Estimates show that about 27% of Medicare’s annual $327 billion budget ($88 billion) goes to care for patients in their final year of life. (Source) If we would count the final years of live, this number would increase to more than one third (if not almost half) of all expenses.

I personally would not want to have life prolonging treatments. I would like to die in dignity. But that’s my personal choice.

We all know that medical progress will bring new, better and more expensive treatments – and together with higher live expectancies, medical expenses will grow to new heights. And we are aware that the funding of health care will struggle to cope with these increases.

What does this mean for health care policies? We may not like the concept of a class “diversification” of medical services. Everyone should have the same access to health care – irrespective of wealth. But …

• we accept that people in Africa generally have worse services than we have,
• we know that people in luxury cars generally have higher survival rates in traffic accidents than poorer equipped people,
• we are even aware that richer people normally live more healthily, eat healthier food, do more sports and live longer lives this way.

It is not a very pleasant thought, but we will have to accept that access to the newest and most expensive treatments will be “rationed” by wealth. (Nobody claims “Mercedes for everybody.”) And as medical services advance, everyone will get better treatments as soon as they become generally affordable. (Like better security even in cheaper cars after a few years of financial exclusivity.) In fact, even poor people in our western world today have better health care than rich people have had hundred years ago.