A great deal of overall health care expense is incurred by people in the last years of their lives. Part of the conversation that needs to take place involves a frank discussion of what their wishes are and what's reasonable. At some point procedures and diagnostic tests are counterproductive. In most cases they continue past a point of being beneficial.

I'm certainly not saying that people shouldn't have treatment or go into the hospital if needed, but our medical culture is geared toward considering everything except the fact that old people die. And how they die is a conversation they and their families need to be included in.