---

Xkeeper's note: Speech in Tanks's video is highlighted.

---

SAWYER: And we have with us a couple of people who really represent the opposite ends on this spectrum too. I want to talk, if I can, to Jane Sturm. Your mother, Hazel - Hazel Homer --

JANE STURM: Yes.

SAWYER: -- 100 years old and she wanted --

STURM: She's 105 now, over 105. But at 100, the doctor had said to her, I can't do anything more unless you have a pacemaker. I said, go for it. She said, go for it. But the arrhythmia specialist said, no, it's too old. Her doctor said, I'm going to make an appointment, because a picture is worth a thousand words. And when the other arrhythmia specialist saw her, saw her joy of life and so on, he said, I'm going for it.

So that was over five years ago. My question to you is, outside the medical criteria for prolonging life for somebody elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, quality of life? Or is it just a medical cutoff at a certain age?

OBAMA: Well, first of all, I want to meet your mom, and I want to find out what she's eating. But, look, the first thing for all of us to understand is that we actually have some -- some choices to make about how we want to deal with our own end-of-life care. And that's one of the things I think that we can all promote, and this is not a big government program. This is something that each of us individually can do, is to draft and sign a living will so that we're very clear with our doctors about how we want to approach the end of life.

I don't think that we can make judgments based on peoples' spirit. That would be a pretty subjective decision to be making. I think we have to have rules that say that we are going to provide good, quality care for all people.

GIBSON: But the money may not have been there for her pacemaker or for your grandmother's hip replacement.

OBAMA: Well, and -- and that's absolutely true. And end-of-life care is one of the most difficult sets of decisions that we're going to have to make. I don't want bureaucracies making those decisions, but understand that those decisions are already being made in one way or another. If they're not being made under Medicare and Medicaid, they're being made by private insurers.

We don't always make those decisions explicitly. We often make those decisions by just letting people run out of money or making the deductibles so high or the out-of-pocket expenses so onerous that they just can't afford the care. And all we're suggesting -- and we're not going to solve every difficult problem in terms of end-of-life care. A lot of that is going to have to be we as a culture and as a society starting to make better decisions within our own families and for ourselves.

But what we can do is make sure that at least some of the waste that exists in the system that's not making anybody's mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn't going to help. Maybe you're better off not having the surgery but taking the painkiller.

And those kinds of decisions between doctors and patients, and making sure that our incentives are not preventing those good decisions, and that -- that doctors and hospitals all are aligned for patient care, that's something we can achieve. We're not going to solve every single one of these very difficult decisions at end of life, and ultimately that's going to be between physicians and patients. But we can make real progress on this front if we work a little bit harder.

---

Originally posted by Dawn

---

It's still morally and ethically wrong to judge someone based on their quality of life.

---

---

I don't think that we can make judgments based on peoples' spirit. That would be a pretty subjective decision to be making. I think we have to have rules that say that we are going to provide good, quality care for all people.

---

Originally posted by Dawn

---

You've gotta' be kidding me... Where are his facts that his health care system outdoes our current one in the 'good, quality care' department? All I'm seeing now is a guy trying to control everyone's 'Right to Life.' That answer is nothing but Obama's usual verbose answers he always gives. Cut the crap and give me the facts mister president.

---

---

The opponents of public health care insist that the US has the best health care system in the world. They claim that moving the US to a Western European model of national health care would result in a huge step backwards in both quality and access.

Well if that is the case, then why isn't health care reform a huge issue in Western Europe? If the European systems are inferior to the US system, then why aren't the French and the Germans mired in a crisis that is even worse than the US one?

I'm sure they are far from perfect, but if their health care systems were as inefficient and intrusive as US critics claim they are, then the voters in France and Germany would be demanding radical reforms. Why aren't they demanding a market based health care system?

---