I believe that a major reason that governs American health care is a failure to recognize quality of life questions as legitimate during the course of any treatment. Coming from a family of health care professionals (a family practice physician father, cardiologist aunt, ER surgical aunt, nursing brother, husband in pharmacy), all of my family members through years or practice recognize that it's not just about cost, care "rationing", or the latest-and-greatest treatments. Americans fundamentally have a problem understanding that they will not live forever, and there is no cure for the ultimate end of all humans.

I completely agree with a statement in the Post article regarding the fact that we already have a form of "rationing" going on, and the saddest thing is that Americans have been aware of this for decades, without enacting change to help their fellow Americans. There must be a nationally-established and adhered to concept of excellent baseline health care, and make it available to everyone. Preventive care must come to the forefront, which requires proactivity from health care professionals AND the American populace.

Sorry for the rant, but the entire health care system debacle goes far beyond cost--it stems largely from the attitudes of health care industry, professionals, and the American populace.

Laura said: "There must be a nationally-established and adhered to concept of excellent baseline health care, and make it available to everyone."

Made available or imposed on everyone? And if preventive care is provided for everyone who pays and who holds those with unhealthy habits accountable?

The debacle is the assumption that an individuals health is the concern of anyone save the individual. If you want to sell your liberty for a "free" lunch go for it. I don't see this exchange as a bargain and don't care for others who wish to make this choice for me.

Dan, who will make the choice for you if you are incapacitated? Also the key is "availability", not "mandated". There is a HUGE difference.

Laura, our economy makes plenty of gasoline available for purchase without the need for government subsidy. In fact the government taxes it at a pretty good rate. Why does some czarline authority have to mandate healthcare availability when no such agency is needed to ensure ubiquitous gasoline availability?

The truth is health care is readily available. Take an informal survey of your friends and neighbors and they will agree. Good health care may not be cheap but it is available and I venture the people who do complain about the expense are paying out of pocket for many of life's luxuries such as cable TV and cellular phones at a cost of several thousand dollars a year! When such people show a willingness to give up their multimedia entertainment then I may give some credence to their complaint about excessive health care costs.

And you do understand health care cannot be made any more available unless the supply of medical practitioners is expanded. How do you suggest that be done? I know how it could be done but it would require a rewrite of medical malpractice law and tax incentives to encourage more medical students. Neither of these approaches is suitable to the current majority political party so I do not expect much progress in this area.

Laura this is why it is so critical to **thoroughly** address these questions well before the need to apply the answers occurs.

I believe that most of us will make the socially (and financially) responsible decision but even for those who won't it becomes even more critical to make that decision NOW.

So folks... do YOU have an advanced directive? Is it even remotely specific?
Fix this.