Where Should Society Draw the Line on Moral Choices?

In this opinion article in the Wall Street Journal, Senator Rob Ortt raised concerns regarding New York’s consideration of assisted suicide legislation, describing it as “the government granting medical professionals the power to sanction death.”

While there are compelling arguments on both sides of this deeply personal issue, my purpose is to take a broader step back and ask: Where are we, as a society, heading on moral choices?

Consider organ transplants. We currently prohibit individuals from selling their organs, despite overwhelming demand and life-saving potential. A commercial market for organs could increase supply and offer financial help to willing donors. Yet, society has drawn a firm moral line: human organs are not for sale.

A similar debate surrounds prostitution. Supporters argue for bodily autonomy and economic freedom. Still, most of society continues to view the commodification of sex as morally corrosive and socially harmful.

In contrast, we’ve shifted our position on other moral boundaries. Gambling, once widely considered a vice, is now normalized—especially in sports. And compensation for student-athletes, once taboo, is now accepted at the college level and even in high schools in at least 10 states.

We see a pattern: the line is moving—steadily and unmistakably—toward expanding individual freedom and away from collective moral judgment. Assisted suicide, now legal in 10 states and the District of Columbia, is one more step along this trajectory. Proponents argue for personal autonomy in the face of suffering, but we must also ask: Are these shifts truly serving the common good?

Personally, I do not believe society is better off for having legalized gambling, prostitution, or commercial organ sales. Nor do I believe we benefit from the commercialization of amateur sports. And I am not convinced that assisted suicide—especially in a system that still underfunds palliative care and hospice—is the right path forward.

As Senator Ortt suggests, improving access to high-quality end-of-life care could address much of the suffering that leads individuals to seek assisted death. Rather than continuing to move the line, perhaps we should pause and reflect more deeply on the long-term moral and social consequences of where it is being drawn.

What we need is a Big Beautiful Overhaul

This opinion piece, titled Medicaid Is Overdue for a Big Beautiful Overhaul, calls for a significant reform of Medicaid and argues that the Big Beautiful Bill fails to implement meaningful changes. It highlights the complicated nature of Medicaid, which operates under federal and state oversight with dual funding. This dual oversight results in a convoluted set of regulations and conflicting incentives, making Medicaid one of America's most expensive and inefficient insurance products.

To improve Medicaid, a single governing body—either state or federal—is essential. Additionally, the oversight regulations need to be greatly simplified.

Moreover, Medicaid should implement a payment formula for providers that promotes primary care. Offering concierge medicine to Medicaid patients could enhance care quality while significantly reducing overall costs. For more details, visit www.thejourneys-end.org.

What a waste

Three decades ago, there were no healthcare companies in the top 25 of the Fortune 500. Today eight of the top 25 are healthcare companies. Ironically, none of those top eight actually provide care to patients. They are organizations adding greatly to the overall cost of healthcare but creating almost no value for patients. In fact, they tend to create frustration for patients. The murder of United Healthcare’s CEO (number 3 on the list) illustrates the level of frustration created by these overhead entities dominating healthcare.

So why do we spend so much of our healthcare dollars on overhead? It is estimated that we spend one trillion dollars annually for billing alone - what a colossal waste of money. These costs are unnecessarily high because we make everything in healthcare too complex - from coding, to HIPPA, to fraud and abuse. These self-imposed systems are insanely complex and ineffective.

Fundamental progress will require these overhead burdens to be changed or eliminated. Go to www.thejournys-end.org to learn more about our options for reform.