The significance of a wish.

Wanglie's bills of $800,000 over some seventeen months are an eloquent reminder of our society's economic limits. How does this affect our capacity to purchase health insurance to meet a growing list of human needs and desires? As a society we visualize health insurance as an open-ended individual entitlement, which is one of the major problems confronting our ability to pay for health care generally. Such policy considerations, while not germane to this particular court proceeding, are crucial to the morality of health insurance and to our ability to set priorities among technologies acknowledged by our health care professions to be only marginally useful, or of no medically demonstrable benefit. The case of Helga Wanglie raises questions of how 'benefit' is to be determined in our society, and what role the medical profession may legitimately play in developing a definition of medical benefit. It also challenges us to assess the medical profession's role in creating public moral values to distinguish care that is recompensable under health insurance from benefits that more properly reside in the private domain of personal preferences.