4 ms·

It's worse than just lost startup opportunities. I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wea

It's worse than just lost startup opportunities. I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wealth, leaving absolutely nothing to the next generation. Long term care is needed by a lot of folks over the age of 65 (~70% of adults age 65 will require at least partial long term care). Even "reasonably cheap" care (in my experience, roughly the same quality as living in a college dorm, with a roommate and a meal plan) can easily run 10k/month - or 120k a year. Of those needing long term care (roughly half of all folks): Men will need that care for an average of ~2 years, women nearly 4 years. 20% will need that care for 5 years or longer. I watched my parents spend all of their inheritance covering long term care costs for their parents (Alzheimers is a bitch). Once the inheritance was gone, they worked longer than they would have preferred to continue covering those costs (my mother only retired this year when my grandmother died of covid - as horrendous as it sounds, it was almost a blessing). My personal take is that "single family homes" and "private healthcare" are a literal fucking disaster for long term wealth inequality. That policy combination takes a lot of middle class families and leaves them poor. * - I personally don't think it's an accident at all, I think it's very, very intentional.

dragonwriter 5y ago
To be fair, long-term care is not just an opportunity to accidentally (from the perspective of the holder, not the system) get rid of one’s accumulated wealth, it is often the motivation for intentionally doing so prematurely, in order to qualify for Medicaid (which pays for the majority of long-term care in the US.) OTOH, for people who don’t have the knowledge or professional advice to do this (which, of course, correlates strongly with having more wealth to start with), it is a trap for accidental wealth drain rather than intentional redistribution, so the poor get generationally poorer, while the better off are also better able to protect generational wealth, both benefiting from programs for the medically indigent.
- coryrc 5y ago
  Every dollar spent on the elderly who had their whole life to prepare is a dollar not spent on a child growing up in poverty who has not yet had a chance. Families should take care of their own. If nobody is willing to do that for you, you probably aren't deserving.
  - lazide 5y ago
    Well, except it isn’t right? We can and do budget them separately. Might be more fair to say ‘every tomahawk missle fired randomly at a target at the Middle East is an entire middle class families lifetime income down the tubes’.
    - coryrc 5y ago
      It's just as fair in my opinion.
ancode 5y ago
> I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wealth, leaving absolutely nothing to the next generation. That's not true, the money isn't just lost. The money is passed to the children of the person who extracts the money from the sick people. It's by design.
- lmm 5y ago
  The money isn't passed on intact though. At the end of the day we pour a huge proportion of our real production - human hours of labour - into prolonging the lives of people who are barely remembering or experiencing anything.
makomk 5y ago
This isn't just a US thing. For example, even though healthcare is nominally free at the point of use here in the UK, that doesn't cover long-term care for the elderly - you will have to pay privately for that out of your wealth to companies of varying degress of sleaziness until you have no more left, at which point the government will hopefully consider picking up the bill. Our current conservative goverment is planning on capping this and it seems fairly controversial.
0des 5y ago
> my mother only retired this year when my grandmother died of covid - as horrendous as it sounds, it was almost a blessing I can only imagine the hardships your family endured for this sentence to come out. I'm glad things are working out for you guys and I'm sorry for your loss.
sophacles 5y ago
> I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wealth, leaving absolutely nothing to the next generation. ... > * - I personally don't think it's an accident at all, I think it's very, very intentional. Its extremely intentional wealth stealing, and it's even worse than just lost generational wealth transfer. Filial responsibility laws mean that your illness and long-term care are your children's financial burden: https://en.wikipedia.org/wiki/Filial_responsibility_laws https://en.wikipedia.org/wiki/Filial_responsibility_laws . In the worst cases, people estranged from their parents for decades end up bankrupted. Depending on what state your grandmother lived in - your mother may have been on the hook even if she hadn't chosen to keep working to care for her mom.[1] The idea that paying for elderly parents' expensive (intentionally or accidentally) care is a choice only applies to people in less than half of the states. These laws make the only choice "pay the provider directly now" or "pay the provider costs and late fees, etc via the courts". So anyone who wants to claim that the people who care for their parents are chosing to do so is claiming wrong - if your parent spends their last days in one of 26 states, the parent is chosing what your wealth is used for. [1] I hope that didn't come across as suggesting your mom was only making a financial choice, or that she didn't make her choice out of love. I'm sorry you lost your grandmother and I hope your mom enjoys her retirement.
siquick 5y ago
My partners grandmother in Sydney moved into a care home earlier this year as she nears the end of her life. She had to pay over $500,000 upfront which gives her 10 years of care there, and then its a pro-rated amount is refunded upon death. I can't imagine there are too many people in this world with half a million dollars ready to go.
coryrc 5y ago
Why should strangers pay so your family can receive an inheritance? That's basically paying you because your parents were wealthy.
lmm 5y ago
I was agreeing with everything up until the last paragraph. If you had an inheritance to pass on you were already in the wealthy class; letting the rich spend everything they can and more on end of life care reduces wealth inequality (though it's a very poor allocation of society's production IMO).

dragonwriter 5y ago

To be fair, long-term care is not just an opportunity to accidentally (from the perspective of the holder, not the system) get rid of one’s accumulated wealth, it is often the motivation for intentionally doing so prematurely, in order to qualify for Medicaid (which pays for the majority of long-term care in the US.) OTOH, for people who don’t have the knowledge or professional advice to do this (which, of course, correlates strongly with having more wealth to start with), it is a trap for accidental wealth drain rather than intentional redistribution, so the poor get generationally poorer, while the better off are also better able to protect generational wealth, both benefiting from programs for the medically indigent.

coryrc 5y ago
Every dollar spent on the elderly who had their whole life to prepare is a dollar not spent on a child growing up in poverty who has not yet had a chance. Families should take care of their own. If nobody is willing to do that for you, you probably aren't deserving.
- lazide 5y ago
  Well, except it isn’t right? We can and do budget them separately. Might be more fair to say ‘every tomahawk missle fired randomly at a target at the Middle East is an entire middle class families lifetime income down the tubes’.
  - coryrc 5y ago
    It's just as fair in my opinion.

ancode 5y ago

> I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wealth, leaving absolutely nothing to the next generation. That's not true, the money isn't just lost. The money is passed to the children of the person who extracts the money from the sick people. It's by design.

lmm 5y ago
The money isn't passed on intact though. At the end of the day we pour a huge proportion of our real production - human hours of labour - into prolonging the lives of people who are barely remembering or experiencing anything.

makomk 5y ago

This isn't just a US thing. For example, even though healthcare is nominally free at the point of use here in the UK, that doesn't cover long-term care for the elderly - you will have to pay privately for that out of your wealth to companies of varying degress of sleaziness until you have no more left, at which point the government will hopefully consider picking up the bill. Our current conservative goverment is planning on capping this and it seems fairly controversial.

0des 5y ago

> my mother only retired this year when my grandmother died of covid - as horrendous as it sounds, it was almost a blessing I can only imagine the hardships your family endured for this sentence to come out. I'm glad things are working out for you guys and I'm sorry for your loss.

sophacles 5y ago

> I think healthcare in the US is riddled with ways to "accidentally"* spend the entire accumulation of your wealth, leaving absolutely nothing to the next generation. ... > * - I personally don't think it's an accident at all, I think it's very, very intentional. Its extremely intentional wealth stealing, and it's even worse than just lost generational wealth transfer. Filial responsibility laws mean that your illness and long-term care are your children's financial burden: https://en.wikipedia.org/wiki/Filial_responsibility_laws https://en.wikipedia.org/wiki/Filial_responsibility_laws . In the worst cases, people estranged from their parents for decades end up bankrupted. Depending on what state your grandmother lived in - your mother may have been on the hook even if she hadn't chosen to keep working to care for her mom.[1] The idea that paying for elderly parents' expensive (intentionally or accidentally) care is a choice only applies to people in less than half of the states. These laws make the only choice "pay the provider directly now" or "pay the provider costs and late fees, etc via the courts". So anyone who wants to claim that the people who care for their parents are chosing to do so is claiming wrong - if your parent spends their last days in one of 26 states, the parent is chosing what your wealth is used for. [1] I hope that didn't come across as suggesting your mom was only making a financial choice, or that she didn't make her choice out of love. I'm sorry you lost your grandmother and I hope your mom enjoys her retirement.

siquick 5y ago

My partners grandmother in Sydney moved into a care home earlier this year as she nears the end of her life. She had to pay over $500,000 upfront which gives her 10 years of care there, and then its a pro-rated amount is refunded upon death. I can't imagine there are too many people in this world with half a million dollars ready to go.

coryrc 5y ago

Why should strangers pay so your family can receive an inheritance? That's basically paying you because your parents were wealthy.

lmm 5y ago

I was agreeing with everything up until the last paragraph. If you had an inheritance to pass on you were already in the wealthy class; letting the rich spend everything they can and more on end of life care reduces wealth inequality (though it's a very poor allocation of society's production IMO).