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how is/was that currently handled with medicare?

PBS Frontline just had a program on this subject. The problem is that much medical funding goes to treat people in their final days of life.

The program shows that doctors try to talk family into letting the individual go. But some cannot bear to make that decision and insist on additional care--keeping people on respirators etc who have no hope of recovery. Quality of life is low. Why go on. But sometimes it takes weeks or months. And this is very expensive care.

You also have terminal cancer patients who want exotic treatments.

I think we understand. But insurance company can say "that treatment is not covered." That makes people mad, but is really best in some cases.

Blank check coverage of whatever treatment someone can come up with is the dumbest part of the law. An authority with the ability to say no in extreme cases is something we should have.
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