State-sponsored websites could provide easily accessible and reliable quality ratings of hospitals, nursing homes, assisted living facilities, and home health and hospice programs, helping to align market forces with public health priorities. Medicare’s star ratings of nursing homes, while far from perfect, are having a noticeably positive impact on quality of long-term care.

I’ve been making this case to state legislators who sponsor or support legalizing assisted suicide, almost all of whom are Democrats. I get a lot of “yes-but” responses: Yes but, you’ll never get doctors to practice the way you describe. The less polite refer to entrenched interests in the status quo and financial pipelines of the medical-industrial complex. Without disputing my premise, one senior blue state senator recently told me I was naïve to think anything substantial would change.

He sounded depressed, but I couldn’t let him off the hook. I pointed out that if the physician-assisted suicide bill he supports becomes law, his mother’s internist will still not have been adequately trained or have the skills needed to treat her pain or breathlessness. He will be no better at listening to her concerns or counseling her through the difficult, but normal, process of leaving this life. He will, however, be able to write her a lethal prescription.