Physicians and surrogates should take patients' preferences into account in making clinical intervention decisions, even if the patients have been found to lack decision-making capacity.
The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians have an obligation to consider a patient’s quality of life when making treatment decisions and should consider giving patients the options of withholding or withdrawing aggressive treatment if that treatment will not restore the kind of life the patient finds meaningful.
Utah's preventive care plan for the uninsured offers limited benefit for young healthy individuals but does not provide the necessary care for it's more chronically ill participants.
Physicians who are interested providing care to uninsured patients can consider a number of options to balance his altruistic desires with his personal needs.