It may be a chiyuv on the community to provide health care for all — Rabbi Dr. Moshe Tendler (yes, he is a modern orthodox Zionist but he is also a leading posek for medical matters) gave a pretty convincing proof to this a few years ago and I’ve seen no counterargument. (Is there *any* rabbi who says that we are permitted to stand by and let someone die because they can’t pay for medical treatment? It happens, more often then people believe.) Most developed countries in the world, including Israel, do this.
End of life care isn’t going to be affected much (either expanded or restricted) by the various proposals in Congress, except that if we do manage to get universal coverage after that it will become more possible to provide halachically acceptable end of life care without bankrupting a family with no or inadequate insurance. This alone would seem to make health insurance reform a good thing. Whether it is done through public or private plans would not seem to matter. (I can’t understand why people are so upset about a “public option” or lack of one.) I will add that my wife is a physician who treats Medicaid patients and she tells me that in the four plus years she has done this in New York they have never denied coverage for treatment she has recommended.