A death benefit or the last two weeks of life

It should come as no surprise that humans are uncomfortable with death and mortality.  American culture is obsessed with youth.  We don't want to admit to aging or dying.  I would be happy to show anyone the rows of aging creams in any pharmacy.

I listened recently to this great podcast

from This American Life about loopholes.  In it, a lawyer had read the small print and figured out an investment opportunity with annuities (sadly the loophole has been closed).  He contacted someone who was terminally ill.  I will over-simplify it, but if they agreed to sign forms, an unrelated investor would receive their entire original investment plus interest (even if there was a loss) upon the original person's demise.  The investor didn't have to be related in any way to the terminally ill patient.  For this agreement, the patient would receive thousands of dollars in cash. 

One daughter (in the program) explained that her mom really appreciated the money before she passed on.  When she went to the  mall with her grandson, she could buy him the things he wanted; she wouldn't have been able to afford them before.  The daughter said it meant a lot to her mom during her last days.

There are many issues with funding medicare.  Medicare costs keep spiraling.  And it's a sobering statistic that 80% of of the spending occurs in the last two weeks of life*.  That fact is shocking to me.  I know we are uncomfortable with death.  We hate it, we rage against it.  People are especially uncomfortable with losing parents and loved ones.

But we are bankrupting our country because we can't admit the truth, that we are dying and our loved ones will die.  (How does the cliche go?  The things that won't change - death and taxes). 

The pragmatist in me pondered the annuity idea and this medicare fact.  What if, like in the podcast, we gave terminally ill people a choice.  The government would give a portion of the money ($20,000, $50,000) cash to a family in the above situation.  The person/family then agreed that they would get only palliative care - do not resuscitate, manage pain, etc.

If I were terminally ill and near death - I would much rather have that money to spend at the end of my life.  I would want my children to have that money after I'm gone.  I would rather they have a nice vacation or pay down debt than have that money go to doctors and hospitals.

Money is such a driving force in our culture.  At times, it seems like we are selling our souls (what makes us human, what makes us unique).  But the profit motive cannot be denied. 

Most people make decisions based on finances, at least partially based on finances.  There are many other factors, but finances are often key. 

 People wouldn't be forced to take the money.  But it seems to me that when there is a financial incentive, people are much more willing to make a tough choice. 

Some may say (like the above lawyer's actions) that this is immoral or unethical.  It's true that issues of life and death are incredibly complex.   But we as a country are already steeply involved in these issues. We are keeping people on feeding tubes and ventilators because we can't bear to let their bodies go.  And some of these people were frugal during their lives.  Maybe they would take the sugar packets from restaurants.  Maybe they would drive five extra miles to save $.10 in gas.   They would be shocked and saddened to find out that their children and the government had spent $200,000, $500,000 or more in their last two weeks.

I support medicare - I support caring for our aging and infirm elderly.  But I also support making the hard choices and decisions; in recognizing what we are really paying for. 

Just because we can keep someone's body alive, doesn't always mean we should. 

*I searched for the original reference to this statistic, and I can't find it.  But it's clear from the news link, we (the government) spend(s) a lot of money during the last few months of life, and often in the ICU (which is very expensive).