Death and dying...and money. I talk to people about it all day, every day. It's what I do for a living. I know how my clients think about it. More importantly I know how their children think about it...And if you want to see folks pull the plug on Granny faster than you can say boo, just take government OUT of health care. End Medicare and you'll see families pull the plug on Granny so fast your head will spin.
Years ago a physician wrote an interesting op-ed in, I believe, the Wall Street Journal. In it he told the story of an elderly gentleman who came in heart failure. He told of the heroic medical efforts made to save this elderly man's life. At every juncture the family was asked whether they wanted the medical personnel to forge ahead, to try this procedure, to try that treatment. Always the answer was yes... do everything possible to save Grandpa. And so they did.
But the problem was, once saved, Grandpa wasn't getting well; or at least not well enough to go home. He kept losing weight. The medical staff puzzled over the situation until they determined that the problem was his dentures. Grandpa couldn't eat properly because his dentures didn't fit. When the family was asked to authorize new dentures, they declined. The same family who originally wanted NO EXPENSE SPARED in saving Grandpa's life. Why the difference?
All the heroic medical care was covered by Medicare, but the dentures...the family would have to pay out of pocket for that...and they didn't want to go there.
I wish that this story didn't ring true but unfortunately it does. As long as the GOVERNMENT is involved in and paying the bulk of Granny's healthcare, the family wants Granny to have as much healthcare as Granny wants. But the minute that Medicare doesn't pay (nursing home coverage comes to mind) the family begins to wonder if healthcare is really the right thing to do for Granny. The giant sucking sound they hear is their inheritance going down Granny's drain.
And then they call me. The conversations are stilted and awkward. They are trying to pretend that it's not really about the money; that they haven't already calculated the size of Granny's estate and what they'll do with their cut. That they don't see every month of Granny's care as a stab to their heart and pocketbook. But they do. They know it and I know it.
It's gotten to be so bad that when discussing with folks whom they should name as their agent for health care I point out the conflict of interest that their heirs have, that when it comes time to pay for end of life care that a child (or more often the child's spouse) might feel that the nursing home care is just depriving them of their rightful inheritance.
If you really want to know who is going to pull the plug on Granny, get rid of Medicare and wait to see whom among the kids and their spouses will get to the plug first. They've already planned how they are going to spend the inheritance and they sure as hell aren't going to spend it giving the ole biddy a few more months...
OUR SENIORS OUGHT TO BE TERRIFIED THAT THE GOVERNMENT WILL GET OUT OF THE HEALTH INSURANCE BUSINESS.