[bpodgursky]

The worst part is the payment structure and how it doesn't allow real choice. If you told the 88 year old:

"We can (a) pay $500,000 on treatments that will likely extend your life 1 year, or (b) put $250,000 in a tax-advantaged account to put your great-grandchildren through college", I bet that 99% of those 88 year olds would take option B and take hospice care instead. They would all prioritize their children, grandchildren, etc!

But that's not the option... it's them, vs some nebulous national slush fund of cash where they and nobody they know gets no benefit out of being selfless. We should fix that.

[neither_color]

And in the rest of the non-nihilistic world those grandchildren would rather have one more year of grandma than any amount of money 15 years later. This whole discussion of letting seniors die to optimize economic potential is gross.

[Swizec]

That probably depends a lot on the state of the grandma. Spry and lively full of great conversation and wonderful tales of old times? Yes! Barely able to remember her own name from dementia or in constant terrible pain from her life of labor on the farm finally catching up to her? Eh …

The latter is especially difficult. I have a grandma in the family (not mine) who really just wants to die. Can’t even get out of bed anymore, can barely eat, constant pain that even painkillers can’t fix anymore … but her family can’t let her go because “1 more year with grandma”. Kinda selfish really

[WalterBright]

Every day you can wake up, get out of bed and stand up is a beautiful day.

[brandonmenc]

> And in the rest of the non-nihilistic world those grandchildren would rather have one more year of grandma than any amount of money 15 years later.

Not in families that have regular, frank discussions about death and quality of life.

My worst nightmare is having people in charge of my care who are unwilling to pull the plug. Doubly so if they are also paying for it.

[bpodgursky]

That's a ridiculous claim. I don't think you have any concept of how much people suffer under student loan debt.

It's not "just money"... it's living your entire young-adult life under a yoke. It's delaying (or being unable to) buy a house, get married, and have kids of your own. I loved my grandma, but I would absolutely have traded years of her life w/ me in order to afford raising the son I have now (I have a good job, and I didn't have to make this choice).

(on a related note, my grandma spent most of the last year of her life in an assisted care home after a stroke... she gained nothing from that year, and me and my sister, her grandchildren, gained no closure from those last non-verbal visits. I don't think this is even something she wanted for herself.)

Sorry if it sounds calculated, but these are real decisions people make, and money is the lever by which people accomplish their life goals.

[taxicabjesus]

My nearly-101 year old grandfather needed his pacemaker replaced. The doctor gave him the choice. He must have thought, "THIS IS MY CHANCE" and elected to have his pacemaker replaced, somewhere around his 101st birthday.

He died of complications of the replacement surgery - his IV lines got infected. I don't think Medicare got a refund on whatever they spent on the replacement pacemaker.

Sometimes US medicine is great. Sometimes US medicine is a wealth transfer program.

[bserge]

"Live miserable and alone for 364 days grandma, so we can see you one more day"

Talk about gross.