Leonard Fleck, PhD, Professor of Philosophy at Michigan State University, wrote in his May-June 2006 article "The Costs of Caring: Who Pays? Who Profits? Who Panders?" that appeared in The Hastings Center Report:

“We need to reject the view that we have a moral obligation to spend any amount of money to save all lives and life-years that medical technology permits. The result of adopting this view would be a gross distortion in our society’s health care priorities that would not be just, compassionate, or prudent…

Literally dozens of extraordinarily expensive cancer drugs and medical devices are now entering the market. All of them are ‘effective’-they prolong life. But the added time is often measurable in weeks and months, not years, which yields very high cost-effectiveness ratios-literally hundreds of thousands of dollars per quality-adjusted life year (QALY). Aggregate costs for all these treatments can quickly mount into the tens of billions of dollars. This has two morally problematic systemic consequences: employers drop or drastically restrict health insurance, and health priorities get skewed in ways that are both unjust and uncaring.

As the cost of health insurance to employers mounts by double digits, more drop coverage as an employment benefit or increase copay requirements substantially. In either case, the economically disadvantaged have less access to needed health care than those who remain well insured and well paid…

I have argued elsewhere that the need for health care rationing is inescapable.”

May-June, 2006