I understand the author's points and agree that there is too much money spent on questionable expensive procedures very late in life. However, I would make some counterpoints:
First of all, when you start rationing health care you end up making decisions based on actuarial figures which pigeonhole everyone into categories based primarily on age - much the same as we see happen with auto and other insurance rates. Thus, we might see a 70 year old granny denied certain procedures because statistics show that they only have a few years left to live. But what if Grandma had lived a healthy life and made responsible health decisions or what if her family had a history of being long-lived? It is not uncommon to see healthy people live well into their 80's and even into their 90's with pretty robust health. Is it fair to ration a healthy grandma's care the same as it might be to ration another grandma who had lived and eaten very unhealthily and whose body was failing on many fronts?
The biggest obstacle to providing reasonable safety nets and insurance coverage to our elderly is the way the entire health care system has been structured. Instead of looking first to nature as man has done for thousands of years and instead of teaching and rewarding good dietary and other health habits, we have a system that funnels everything into the hands of mainstream medicine and suppresses natural healing. And the system is propped up by an insurance industry who only covers the "approved" mainstream drugs and treatments. Without the props of insurance and restrictive laws and codes, the current system would collapse due to being largely unsupported on its own merits.
If we taught and rewarded good health habits, had insurance and safety nets structured to provide incentives for people who took responsibility for their health and disincentives for those who didn't (instead of robbing the healthy to reward those who refuse to take charge of their health), had people look first to nature instead of unnatural drugs that manage symptoms instead of cure, and gave people more freedom to address their own private health issues as they see fit instead of funneling them into a lifetime system of managed illness and ever increasing side effects, our health care costs would be slashed tremendously and we would not have to worry nearly so much about rationing health care to healthy grandmas.
Again, I agree that we should cut needless spending wherever possible. But I also believe that our elderly are one of our most valuable resources - one which today's me-first society has tragically neglected and ignored - and I would hate to see even more mistreatment heaped upon our elderly because of a broken system that is based on profits and control instead of healing and health freedom.
My two cents,
"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."
- Thomas Edison