Long Term Care Crisis

[The Great Zaganza]

Insurance only works, mathematically, when it is mandatory.
that's the only way to keep costs down.

Companies generally, but Healthcare providers in particular have usually complete power over their customers, as consumers often don't have the option not to have a procedure, or not the time to shop around for the best/cheapest options. It's also something everyone needs at some point in their lives.

Because of this, healthcare needs to be a Public Service - otherwise, you get something that maximizes Profit, not Service.

 

[ponderingturtle]

Because of this, healthcare needs to be a Public Service - otherwise, you get something that maximizes Profit, not Service.

Capitalism will not stand such heresy!

 

[Trausti]

Because of this, healthcare needs to be a Public Service - otherwise, you get something that maximizes Profit, not Service.

I dunno. Are you under the impression that public healthcare services don't ration care? And if you urgently needed an MRI or other diagnostic test to determine if you have cancer, would you prefer capitalist waiting times or public healthcare waiting times?

 

[mumblethrax]

The state requiring that people deplete their estates before they'll take on the cost of end-of-life care doesn't seem like such a terrible thing to me. That money might otherwise serve as inheritance, but leaving money to children is a practice that increases inequality by heaping further advantages on people who have already enjoyed a lifetime of advantages, relative the the bulk of Americans who will never inherit a dime.

Of course the people who have enjoyed the most advantages won't have their fortunes significantly diminished by these costs, so a less regressive way of shouldering the burden would be reasonable. An increase in/reintroduction of a graduated estate tax seems justified here.

The anti-meritocratic right would no doubt attempt to frame this as a "death tax", at which point supporters could point to the Rich Kids of Instagram account and call it an anti-douchebag tax.

 

[dirtywick]

to me inequality is eroding the middle class, and this just serves to further deplete the middle class as they’re the only ones with something to lose. the poor already have nothing to contribute to eol and the rich won’t even notice

 

[The Great Zaganza]

I dunno. Are you under the impression that public healthcare services don't ration care? And if you urgently needed an MRI or other diagnostic test to determine if you have cancer, would you prefer capitalist waiting times or public healthcare waiting times?

Even if that was the case, there would be more money available without having to siphon a huge chunk off for profits and shareholders.
A State can also force everyone else to keep their profits to a minimum, because as the biggest customer, it can dictate prices - hospitals very much can't.

 

[ponderingturtle]

The state requiring that people deplete their estates before they'll take on the cost of end-of-life care doesn't seem like such a terrible thing to me. That money might otherwise serve as inheritance, but leaving money to children is a practice that increases inequality by heaping further advantages on people who have already enjoyed a lifetime of advantages, relative the the bulk of Americans who will never inherit a dime.

Of course the people who have enjoyed the most advantages won't have their fortunes significantly diminished by these costs, so a less regressive way of shouldering the burden would be reasonable. An increase in/reintroduction of a graduated estate tax seems justified here.

The anti-meritocratic right would no doubt attempt to frame this as a "death tax", at which point supporters could point to the Rich Kids of Instagram account and call it an anti-douchebag tax.

And who cares about their spouses left destitute this is why you shouldn't get married, to protect your retirement savings.

 

[mumblethrax]

to me inequality is eroding the middle class, and this just serves to further deplete the middle class as they’re the only ones with something to lose. the poor already have nothing to contribute to eol and the rich won’t even notice

The "poor" (ie, over 50% of Americans) have nothing so we should work harder to prevent the (upper) middle class from losing an advantage they have done nothing to deserve is not an argument I have much sympathy for.

And who cares about their spouses left destitute this is why you shouldn't get married, to protect your retirement savings.

What reason is there to care about spouses left destitute more than spouses who started out that way? These are arguments that the state should prioritize the subsidy of the "lifestyle to which I am accustomed" over basic needs.

 

[dirtywick]

The "poor" (ie, over 50% of Americans) have nothing so we should work harder to prevent the (upper) middle class from losing an advantage they have done nothing to deserve is not an argument I have much sympathy for.

when i said middle class i meant middle class

 

[mumblethrax]

when i said middle class i meant middle class

The middle class, by and large, does not inherit anything. Inheritance is the purview of the affluent and super-affluent.

Part of the problem here is that people have wildly inflated expectations about what they're going to inherit. Most people get nothing, and the people who get something almost invariably get less than they think they will.

 

[dirtywick]

having funeral costs covered and a few thousand bucks for each of the kids would actually go a long way to a lot of middle class folks imo. deplete the some of the estate imo

 

[mumblethrax]

having funeral costs covered and a few thousand bucks for each of the kids would actually go a long way to a lot of middle class folks imo. deplete the some of the estate imo

The majority of Americans (including the bulk of the middle class) do not inherit anything. Not "a small inheritance." Nothing.

And you're still arguing for unearned advantages in any case. The working class also has funerary costs.

 

[TragicMonkey]

Heh. My mother inherited a little money when my grandparents --both sets-- died; they'd been saving up all their lives for their own end-of-life care, and didn't burn through all their savings before they died. So they left it to the next generation. My mom's share was (wisely) invested in order to prepare for her own end-of-life care. With luck she won't outlive that money, and whatever remains will be passed down to her kids who will --you guessed it! -- invest it to save for their own end-of-life care. So in my case we've got three generations who are both inheriting money and using it for end-of-life care.

I'm curious to know if this makes us/me evil for inheriting the money, or good for using it for our medical expenses rather than relying on whatever scraps of assistance we can suck out of the state?

 

[dirtywick]

The majority of Americans (including the bulk of the middle class) do not inherit anything. Not "a small inheritance." Nothing.

ok so you’ve identified my problem with eol care depleting estates.

And you're still arguing for unearned advantages in any case. The working class also has funerary costs.

unearned is an interesting word there. but anyway i’m not arguing the working class should have their estates depleted by eol care either. like, anyone who’s estate isn’t completely depleted by eol care would have something left for their kids.

 

[Roger Ramjets]

unearned is an interesting word there. but anyway i’m not arguing the working class should have their estates depleted by eol care either. like, anyone who’s estate isn’t completely depleted by eol care would have something left for their kids.

As someone who's father's estate was completely depleted by eol care, it doesn't bother me at all. I expected nothing and got nothing.

 

[mumblethrax]

ok so you’ve identified my problem with eol care depleting estates.

And I'm pointing out that that those estates are overwhelmingly in the hands of the wealthy (more or less by definition). You're arguing for state-subsidized estate insurance, which is inescapably a give-away to the affluent, because those are the people who have estates.

unearned is an interesting word there.

It's an inarguably accurate word, unless you think you earned grandpa's money.

but anyway i’m not arguing the working class should have their estates depleted by eol care either.

Don't make me point to the Anatole France quote.

 

[Roger Ramjets]

Should we give a 90-year-old a heart transplant so he can spend another 5 years drooling into his shirt?

No, we shouldn't. In my country we don't.

But should we let old rich people pay for it if they can? I say yes, if they have enough money after we have taxed them appropriately.

We limit healthcare in lots of ways. Limiting the amount spent on people at the end of their life seems a lot less sensible than spending money on kids and young people.

We already do that, so...

Somewhere in the rest of this century, those questions will come home to roost. Japan is the bellwether, with a very old population that is far outpacing new taxpayers joining society.

In the future most work will be done by robots. If you want support in your old age then buy TSLA stock now!

 

[dirtywick]

And I'm pointing out that that those estates are overwhelmingly in the hands of the wealthy (more or less by definition). You're arguing for state-subsidized estate insurance, which is inescapably a give-away to the affluent, because those are the people who have estates.

i don't think eol care should be able to completely deplete an estate is what i'm arguing. cap what they can collect

It's an inarguably accurate word, unless you think you earned grandpa's money.

well, i don't think so. i think i'd be giving grandpa a choice he wouldn't other wise have. he can give it to anyone.

Don't make me point to the Anatole France quote.

i'm not familiar with the quote

 

[dirtywick]

As someone who's father's estate was completely depleted by eol care, it doesn't bother me at all. I expected nothing and got nothing.

thanks for sharing that

 

[dirtywick]

Heh. My mother inherited a little money when my grandparents --both sets-- died; they'd been saving up all their lives for their own end-of-life care, and didn't burn through all their savings before they died. So they left it to the next generation. My mom's share was (wisely) invested in order to prepare for her own end-of-life care. With luck she won't outlive that money, and whatever remains will be passed down to her kids who will --you guessed it! -- invest it to save for their own end-of-life care. So in my case we've got three generations who are both inheriting money and using it for end-of-life care.

I'm curious to know if this makes us/me evil for inheriting the money, or good for using it for our medical expenses rather than relying on whatever scraps of assistance we can suck out of the state?

makes you rich i guess