treatments. This doesn't mean we are going to do nothing for the elderly. But limits will be imposed on the amount of money spent for curing/fighting terminal/life threatening illnesses. This is imposed on us by both the limit of our resources and the advance of our technology that enables us to extend life.