Long Term Care Crisis

[Trausti]

I don't know why success is so vilified in certain corners.

When you view the world through the blank slate, the only reason for disparaties must be invisible societal forces. If one is successful, he must have wronged someone else. We need to correct that wrong.

 

[mumblethrax]

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

This doesn't particularly make sense as a reply.

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.

Because length of stay is not the only relevant difference. Medicare covers Skilled Nursing Facilities, where you're much more likely to be getting rehabilitative care from medical professionals.

 

[mumblethrax]

Ah. So it's about whether people deserve help?

No, it's about adopting policies that produce a more egalitarian and meritocratic society.

Nobody is saying you're a bad boy for putting your nieces in your will.

I don't know why success is so vilified in certain corners.

Inheriting money isn't any kind of success. If I were interested in "punishing success" I'd probably want to do it while the people who had success were still alive. No use flogging a dead horse.

The state has no more right to my savings than my children do beyond what is agreed upon in the tax code.

Then it's entirely down to producing just policies, which is what I'm arguing for.

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.

All the more reason not to compound those unearned advantages with additional unearned advantages.

When you view the world through the blank slate, the only reason for disparaties must be invisible societal forces. If one is successful, he must have wronged someone else. We need to correct that wrong.

Where on Earth are you getting the idea that I "view the world through a blank slate"?

 

[TragicMonkey]

Because length of stay is not the only relevant difference. Medicare covers Skilled Nursing Facilities, where you're much more likely to be getting rehabilitative care from medical professionals.

Medicare covers SNFs for 100 days maximum. That's a little over 3 months.

 

[mumblethrax]

Medicare covers SNFs for 100 days maximum. That's a little over 3 months.

Yes, because it's rehabilitative. That's what makes it 'medical', according to Medicare.

 

[TragicMonkey]

Yes, because it's rehabilitative. That's what makes it 'medical', according to Medicare.

A strict time limit is just what patients need to encourage them to heal up, eh?

 

[mumblethrax]

A strict time limit is just what patients need to encourage them to heal up, eh?

Medical resources are scarce, and have to be rationed somehow. I do not find it surprising that Medicare will not pay for rehabilitative care indefinitely. At some point, it becomes a poor use of limited resources.

 

[Donal]

I don't know why success is so vilified in certain corners.

Succes sisn't villified. Greed is. You confuse being wealthy with being successful.

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.

No, it generally falls into how much money one has relative to what they need to get by. Granted, that and other factors can be moving targets based on the situation, but it is all far more complicated than "you have more than me". There's also dispute as to what actually constitutes "Earning". But, you've had this explained to you before.

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.

That is a really good argument for closing loopholes.

 

[Darat]

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?

It accounts for many of the problems in societies like mine so yep it is “evil” in that sense (it’s also anti-capitalist so always amuses me how many claimed capitalists defend it).

It’s also amusing how those that think people should be able to stand on their feet, that we should only get what we deserve by dint of our own hard work, don’t need handouts from the state and so on don’t want that to apply to themselves when it comes to handouts.

I have by the way no issue with parents giving their kids stuff or anyone else, when they are alive as I don’t think the dead should be able to own anything.

 

[Darat]

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.

Of course that’s a medical expense, who would claim it wasn’t?

 

[Darat]

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.

What has intelligence and behaviour got to do with wealth? Is King Charles really so much more intelligent than a winner of the Euromillions?

 

[Darat]

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.

How is being against inheritance vilifying success?

 

[Darat]

Medical resources are scarce, and have to be rationed somehow. I do not find it surprising that Medicare will not pay for rehabilitative care indefinitely. At some point, it becomes a poor use of limited resources.

But the USA is nowhere near having to make that type of choice, it needs to improve the efficiency of its healthcare system to match those of most of the countries that have a form of decent universal healthcare for all. Simply doing that would free up billions every year.

 

[Trausti]

What has intelligence and behaviour got to do with wealth? Is King Charles really so much more intelligent than a winner of the Euromillions?

It's the traits that make a person build, maintain, and grow wealth. Those traits are not universally distributed, obviously.

 

[rdwight]

Inheriting money isn't any kind of success. If I were interested in "punishing success" I'd probably want to do it while the people who had success were still alive. No use flogging a dead horse.

Having money to leave to whoever someone feels like leaving it to is a success. This whole thread is premised on the idea, but with a cut off of what each poster believes is a reasonable amount to leave behind. It's my money, earned and taxed already. Where it goes should be my discretion, as I have earned that right.

Then it's entirely down to producing just policies, which is what I'm arguing for.

Which is reasonable and is why wealth confiscating is not exactly on the table is it? Again, no one believes this when it comes to their own money. If I live life as a miser so that I can leave my family money, you believe my efforts should be ignored based on what?

 

[rdwight]

Succes sisn't villified. Greed is. You confuse being wealthy with being successful.

No, it generally falls into how much money one has relative to what they need to get by. Granted, that and other factors can be moving targets based on the situation, but it is all far more complicated than "you have more than me". There's also dispute as to what actually constitutes "Earning". But, you've had this explained to you before.

That is a really good argument for closing loopholes.

You literally started this thread because a friends mother had to pay for own healthcare and could not leave an inheritance. Why do her children deserve that money based on your reasoning? I'm sure their basic needs are met. Since that's somehow where this convo lead in your mind. Why are they not greedy for expecting that money? You can't keep this reasoning consistent within this thread.

 

[rdwight]

How is being against inheritance vilifying success?

You are not against inheritance so let's start there. You feel you should control at some level the amount. To someone with nothing, 100k is more than someone deserves. Why should the cut off be arbitrarily high? I don't agree with tax policy that people willfully exclude themselves from.

 

[mumblethrax]

But the USA is nowhere near having to make that type of choice, it needs to improve the efficiency of its healthcare system to match those of most of the countries that have a form of decent universal healthcare for all. Simply doing that would free up billions every year.

Of course, it's a no-brainer that we've been no-braining for 60 years. There's zero hope of that happening before the demographic bomb goes off.

And the fact that our healthcare system is so inefficient just means there are fewer resources to go around.

Having money to leave to whoever someone feels like leaving it to is a success.

It could be, sure.

There's no good reason for the state to protect this money from costs incurred, however, and expecting that people cover their own non-medical costs until they are no longer able to do so in no way "vilifies success".

What we have here is people attempting to privatize their gains and socialize their losses. Does the fact that I've had some success in my life mean the state should cover my rent so I have more money to leave to my family?

 

[mumblethrax]

You are not against inheritance so let's start there.

Why would you presume to know this?

I'm against inheritance. I think it would be better world if it just weren't a thing.

Obviously that will not be the outcome of ordinary political processes, because people are tribalistic, and I'm happy enough to compromise on it.

That doesn't dispose of the principled opposition, however.

 

[The Atheist]

Of course, it's a no-brainer that we've been no-braining for 60 years. There's zero hope of that happening before the demographic bomb goes off.

Bingo.

Our idiotic government has been resisting increases to pension age (and means testing) for decades. Those pigeons are coming home to roost very quickly.