Oh, I like this

Cardinalpark is pushing for Medicare and Medicaid to become defined contribution plans rather than defined benefit plans, citing the success his company has had in doing that with its own health insurance. This is a sort of variation on the types of plans I discuss here and, obviously, I think it’s a great idea.

However, what really caught my attention was this idea from one of the commenters:

I think HSA for medicare would be a great way to go. In addition we should do away with the current estate tax and replace it with an end of life health care bill. So that the heirs receive a bill for a % of the medical cost for the last three years of life up to a % of the estate. Combining these two would go a long way to reduce health care costs as families ration their own care. Dr visits & MRI's with HSA's and massive end of life care with the estate bill.

I really like this. It lets the person who is at the end of his life decide whether he wants to spend his money on extreme measures or would prefer to leave a larger estate to his heirs.

We would need to build in safeguards of course; we don’t want a greedy heir to be able to take control of his infirm grandmother’s finances and decide to preserve his inheritance by consigning Grandma to the tender mercies of Shady Farms CutRate Hovel for the Aged. In a mild bit of irony the best safegaurd would be detailed end of life instructions like, oh, I don’t know, maybe an expansion on the basic Order for Life Sustaining Treatment?