Ought the young make health care decisions for their aged selves?

Though the chief responsibility for providing for the health care of older Americans has been (and should remain) society's, there has been increasing interest in private solutions. Individual provision, however, would require not only adequate wealth but prudent planning, demanding in turn more discipline, self-control, and foresightedness than many individuals are normally capable of. One possible corrective is pre-commitment, a strategy of binding oneself to a plan chosen to allocate resources optimally over the life span. Though pre-commitment may have some important uses, however, it is far from clear that people should be encouraged or enabled to rely upon it for old-age health care planning. The present paper examines some of the philosophical and policy concerns attendant to the use of pre-commitment strategies for resource allocation in old age.