I would tend to suspect insurance issues for a person who limits their doctor visits. You wouldn't believe what insurance companies are trying to get away with now, and if they know that the person's income is fixed or limited, they have no fear of legal action. Well visits now are being limited annually to two or three by some companies, and annual deductibles are outrageously high. And on the flip side, if doctors know that a patient has good insurance that pays liberally, they will schedule frequent visits in order to collect more payments. This tendency for money to be greedily drained off the top is one thing that contributes to the serious lack at the bottom. I worked in health care most of my life, so I know how things can go. Until something is put into place that prevents this, there is nothing to hold the medical profession accountable. I saw recently where Aetna had to pay 24 million for failing to provide the coverage needed for a lady who had cancer and needed a particular beam radiation...and I'm sure they nearly messed their pants when they were held responsible for that woman's death. When I saw the article I wanted to jump up and cheer....because it won't take many cases like this before the insurance companies will get it that they can't put people in that kind of bind, especially when they agree to cover, and then back out of the agreement. I had it happen twice, and both times had to cover the steep cost out of pocket. For a cancer patient, unless someone is extremely wealthy, paying out of pocket for treatments can totally wipe out a family. Some homeless individuals are in that state because of having health care drain their life's savings. So, quality of life unfortunately is not just measured according to wellness. There has to be restraint placed upon greed in what is charged for procedures, as well as accountability in insurance companies. Many years ago a local ER had a 400% markup in prices for procedures for paying customers in order to help cover indigent care. The night I was diagnosed as being diabetic, I was held in the ER overnight, and the next day just long enough to squeeze a two day ER charge of thousands of dollars out of my work insurance, which was good coverage at the time. When they commented that I had "good" insurance, I should have known what they were going to do...and I would have been better off just being sent home with instructions for insulin shots. It was their way of balancing the books....but it was stealing from the insurance company. When it came to the issue of dealing with cancer, I discussed it with my family before I even went to surgery...that I would pursue it only so far...but that if it became a long, drawn out, costly situation, I would have to just take what comes, because of my age and already existing health issues. Wellness alone does not guarantee quality of life, if over half of one's income is being poured into health care. And, sadly, some who go through cancer treatments once vow to never go through it again...I have a friend who is in the middle of round two, and reaching the "is all this really worth it at my age" feelings. I have another friend who started sleeping on the bathroom floor in order to be closer to a place to throw up. If folks have not been through it, it's difficult to understand fully all that the person is going through...physically, emotionally, financially, and spiritually. So, I do have at least a little understanding of folks who prefer to pass with dignity at home with their families. And...if insurance heads in the direction that is trying to be pushed upon this country, with no coverage for pre-existing conditions, we'll be seeing a lot of stuff happening to friends and loved ones that we don't care to see.