[ame=http://www.youtube.com/watch?v=G2y8Sx4B2Sk]"Eugenics"[/ame]
Are you familiar with Eugenicists Ezekiel Emanuel's "Useful Life Years" concept?
"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years"
What's your point? You're quoting a paper about ethics: if we have one heart and two people in need of a transplant, one 18 years old and one 90 years old, how do we choose who to give it to? Should that question not be explored and discussed? Or should we approach the question the way I assume you do: "assume you have two viable hearts ready for transplant." Wow, that does make it easier.
Does examining the ethical ramifications of questions like that mean we're dissolving Medicare or denying treatment when it's possible to give it? No. Not only is Medicare policy not changing on that front, Ezekiel Emanuel doesn't make policy for CMS. Moreover, in that paper, Emanuel and his coauthors
explicitly rejected using their ethical argument on a system-wide basis:
"Accepting the complete lives system for health care as a whole would be premature. We must first reduce waste and increase spending. The complete lives system explicitly rejects waste and corruption, such as multiple listing for transplantation. Although it may be applicable more generally, the complete lives system has been developed to justly allocate persistently scarce life-saving interventions. Hearts for transplant and influenza vaccines, unlike money, cannot be replaced or diverted to non-health goals; denying a heart to one person makes it available to another. Ultimately, the complete lives system does not create classes of Untermenschen whose lives and well being are deemed not worth spending money on, but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible."