7 ms·

The American System (hint, i am not american) is very broken. Yet any sane system would obviously see benefits of centralizing end of life care for sick people.

by dtx1 4y ago

The American System (hint, i am not american) is very broken. Yet any sane system would obviously see benefits of centralizing end of life care for sick people. If you manage to build a system that's so broken that centralization of healthcare is MORE expensive for everyone than decentralized at home care than that system is the problem. And to be clear: It would be great if we had enough doctors, nurses and resources for everyone to die in their own home with all the amenities of a hospital specialized to end of life care but hat is practically impossible. And I don't mind socializing healthcare. On the contrary, I think it's a necessity for any civilized country. But given the aging societies of basically all western nations I would bet all I own that by the time I need end of life care, at home care with private nurses will become the privilege of the super wealthy. Here in Germany, the system is already essentially collapsing and it's not even a money issue, it's a personal issue. But sure let's burn it all to the ground for the now-dying so by the time my generation needs it there's nothing left.

mindslight 4y ago
I don't necessarily disagree about the costs of decentralization, but will say that it appears to rely on some assumptions like that the family won't be providing any care, etc. I don't think that doctors and nurses are the limiting factor for home care, but rather CNA's and home health aides - basically people that check in on patients around the clock and make sure they're kept clean and attended to. In the context of the US system, your original comment is just completely off the mark. Our healthcare system is universally terrible, independent of the cost ("not my job" at every level). Consigning a elderly person to that system is basically the last thing anybody wants to do, hence the focus on dying at home etc. I can't speak about Germany's system. But it's worth remembering that money is not equivalent to resources, and that spending an imprudent amount of money on elder care right now doesn't imply that there won't be resources left for you later. Whether the system is "burnt to the ground" has more to do with if the institution is destroyed or hollowed out, rather than how much it costs.

by dtx1 4y ago

mindslight 4y ago

I don't necessarily disagree about the costs of decentralization, but will say that it appears to rely on some assumptions like that the family won't be providing any care, etc. I don't think that doctors and nurses are the limiting factor for home care, but rather CNA's and home health aides - basically people that check in on patients around the clock and make sure they're kept clean and attended to. In the context of the US system, your original comment is just completely off the mark. Our healthcare system is universally terrible, independent of the cost ("not my job" at every level). Consigning a elderly person to that system is basically the last thing anybody wants to do, hence the focus on dying at home etc. I can't speak about Germany's system. But it's worth remembering that money is not equivalent to resources, and that spending an imprudent amount of money on elder care right now doesn't imply that there won't be resources left for you later. Whether the system is "burnt to the ground" has more to do with if the institution is destroyed or hollowed out, rather than how much it costs.