This popped into my mind last night, after reading Gregg Easterbrook's somewhat glib piece about why wealthy liberals should just voluntarily pay more to the government than the law requires them to. The more you try to figure out ways to square the healthcare costs circle – fiscally and morally – the harder it gets. But this option is easily grasped and needs no government action.

If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age, then we'd immediately make a dent in some way on future healthcare costs. A remarkable proportion of healthcare costs go to the very last days or hours of our lives.

This seems to me particularly apposite for the boomers who, even if Paul Ryan got his way, would still be grandfathered into the most generous combination of personal prosperity and government support of any generation in history. Wouldn't a few fewer unconscious hours or days be a sacrifice worth making?

Of course, this would be entirely voluntary – and not even nudged (although, frankly, I see no reason why the government shouldn't nudge you to make arrangements ahead of time given that others will be forced to pay the costs). "Death panels!" Christianists would scream, revealing exactly how un-Christian they are. Christians, of all people, it seems to me, have nothing to fear from death, and a great deal to gain from giving a few of their own unconscious final days to make it feasible for others to have a few more conscious and healthy ones.

How about an easily reached website that makes such a legal process easier to accomplish?