I think the point raised by GP is about distribution of finite resources for maximum benefit. E.g. do we spend a large amount of money to extend someone's life by 2 years if we could spend the same money to save 10 lives elsewhere?
1. I think we underestimate our scarcity nowadays, since much of it is completely manufactured by rich powers who want to keep an obedient working class. We are definitely approaching a point of achieving post scarcity society. No one should have to starve nor fear for their health in 90% of cases.
2. In such a case, we'd add help chip in for it. There aren't thousands of new people every day needing artificial hearts. There is certainly enough commerce in any first world country to fund such cases.
