A many opponents of Obama’s health care reform proposal claim that ObameCare would lead to rationing of health care, especially for the elderly. Opponents cling to a reference to “end-of-life care” in making the argument that ObamaCare would seek to deny to at least limit care for elderly and terminally ill patients in order to save money. “Barbarism,” cry opponents.

Currently America’s public option for the elderly - Medicare - offers gold-plated, tax-payer-funded health care regardless of cost-benefit analysis. For instance, a terminally ill patient on Medicare may receive, say, $1 million in health care all for the purpose of extending life one week and then have the tax-payer pay for it.

Many Americans would defend such a scheme on the grounds that any cost is worthy extending life. But who should pay that cost? Medicare patients pay a fraction, if any, of the cost. Working Americans must pay the rest. Such system is simply unaffordable. I will put aside for a moment the debate as to whether there should be any public funding of medical care, and instead take it as a given there is. Should there be limits to such care when others are paying? I believe so.

Spending millions to save the life of a child is acceptable, but should millions be spent to extend the life of a 80-year old by, say, a few months? Not at taxpayers’ expense. It sounds cruel, but sometimes Grandma must be cut from the cord.

It is simply unacceptable that hard-working people should have to pay the medical bills of someone they don’t know all for the purpose of artificially extending a life already lived. An 80-year old with a heart condition normally passes away with solace, but medical advances allow for the artificial pumping of the heart to keep the recipient alive for a few more years. If the recipient or his loved ones want to pay for such treatment because they value the extra time, then that is their right to do so, of course. But is uncalled for when the recipient asks others to pay his medical bills. Such treatments are simply too expensive and measured in a objective, dispassionate light they incur most costs for society than benefit. If the public cost was, say, $100 then we may conclude that such cost for keeping someone alive until 82 is worthy it. But can we say the same when such cost is a $1 million and when thousands of people expect the same treatment for an aggregate public bill of a billion? I think not.

I believe in private care. Individuals and their families, with the exception of the mentally ill, must provide for themselves or rely on private charity. But if we are going to have a public option - either Medicare or ObamaCare - then certain cost-efficiency rules must be established. There should be no rationing of care for young to middle-aged people, but if persons and their loved ones want expensive life-extending treatment for ages above, say, 80 then they must pay out-of-pocket and not coerce their neighbors into taking the check.