I know some people may explode at this proposal, but does anyone out there favor forms of healthcare rationing? I’ve thought about two types:

1. If a person’s body is no longer able to function without minimal support, and having no chance for recovery, letting “nature take it’s course.” (Illustrated by the last vegetative state patient I remember having to putting 9 meds down their G-tube, along with continuous feeding, total incontinence, etc.)

2. “Covenant dependent” services, i.e. requiring patients to actively take steps to manage their issues in order to continue to receive healthcare resources (Inspired by watching my COPD pts leave the unit to get their smokes, addicts having PICC lines for treatment of drug abuse related infections sneaking out, scoring and using their lines to inject, etc.)

Is it really so unreasonable to say we don’t get a healthcare “blank check” from society?