There has always existed some form of rationing of health care resources, and quite a bit of it has nothing to do with the insurance companies.

When the elderly are injured, or suffer heart problems, or have some other health event, their age is and should be a component of the treatment decision.

I was listening to a couple of nurses talking about a local hospital's cardiac unit and the things that had been happening lately. Apparently, with all the issues about the health care bill uppermost in people's minds, death panels or what have you, families are worried that their old relatives are going to get a great big lack of care. They are insisting lately, more and more often, that their 90-year-old mother or father gets the same regimen given to a 40-year-old heart patient with the same disease/symptoms.

The two nurses kept saying, "HE went to the Cath Lab? Aw, cmon!" and things like this. Then they rapidly explained to me that the recovery after certain heart procedures -- for an 85 or 90-year-old -- was so prolonged, and often so distressful for the patient, that they believed it was wrong to put them through it. It took away months of the person's quality of life, when they had a limited time left to them as it was. And after those months there wasn't any guarantee of notable improvement. So the person is often changed for the worse, and has had weeks of a bad time, too. What has happened to their household living situation in that time is also something to consider. Where does the person live, and what does he go home to?

Since I think I will walk out on an ice floe above the Arctic Circle and let the polar bears have me when my age becomes burdensome, I feel personally unthreatened by the spectre of poor elderly care. But other people are worried. They really need to know what to best expect in the situation. I'm lucky that I'm able to ask medical people who I know care about me, and would want me to live as well as possible, as long as possible.

There are so many medical members of my family that I'm hearing some pretty radical points of view on the health care situation. It may be because most hospitals and practices are tightening up procedures in advance of any reform. The centers are squeezing all their personnel to get every bit of profit they can -- and simultaneously make sure they are being ultra-careful not to run afoul of Medicare regs. It is not a fun time to be a doctor, evidently.