I certainly agree with Former Governor Lamm. As a nurse I have had a large number of elderly patients receive high cost procedures that only provide some benefit, or are taking costly drugs like zocor, epoeitin and many others when they are already quite chronically ill and often well into their 80s and 90s. I feel the attitudes amongst elderly have changed significantly even in the last 10 years. My grandparents would never have expected CABG, renal dialysis, organ transplants or thousands of dollars a month of drugs to sustain their life in their eighties and nineties. Today's elderly want as much health care as they possibly can get. Prior to the enactment of medicare, the elderly paid out of pocket for health care expenses, making you chose wisely what care you would receive. Medicare, and to some degree Medicaid, has created a whole new type of moral hazard. I do not see my patients taking any sort of fiscal or personnel liability for their health care. Instead of realizing medicare is funded on the back's of our children, the want more coverage to include prescription medications and lower copayment. If in fact we limited life-sustaining procedures, and high cost tech at the end of the life span, and perhaps even for babies below a certain birthweight, then we probably could offer seniors prescription coverage for their more basic needs. Instead we operate under some fantasy that because we don't want economic principals to apply to healthcare, then they don't apply. Other countries have better health outcomes than us, spend far less on their health care per capita, and seem to have equal if not higher quality of life markers. One added note, giving the elderly every bit of tech health out there is no guarantee they will have a higher quality of life in their last year. The united states should be looking at diverting some of the money wasted on cholesterol and colon cancer screening for 90 year olds into susidizing long term care in the future.