My wife and I disagree about some of the key end-of-life issues. When such morbid subjects arise, as they must and as they have with increasing frequency as the debate over medical care rages on, she remains adamant that she does not want to linger in pain, holding on to those final months, weeks, days or moments through any extraordinary medical intervention.

On the other hand, I want to live for every additional second modern medicine or Providence might permit. Dylan Thomas summed up my feelings in his most famous poem:

As President Barack Obama and Congress discuss health care legislation, and we citizens worry over the ramifications of possible policy outcomes, there arises the haunting specter of euthanasia. My wife and I may disagree on what end-of-life decision to make, but we agree that it should be our decision, not the government's.

A proposal to cover millions more Americans with medical insurance predicated on spending less on medical care in the process perplexes enough. But for those who care about freedom -- not having government tell you how to live -- and those who wish to live as long as they can -- by definition, not having the government tell you to hang it up and die -- there is even more to fear.

It's not that Obamacare is a one-step federal government takeover of medicine. But it does qualify as another giant step in that same frightening direction.

We've known for years that the more the government picks up the tab for our doctors, nurses, and drugs, the more the government will tell us how to live our lives. What to eat. What not to eat. What not to smoke or drink. What recreations not to engage in (too dangerous), and that we need to do more leg-lifts and jumping jacks with more gusto -- like a scene I recall from 1984.

Already cities have banned trans fat. The poor, who happen to smoke or drink alcohol in larger percentages than those more well off, are increasingly crushed under sin taxes. There's talk of hiking taxes on Dr. Pepper -- and candy.

We can hope that the power of police unions can keep donuts on the market at relatively low expense.

But expect much worse. And though the excuse for ever greater nannying will always be to protect the taxpayers (forced by politicians to pay the medical bills of everyone else), it will be government experts, not taxpayers, dictating dietary and exercise mandates to the population.

Still, the issue of euthanasia is even more frightening. Older people, as their bodies deteriorate, cost more money. Putting hospitals under increased government budgetary oversight and command will not miraculously increase government budgets for hospitals. Cutting costs will become a draconian theme, never ending . . . until death.

Even now, "death by waiting" is a common rationing procedure in Britain and Canada. If you are young and living under socialized medicine, getting dialysis from government-run hospitals is fairly easy; if you are old, wait. The system's limited medical facilities, doctors and nurses practice a kind of triage. The aged are the hopeless, in this common scenario, and give up their lives for the good of the hospital budget.

This is hardly an "easy death" or "good killing" ("euthanasia" comes from euthanos or “good death”). It is death by bureaucracy. Bureaucrats love their queues, need their queues. And the impetus is clear: Saving "the taxpayers" -- not the patients.

Former Colorado Governor Dick Lamm addressed this issue decades ago when he philosophized, "We've got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life."

Mr. Obama and the congressional architects of their new medical regime are promising to cut the overall cost of care. Are we really to believe there will be no pressure to deny expensive treatments in order to save money?

Many opponents of Obamacare are jumping on a provision in one version of this legislative work-in-progress, a directive to pay doctors to counsel the elderly -- and terminally ill patients -- on various end-of-life issues. In the New York Post, Betsy McCaughey said this mandate "invites abuse" and that "seniors could easily be pushed to refuse care."

A front-page Washington Post article, headlined "Talk Radio Campaign Frightening Seniors," reported that this controversy "undercuts what many say is the fundamental challenge of discussing sensitive costly societal questions about how to align patient wishes at the end of life with financial realities, for both the family and taxpayers."

Not getting a pacemaker at 75 years old may mean a person dies at 77 or 78, instead of at 83. What are five years of life worth? Who should decide?

With the federal government in the medical care business through the so-called Public Plan, folks in Washington will have the power to decide.

The reality is this: healthcare will change. The form it takes in the future will be determined by many factors and the overall health of the economy will be the most important factor. If the economy is spiraling into third world status then we will end up with what they have in third world countries. National healthcare with poor service, no or little real benefit and most treatments and meds will not be covered. Sure you will be able to wait half a day in an overcrowded clinic to "see the doctor" but most of the "care" (prescription or treatment) will be poorly subsidized or poorly available.

If the economy fairs better and the gummint allows it we will see "concierge care" become a big thing and one can choose to accept the care at the "public option" clinic and see the Doogie Howser that just finished training or worse an SEIU "Medical IT Technician" who will enter your symptoms into a Artificial Intelligence algorithm and produce a "treatment" printout that he will hand you and wish you a good day. If you can afford the "concierge care" you will get something like you are used to at something like the price you are used to paying.

If the gummint makes "outside the public option" illegal (which they will ultimately have to because no matter how poor the service and care are all gummint run programs quickly spiral out of control costwise) then the concierge care will be illegal. The clinic you are seen in will have a back alley entrance. You will pass the cop exiting as you enter and may even notice the envelope he is stuffing into his pocket.

If nothing is done the market will respond to the pressure and people will figure out how to save money on healthcare themselves by buying the healthcare they can afford. So this is the crux of the matter, really. Should healthcare be like almost everything else in life? Should people purchase the car, food, home, you name it, that they can afford? Or should some aspects of life be "equal"? Whatever that means. I am certain if I were to get a brain tumor my care would never be "equal" to Ted Kenndy's. Se even the folks who claim to have the "high moral ground" don't want "equal" when it comes to themselves.

Even if nothing is done healthcare will change. Costs cannot continue to go up and up. Folks are ultimately gonna be told that you don't need an MRI at 35 for simiple musculoskeletal back pain. Is it gonna be a gummint bureaucrat that tells them this or is it gonna be their wallet? I say that if you can afford a diagnostic study you don't need at ANY age of life you should be able to buy it. Just like you can buy a Mercedes instead of a Honda. I don't think we can continue to make our neighbors pay for things we don't need forever and this is part of what is wrong with our current system. Efforts by liberals to "fix" the system will take us to gummint officials telling us what we can do.

So the way I see it, where we are in healthcare in 5 or 10 years depends on a lot of things but the "Bull Run" is being fought right now. The first battle for where we are going is underway. What happens is tied up in what happens to everything else. The economy, energy, etc. If Zero gets his way the economy won't rebound and things will continue to deteriorate. If we can begin to return to less gumint, less taxes, more investment in real opportunities we could just pull this off in spite of the burden the libtards and RINOs have saddled us with. We shall see.

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"It is proper to take alarm at the first experiment on our liberties. We hold this prudent jealousy to be the first duty of citizens and one of the noblest characteristics of the Revolution. The freemen of America did not wait till usurped power had strengthened itself by exercise and entangled the question in precedents. They saw all the consequences in the principle [usurpation of power] and they avoided the consequences by denying the principle. We revere this lesson too much . . . to forget it." - James Madison

" . . . nip the shoots of arbitrary power in the bud, is the only maxim which can ever preserve the liberties of any people. When the people give way, their deceivers, betrayers, and destroyers press upon them so fast, that there is no resisting afterwards. The nature of the encroachment upon the American constitution is such, as to grow every day more and more encroaching. Like a cancer, it eats faster and faster every hour. The revenue creates pensioners, and the penshioners urge for more revenue. The people grow less steady, spirited, and virtuous, the seekers more numerous and more corrupt, and every day increases the circles of their dependents and expectants, until virtue, integrity, public spirit, simplicity, and frugality, become the objects of ridicule and scorn, and vanity, lusury, foppery, selfishness, meanness and downright venality swallow up the whole society." - John Adams

Further, it was not just the founding leaders who were well-informed about their constitution and approaching threats to its protections. By 1830, when the French jurist Tocqueville traveled America, he wrote admiringly of the citizenry, observing that even the backwoodsman was far more well-read and informed than those in other parts of the world, and that they understood their Constitution, and had with them a Bible and a newspaper. Today, with all modern means of communication, Americans possess little understanding of threats to their liberty and, thus, risk losing it to charlatans whose only goal is power.

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