In my experience it is rarely the patient making this choice. Much more often the children, who are often making a big show of how much more they love mom or dad compared to the other sibs.

And the patient made that choice by establishing that family dynamics and by not having specific instructions even while seeing over decades the family dynamics they created themselves. I'd say that is an explicit clear choice. And anyway it isn't outsider's business to tell a family how to care for their own.

> And the patient made that choice by establishing that family dynamics and by not having specific instructions even while seeing over decades the family dynamics they created themselves.

Most people who are old today (or in the last few decades) probably wouldn't have thought about it because it wasn't something that affected their parents who likely didn't live that long in the first place.

Very naive take.

Patients' children regularly override the patient's clearly expressed wishes once the patient no longer has decisional capacity.

Medicare is not insurance. The word "insurance" has a specific meaning, and the traditional Medicare fee-for-service program doesn't meet that definition. (There are a variety of other payers or health plans in the US healthcare system which fill a similar role to insurance but are not actually insurance.)

It doesn't matter what you're due under a contract if the counterparty is insolvent. Medicare beneficiaries are going to have to accept reduced benefits and higher fees. This is unavoidable due to demographic changes.

the society reneging on its contract today means that the current taxpayers will lose the trust in the society and in particular will be significantly discouraged from paying taxes, etc. as they would lose belief in the society keeping its side of the bargain in the future.

It doesn't matter whether taxpayers are discouraged. Medicare taxes are automatically deducted by employers for most workers.

taxpayers are voters. So it does matter a lot if they are discouraged.

> One should be glad that such a large sector of economy - healthcare - has a great stable demand and a great labor market.

This is not the tourism industry, a “great stable demand” is sick and suffering people.

The hospital has limited resources, which are being taken up by people who have no hope of getting better (they ain’t getting younger). A push to do everything we can to stop them from dying buys us what? A few more months of pain and delirium before we reach the same result.

> so what? It is on their dime, not yours.

Actually in Europe it is on a dime of a taxpayer so also his.

No, they paid into it their whole life. So, it is their dime not the current taxpayer’s. The taxpayer is paying for their own future.

That's not how state pensions or state healthcare works.