KIE: In light of the projection of increasing deficits in the present Medicare program, we must rethink our goals for health in old age and curb our insatiable appetite for longer life regardless of expense. The failure of efforts to control costs through efficiency measures has forced elderly persons to forgo decent long-term or home care, and yet public opinion continues to expect more and better health care with no corresponding inclination to pay for it. The emphasis of entitlement programs must be shifted from short-term, critical care medicine for the elderly to the provision of care that improves the quality of their day-to-day life, while not necessarily extending that life; the most expensive forms of life-extending care would then be rationed according to a flat age limitation decided upon collectively by society.