Long Term Care Crisis

[TragicMonkey]

makes you rich i guess

Wouldn't that depend on the total amount of the money? It's more than my salary but not enough to purchase a house where I am, even if I inherit the total sum my mom currently has.

 

[dirtywick]

Wouldn't that depend on the total amount of the money? It's more than my salary but not enough to purchase a house where I am, even if I inherit the total sum my mom currently has.

idk it's just what i heard somewhere

 

[mumblethrax]

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

Sure, but that's still a subsidy. If you aren't paying for it, someone else is. Given the country we (?) live in, that will probably take the form of increases to regressive payroll taxes or something equally dumb, which means that the bottom quintile will be significantly subsidizing those who are better off.

I just don't see any good reason to do this beyond "But I want it!"

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.

Whoever he gives it to won't have earned it. Unless he's especially awful to be around and you have to suck up to him. But you probably shouldn't get more than $20/hour for that.

i'm not familiar with the quote

"The law, in its majestic equality, forbids rich and poor alike to sleep under bridges, to beg in the streets, and to steal loaves of bread."

The working class don't have estates to deplete. "Everyone should have their estate protected!" is a sentiment that is designed to appear egalitarian, but which rather pointedly ignores where wealth accumulates.

 

[dirtywick]

Sure, but that's still a subsidy. If you aren't paying for it, someone else is. Given the country we (?) live in, that will probably take the form of increases to regressive payroll taxes or something equally dumb, which means that the bottom quintile will be significantly subsidizing those who are better off.

it doesn't have to be subsidized stupidly

Whoever he gives it to won't have earned it. Unless he's especially awful to be around and you have to suck up to him. But you probably shouldn't get more than $20/hour for that.

ok, fair enough. it's unearned.

"The law, in its majestic equality, forbids rich and poor alike to sleep under bridges, to beg in the streets, and to steal loaves of bread."

The working class don't have estates to deplete. "Everyone should have their estate protected!" is a sentiment that is designed to appear egalitarian, but which rather pointedly ignores where wealth accumulates.

it's not protecting estates. what i'm saying is if the middle and working class don't have estates now, then maybe if these facilities can't take everything until it's gone, then there'd be something left. so maybe there should be a cap on what they can take for that reason.

 

[mumblethrax]

it doesn't have to be subsidized stupidly

I'm inclined to think that subsidizing it at all is stupid, outside of limited cases where forcing people to sell off property actually increases the burden on the state.

Subsidizing care makes sense. Arguing that the state should reinforce already heavily entrenched class divisions does not.

it's not protecting estates. what i'm saying is if the middle and working class don't have estates now, then maybe if these facilities can't take everything until it's gone, then there'd be something left. so maybe there should be a cap on what they can take for that reason.

Most working class people can barely afford to live. Look at retirement savings by income group prior to retirement age, the point where long-term care typically kicks in. You can't preserve wealth that doesn't exist.

 

[The Atheist]

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

That was an extreme example, but we do do heart bypass surgery on people in their 80s which is every bit as bad.

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.

Quite right - they should be able to gift their wealth to other rich people, and if you don't think there's money in aged care, see how many rest homes McCaw & Carter own.

We already do that, so...

You keep saying you're a Kiwi and I keep wondering if you really are, or if you're some hermit that doesn't many people outside the internet.

You cannot possibly fail to know how NZ's system works if you live here. 42% of the health budget is spent on the oldest 15% of the population.

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

I agree robots could perform those tasks one day, however it will be far too late to matter.

 

[ponderingturtle]

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.

Because the idea is to encourage savings and money for retirement, but if it is all just going to be eaten by long term care costs why bother and live in the now and go on public assistance earlier in your old age.

 

[ponderingturtle]

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.

Why not make all people pay for their health care until they are rendered destitute? What makes EOL care different from say care of a chronic but manageable with large amounts of money disease?

What makes EOL or in general long term assistance instead of just drugs for example something that should make one destitute?

Really the problem is the expectation of free healthcare for the non destitute.

 

[ponderingturtle]

Sure, but that's still a subsidy. If you aren't paying for it, someone else is. Given the country we (?) live in, that will probably take the form of increases to regressive payroll taxes or something equally dumb, which means that the bottom quintile will be significantly subsidizing those who are better off.

I just don't see any good reason to do this beyond "But I want it!"

Yes we need to get rid of the expectation of healthcare not rendering one destitute.

 

[ponderingturtle]

What is different about EOL care vs general health care, why shouldn't you be responsible for all the costs of your health care until rendered destitute? Why should you get free government paid for knee's when you have the resources to pay for them?

IT seems like healthcare costs should be paid for by the individual until they are rendered destitute is the system many here want.

Really we should end medicare, let them pay for their own healthcare until they are destitute and go on medicaid. Medicare is really just an immoral subsidizing of the wealthy.

 

[mumblethrax]

Because the idea is to encourage savings and money for retirement, but if it is all just going to be eaten by long term care costs why bother and live in the now and go on public assistance earlier in your old age.

If this argument works, it works against retirement savings in general, or even just against ever earning any money at all. But of course it doesn't work. The obvious answer is that being on public assistance ******* sucks, and you probably want to put it off as long as you possibly can.

Yes we need to get rid of the expectation of healthcare not rendering one destitute.

The elderly are just about the only people in this country who have access to a reasonable healthcare system. Healthcare isn't the problem here.

But you still aren't coming up with a plausible answer as to why we should care more about people who are "rendered destitute" than those who start out that way. You don't even seem to be willing to think about this--it's all sarcastic responses driven by gut reactions.

What is different about EOL care vs general health care

The fact that long-term care includes non-medical costs.

 

[ponderingturtle]

The elderly are just about the only people in this country who have access to a reasonable healthcare system. Healthcare isn't the problem here.

And if they have the resources to pay for it they should.

The fact that long-term care includes non-medical costs.

This gets to what is or is not a medical cost. Why should medicare cover short term care in a nursing home but not long term, care in a nursing home is either medical care or not.

 

[TragicMonkey]

In this thread I learned that people think Medicare covers more than it does, and that Medicaid is something anyone can get just because they're poor. Those two things are less of safety net and more of an advisory bulletin taped to the side of the circus tent; the trapeze artists will be very surprised if they fall.

 

[Darat]

And if they have the resources to pay for it they should.



This gets to what is or is not a medical cost. Why should medicare cover short term care in a nursing home but not long term, care in a nursing home is either medical care or not.

I think that does get to an important part - is being old of itself a medical condition? Now being old and for instance having COPD the call is easy to make, your COPD is a medical treatment and needs to be treated in a universal healthcare system regardless of your ability to pay. The old age part - not too sure about - there should be a safety net that covers everyone regardless of age if they can't afford the likes of housing or a reasonable standard of living, but if you want more than the minimum and/or you have wealth than yes you should be "forced" to use your kids' inheritance to pay for that. (Inheritance of wealth of course shouldn't exist in a capitalist society.)

 

[TragicMonkey]

Again with the "inheritance = evil" stuff. Do you not distinguish between amounts? There's a significant difference between Johnny Oil-Tycoon leaving his three kids $400 million each they'll use for snorting coke off of superyachts and Mary Middleclass leaving her two kids $20,000 that they'll use for their kids' orthodontistry!

eta: If I die today, my sister will inherit my paltry savings I'm accumulating for my retirement. She'll use that money to pay for my nieces to go to college. Is that wrong? What's so horrible about that? Who am I hurting by not spending all my money before I die?

 

[ponderingturtle]

I think that does get to an important part - is being old of itself a medical condition? Now being old and for instance having COPD the call is easy to make, your COPD is a medical treatment and needs to be treated in a universal healthcare system regardless of your ability to pay. The old age part - not too sure about - there should be a safety net that covers everyone regardless of age if they can't afford the likes of housing or a reasonable standard of living, but if you want more than the minimum and/or you have wealth than yes you should be "forced" to use your kids' inheritance to pay for that. (Inheritance of wealth of course shouldn't exist in a capitalist society.)

Was my friend being in a wheelchair as a result of terminal brain cancer and the 24 hour care they needed a medical expense or not? People who need 24 hour care are generally having more medically wrong with them than being just old.

 

[mumblethrax]

Again with the "inheritance = evil" stuff.eta: If I die today, my sister will inherit my paltry savings I'm accumulating for my retirement. She'll use that money to pay for my nieces to go to college. Is that wrong? What's so horrible about that? Who am I hurting by not spending all my money before I die?

Nobody is saying that inheritance is evil, but the problem is that it stacks the deck in favor of those who are already likely to be doing better, and that's not just true of the ultra-rich. It's a major driver of inequality. The best predictor of whether you'll get an inheritance is how much money you make. It's really striking.

Children who have their college paid for will never have to worry about student debt, which means they're in a better position to pay for their children's college. Everyone in that lineage is now in a much better position to build wealth, but what did they do to earn that advantage? Nothing. (Unless there was foul play involved, in which case, tip of the hat.)

Generational wealth also recapitulates the injustices of the past. People who were denied a level playing field were much less likely to build wealth, which means their descendants today are much less likely to have it.

 

[TragicMonkey]

Children who have their college paid for will never have to worry about student debt, which means they're in a better position to pay for their children's college. Everyone in that lineage is now in a much better position to build wealth, but what did they do to earn that advantage? Nothing. (Unless there was foul play involved, in which case, tip of the hat.)

Ah. So it's about whether people deserve help? I had to take out student loans, so even though I'm making money and saving it to help my nieces with their future college expenses I shouldn't give it to them, because nobody helped me? They are unworthy? In the eyes of...what, a very stern financial God? We are not supposed to help each other, and give the next generation the benefit of having things better than we did?

I hope your next action is to destroy whatever device you're reading this on: past generations didn't get the benefit of this internet therefore why should you? Why are you worthy of technological advantages others lacked in the past? And in the present!

 

[Trausti]

Generational wealth also recapitulates the injustices of the past. People who were denied a level playing field were much less likely to build wealth, which means their descendants today are much less likely to have it.

The most important inheritence is intelligence and behavior. It's the reason so may lottery winners go broke. It's the reason so many Chinese millionaires are descended from landowners who were disposed during the cultural revolution.

 

[rdwight]

I don't know why success is so vilified in certain corners. The state has no more right to my savings than my children do beyond what is agreed upon in the tax code. There is this trend of thought that these things should only fall on the 'rich' which is always subjective, amounting to anyone making more than me.

You can always give away your estate to your children BEFORE you die or become incapacitated. Medicaid clawback is only 5 years. You can gift 18k a year, per person, without the irs even caring, and lifetime limits are wildly generous.