Kill 'em before they get expensive, right?G Ever see the movie
"Soylent Green"?

Geez, Hawke, are you taking a page from Gunner's "Cull Notes" but
directing your cull at seniors like your Aunt who show significant
probabability of not dying in a cost-effective manner?

Maybe so. The point about my aunt is that she shouldn't have had the
procedure done. The odds against surviving were low and the expense was
high. It would have been different if she was paying herself or if
private insurance was going to cover it but she was broke. That
operation cost us taxpayers hundreds of thousands of dollars and it
didn't get her one more day of life. Who knows how much longer she would
have lived if she had just stayed home. More than she got.



Aside from that...

The statistic you cite doesn't support your conclusion or
generalization that it doesn't matter how much each contributes to the
system. Of course it matters, how could it not? If it didn't matter
then contributions wouldn't be necessary or useful.

Your statistic doesn't address total outflow vs total inflow. The
fact that Medicare's aggregate costs turn out that way in no way
implies that it's typical for individuals. For example, they could
spend 30 to 40% of outflow on final year costs for the 1% of those
that incur big costs in final year, while the other 99% quietly die
with no medical expenses at all in their final year. A few withdraw
far more than they contributed while most break even or draw less. The
system works as intended.

It's a hypothetical example that I don't assert to represent
actuality, but it definitely suppports your lone statistic. I know
of several anecdotal examples of exactly this scenario: thought to be
healthy from routine checkups, died one day. My FIL and good friend
Bernie suddenly checked out while riding his snowmobile in wilderness
somewhere north of the border. He might have chosen to be around a bit
longer, but that's exactly the way he'd have chosen to check out. His
buds had to smuggle him back across the border, easy to do during
winter when the lakes are frozen. There's a whole bunch o' border!
You assert, and I quote: "If you are only average then they will
probably spend multiple hundreds of thousands on you in your last
year." Where'd that come from? That may be true for a few but you
offer no basis for generalizing that to be typical.

Medicare gets into trouble when politicians modify it to provide
handouts (medicaid) for non-contributive immigrants and indigent
people of working age, thus buying votes paid for by seniors who
contributed honestly (and involuntarily) to Medicare for decades with
the promise that it'd be there for them in their seniority as it was
for those they supported during their contributing years. Let's fix
that before we start culling seniors as being too costly to keep.

If there is to be welfare and charity for those who are able to work
but are fussy about what they'll do, let it be honestly labelled and
responsibly provided by those who advocate it and those they can
persuade (not legislate) to join them.


What I am saying is that the statistics I saw said that when it comes to
the amount of money spent on health care in a person's entire life
almost all of it is spent in the last year. I don't know what that has
to do with people who drop dead in their sixties or seventies without
spending much on health care. Or with people who spend a lot over the
years on health care either. All I know is that the lion's share of your
costs for health care will be spent in your last year. That's what the
statistics say. Of course not every case is like that but this is a
statistic so it disregards the outliers and gives the general picture.

As for whether Medicare is working like it's supposed to I think it is.
It's an inter-generational insurance scheme that has done a lot of good
for most Americans. The question is about how much is getting spent at
the end and how much are we getting for what we spend. From the
statistic it seems like a bad deal to spend so much when it's only
giving people a very short time to live. It's not like we're saving 80
year olds so they can live to 140. They're dying at 81 after we spend
600K on them. So I don't think it's the system that is no good. I think
it has to to with the way medicine has changed over the last few
decades. In the old days we couldn't have spent that much money on
people. They would have died. Like I just heard we had the first or
second quadruple amputee that lived. In any other war those would have
been deaths. How much do you think it cost to keep a quadruple amputee
from dying? But at least that was a young person who had a lot of years
to live. Spending hundreds of thousands to keep someone alive for less
than a year seems pretty stupid to me. Is a death panel the solution. I
don't know but I do know that if I am over 80 and it looks like I have
not much time left I'm not going to want a million bucks spent so I can
have a few months to live as a screwed up old man. But that's just me.
Some others would be willing to spend a million for one more lousy day.
But to me that's just dumb. You have to die some time. What's a few
months mean when you've already lived a long life?

Hawke