As far as "ludicrous end-of-life-procedures for old people", I agree Americans spend far too much on those, but the bulk of that is people who are 65 or older,

As far as "ludicrous end-of-life-procedures for old people", I agree Americans spend far too much on those, but the bulk of that is people who are 65 or older, which is outside PPACA's purview, since they are already covered by Medicare [1]. If you want to argue for Medicare to reform how it treats end-of-life coverage, I'd support that, but anyone who argues that Medicare should spend less on end-of-life heroics runs into hysterics about "death panels" refusing to pay for an extra 10 days of granny's life support. PPACA is trying to fix a fairly different problem, the under-65 segment, where end-of-life treatment is a much smaller proportion of costs. [1] About 80% of Americans who died in 1997 were covered by Medicare at the time of death: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/