One of the first things we do in introductory economics courses is try to make the point that because humans seem generally to have unlimited wants but because there are limited productive inputs, we are condemned to live with scarcity. Like it or not, we cannot have all we want of everything. We must make choices somehow.
This fact of human existence is crucial for understanding the problems we will increasingly face in the realm of medical care. As we move toward increased use of gubmnt programmes to provide the care, not everyone will be able to receive all the care they might want. This problem of scarcity will most often be stated as a problem of not being able to afford the medical care, but it really stems from a problem of scarcity: when customers don't have to pay directly, they want more than they would otherwise, and getting all the productive inputs to provide all that care (i.e. attracting them from alternative uses) is extremely costly, involving painful trade-offs.
So we have to have a mechanism for deciding who gets the medical care. We must have some sort of rationing scheme. Some people might urge the use of the market to make this decision. Others might urge the use of co-pays and limits on some types of insurance to decide. Others openly recommend letting doctors, committees, and bureaucrats decide (aka death panels?). But we have to acknowledge that not everyone will ever get all they want. Choices must be made somehow.
You may not like that reality. You might think people should behave differently. But the sad fact is that scarcity necessitates our making such choices. There is no way around it.
We see this problem now with cancer patients in the US. From the Washington Post,
Cancer clinics are turning away thousands of Medicare patients. Blame the sequester.
... Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.
Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.
It may seem that the sequester and a cut in funding for medicaid/medicare have caused this problem, and I suppose in the short-run that's right. But in reality, the problem is a much greater quantity demanded at current prices (zero!) than is supplied.
The problem is an old one that economists have presented endlessly: whenever the gubmnt sets a price of zero and tries to guarantee that everyone who wants something at that price can have it, then shortages emerge. And then, to try to fix the problem, the gubmnt must decide how to ration the product.
In this case the rationing is left to medical facilities. And they, quite understandably, are choosing to decline to treat those patients for whom the costs of treatment are extremely high.
Whether we want to acknowledge it or not, these are death panels. These are groups of people deciding who should or should not receive treatments.