Because in reality, there are always tradeoffs and constraints. In the US, a disproportionate amount of healthcare costs come at the very, very end of life.
It's possible to meet the sole criteria of science, quality, and patient wishes with exploding costs. I think the OP's point was that money has to come from somewhere.
"a disproportionate amount of healthcare costs come at the very, very end of life."
One might ask why that is; while some is surely due to natural decline in later years, one could likely also posit that the cost-fears leading up through that period (decades), and the general inability to get people to do preventative care throughout adulthood contribute to that significantly.
It is one consequence of a highly atomized culture. I suspect it happens because individuals are expected to take responsibility for their care (basically, this is the human side of cost-shifting and corporate planning around the care gradient available to someone at a given wealth level).
To someone at the end of their life, money is usually less interesting to them than a few more days of breathing. So the market provides.
The explanation I've heard is that it's rooted in the cultural sanctity of life and how that translates to trying to preserve life at any costs (even when quality of life is no longer present).
To be clear, I'm talking about the absolute twilight of one's life that's reached regardless of levels of preventative care. I think there's potentially an opposite point that could be made: taking care of one's self can prolong this period and make it cost more. Someone who drops dead of a heart attack one afternoon won't have the same end-of-life costs as someone who gradually becomes enfeebled with age.
It's possible to meet the sole criteria of science, quality, and patient wishes with exploding costs. I think the OP's point was that money has to come from somewhere.