End of life care constitutes the large majority of lifetime medical expense. The problem of course is knowing ahead of time who the lucky few % are that will benefit from aggressive care.

I think it’s fair for an insurer to limit such aggressive care. If you are dumb enough to rely on the government as your insurer, then the taxpayer has a right to cut you off (that’s what you get for ceding liberty over your health to the State, IMO).

That said, are there any other medical situations where counseling by the government is mandated? It seems like a bad idea to me entirely on that basis—the government should stay out of the doctor-patient relationship. It’d be fine for them to make turnkey living will solutions, etc available, but I don’t think there needs to be a mandated conversation.