Consider this, imagine there is no federal involvement with flood insurance and you own a home on the Jersey shore. You very well might be able to buy a policy for covering flooding, but you can’t. The risk is so high no company wants to even bother writing up a very expensive policy.

Now imagine a ‘house death policy’. Gov’t decides to bulldoze all houses on a strip because the risk of storm surge is just too high.

The second case might be considered a death panel. The first would not. Now the reality is it may become impossible for you to own a house there. No mortgage company may be willing to loan to you without flood insurance. You can’t afford flood insurance there, if offered. But strictly speaking it’s not illegal. A person with a lot of money could build a house there and self-insure against flood (i.e. take the risk that if the house is destroyed he has to use his own money to rebuild it).

Policies don’t usually spell something like that out in a way that a person can understand: “we’ll pay for life support in circumstance A, B, C, D, but not in E, F…” They usually have a lifetime cap on expenses, but other than that there’s no policy that says (at least as far as I know) “we’ll pay no matter what, for any illness and any treatment, as long as it takes.”

What usually happens is that there is a statement in the policy that they will pay for hospitalization for so many days, up to a cap of so much, or for a nursing home for so many days, etc. I don’t know of any insurance policy that would be open-ended and no cap, although such a thing might indeed exist.

For example, insurance that pays for cancer treatment often has rules about what is covered and what is considered experimental. Again, I don’t think it’s possible to buy coverage that says any cancer treatment, no matter how experimental, is covered. So the arguments that come up between the patient and the insurance company might involve the definition of “experimental.”

In other words, all insurance policies set limits. The arguments come over the definitions of those limits, when they apply, and therefore what should be paid for. I’m not just talking about end of life care and respirators/tubes, but extreme treatments of all types. For example, for chronic kidney disease that needs indefinite dialysis, Medicare kicks in (even for younger people) after a period of about three years, during which private insurance is supposed to pay. Medicare, of course, has its own rules about treatment.

My point is that either way, limits are set. The question is which entity sets them, and how, and for which reasons, and who decides what happens when the patient or family objects to the decision of the insurance company or other entity.

Policy B is no doubt less expensive than A. If you opted for it, it’s not a matter of trust as much as it is simple contract law. With A you’re paying more to never have to worry about negotiating with an insurance company. If you don’t want to pay for that, then don’t. Where’s the ‘death panel’ by either gov’t or insurance here? Whose stopping you from using your own resources to either purchase services directly or pay extra for policies that will pay no matter what?

Re your comment at 6:19—did you not read the last couple of paragraphs of my original post? That’s essentially what I’m alluding to when I wrote:

I also believe that some entity would have been making more of those decisions as time went on and health care became more and more expensive. That’s been happening anyway, with health insurance companies often being the decision-makers.

I don’t know whom I trust less–the government or the health insurance companies. No, actually I do: it’s the government, sadly enough.

Of course I don’t think that it’s a right—in the constitutional sense, that is. That comment of mine was sarcasm.

I believe that you yourself argued in a previous comment that, “If [sick] people aren’t currently getting care, then we have a massive humanitarian problem here in the world’s richest country, which I’m sure you’d want fixed no matter what the cost.” So it seems you believe that uninsured sick people have a “right” (again, not in the constitutional sense, but in the sense that it should happen and other people should pay for it) to medical treatment, no matter what the cost to other people. But a family only has a “right” (in the same non-constitutional sense) to ask that same thing for a very sick loved one—in order to preserve a life that means something to the family—if they themselves can pay for it out-of-pocket, even if they already have insurance? Do you believe that, unless a family can pay out-of-pocket for life support for a person who is in a coma, for example, and who is being tube fed or is on a respirator, that doctors and/or the state should be the ones—rather than the family—to make the decision to sustain the person or to discontinue ventilation and/or the feeding tube?

Which right is that? The right to demand stuff for free?

I think I missed that last time I read the Constitution. Did they uncover some writing perhaps on the other side of one of the pages of the original Constitution?

So, in this case you’d like to take away the right of everyone but the mega-rich to make this decision about their family members.

Even if you have all the money in the world, you still need medical professionals to do the work and they may refuse if they think you’re desires are abusive to the patient. (Granted I don’t have a lot of faith when lots of money is concerned, as Michael Jackson demonstrates, having lots money means you can probably find a doctor willing to do almost anything regardless of its ethics)