Nearly everyone in health care wants to cut waste and reduce unnecessary costs — until the conversation turns to advanced chronic illness and end-of-life care. Fears about “pulling the plug on granny,” no matter how ill she may be, have slowed progress toward value-based care. As Atul Gawande notes in Being Mortal, “Such talk, however carefully framed, raises the specter of a society readying itself to sacrifice its sick and aged.”