I have just been told by my doctor that I have a mild form of heart disease. Not “drop-dead tomorrow” heart disease, but worrisome. I also had to be helped down from a mountain climb in August because of a deteriorating hip. Age is presenting its bill, as it does to all who live a long life. Yes, it’s a bummer, but one bright side is that it gives me certain bona fides to discuss end-of-life care and the cost of the elderly in our aging society. I now have skin in the game.

My generation’s bodies are developing ailments and chronic conditions faster than our economy can fund. Modern medicine has presented us with a Faustian bargain: Our aging bodies can bankrupt our children and grandchildren. We have run into the “law of diminishing returns” in health care, where we are often doing more and more, with higher and higher technology, at more and more cost, for less and less benefit. Health care is important, but it cannot trump every other societal need. We must begin a dialogue by thinking clearly about the costs and goals of medicine in a rapidly aging society.

I believe that parts of medical ethics are unethical public policy because they drive too much marginal medicine and lock in higher and higher costs. Families without any financial responsibility demand endless (and often marginal) care paid for by a government that can’t even come close to balancing its budget. We crowd out other important national priorities keeping frail, elderly and often demented people alive on public money. We need a new ethical structure that compares the money spent on marginal procedures in health care with the other important needs of our society. Health care is always at the front of the budget line with its hand out. It is considered inappropriate to even apply a cost-benefit analysis on the marginal care we deliver.

We spend billions on marginal and often unnecessary procedures on people who are in the final dying process, yet we leave millions of Americans out of the health insurance system and America’s kids have the worst dental health in the developed world. We are spending too much on the dying and not enough on the living, too much on the past and not enough on the future.

Why give chemotherapy or even antibiotics to people with end-stage Alzheimer’s disease? Keep them pain free and clean, love them but don’t automatically try to get the last technology-produced breath from then. Start a preschool program instead or do something about the atrocious state of obesity in our children.

I believe for some high-technology medicine, like transplants and kidney dialysis, age should be a consideration in the delivery of that technology. In a world of limited resources, we have a larger duty to a 10-year-old than to a 90-year-old. All religions, cultures and traditions distinguish between death after a long life and a premature death.

I am a fan and a friend of Dan Callahan, a medical ethicist who believes that beyond age 85 we should not make available expensive, high-technology medicine. At age 85, Callahan suggests we have had our “fair innings” (Norm Daniels’ term) and that money would be better spent on the health needs of younger Americans who have not had their fair innings. I believe people over 85 should get ordinary medicine, kept pain free, but not the expensive high-technology medical miracles.

No other society would take a 90-year-old with a terminal disease out of a nursing home and put them into an intensive care unit. My wife and I were once at the bedside of a 93-year-old man with three fatal diseases (metastatic cancer of the prostate, end-stage kidney failure, and he had just been brought into the intensive care unit with a serious stroke). Massive resources were being poured into this gentleman, while blocks away people were going without primary care and kids were going without vaccinations. The nurse in the room asked the cosmic question: “When God calls, how much do we argue?”

Ten percent of U.S. hospital beds are ICU beds, while the rest of the developed world uses 3 percent of their hospital beds as ICU beds. What do we get for our extra intensive care beds? We do save many people, but we also get many unnecessarily expensive deaths. We have failed to develop policies that rationally limit the use of intensive care beds to those who truly benefit. An ICU bed was designed for a realistic salvage attempt, not end-stage care.

The hubris in thinking that medicine can deliver to an aging society all the “beneficial” medicine its inventiveness has developed is misplaced and harmful to other public policy priorities. For all our spending, the U.S. denies more health care to more people than any other developed country. We are the only developed country in the world that doesn’t have universal health care.

Among the 19 wealthy countries, the United States ranked 19th in curing people who could be cured with decent care. The number of people under 75 who die from curable illness was almost twice as high in the United States as the best on this measure from France, Japan and Spain, writes T.R. Reid. We have technologically brilliant medicine, but a morally flawed health care system.

If public policy allows health care to trump all other considerations, we risk having a medical Taj Mahal amid massive social squalor. We will have seniors getting all the medical miracles of medicine while other Americans die because they have inadequate care. Public policy tries to bring social balance to the total society and should not allow one category of needs to trump all other social considerations. But that is what is happening today in America: Aging bodies, including mine, and modern technology are growing a giant unsustainable burden on our children and grandchildren and crowding out other important civic needs.

Richard D. Lamm was Colorado’s 38th governor.