I think it needs to be taken on a case by case basis. The elderly and the obese are often in the same age group. The elderly are often overweight and suffering from cardiovascular disease. Why should the government or medicare spend any money on by pass surgery when it has been known for decades that cardiovascular disease can be reversed through diet, exercise and stress control? I suppose one could call it rationing, but if by pass surgery was no longer paid for by the government or medicare, people would simply have to make a choice. 1) they could pay for it themselves 2) they could reverse it by changing their lifestyle or 3) they could do nothing and risk dying from a heart attack or stroke.

In the end, the answer is that we need to get back to personal responsibility.