An article (or column) from the Baltimore Sun was syndicated into the Palm Beach Post, a newspaper I read each day. The author of this article is Susan Reimer. The title of her piece is "Longevity happier in theory than in practice."
Ms Reimer relates crosscountry conversations with close friends whose mothers are very old and no longer functioning normally. The conversation drifts into other personal talk but Reimer brings them back to discussing the end of life.
"We shouldn't be planning vacations," she says. "We should be working on exit strategies. The one of us who still has it together needs to promise to mix the pills in the applesauce for the ones who don't."
Serious stuff. But then Reimer presents some facts. In her own words:
"More of us are living longer and dying slower. Estimates are that 70 percent of us will need some kind of residential care in the final years of life, and few of us have the savings or the insurance to pay for it - about $75,000 a year in a nursing home and about $20,000 a year for home care. (It is not either/or. And almost all of us who have home care will eventually need nursing home care.)
"The CLASS Act, part of the health care reform legislation of 2010, would have provided long-term care insurance for anyone who wanted to buy it, regardless of age or health. But it was withdrawn last month when the Obama administration realized that it was wildly unaffordable.
"Private insurers appear to have made the same actuarial mistakes and are asking for permission to increase premiuns on policies they have already sold by 40 percent. Some companies are getting out of the long-term care insurance business altogether.
The assumption that many of us have - that Medicare will pay for our care when we are both old and sick - is wrong. Medicare only pays for short nursing home stays or short-term at-home care, under certain medical conditions.
"It is Medicaid that is bankrupting itself to pay these costs - and most of us are only eligible after we have drained our savings. None of us wants to face up to end-of-life issues, let alone pay up thousands of dollars a year in premiums for long-term care insurance.
"And we can't seem to talk about any alternatives to prolonging even the most painful or undiginified life."
Tough stuff, that. In just a few paragraphs we have an outline of a serious national problem that will only worsen as more people continue to 'live longer and die slower.'
Please note that I write "national problem" because it can't be solved in any piecemeal helter-skelter way. The favorite comeback of those who won't face reality is to speak of extended care in the family. Oh if it were only so. But the extended family of old is as rare as the two-parent, one-salary family of old.
Matters are made worse by new medical discoveries and technologies which extend the life of a terminal patient years past the natural time of death that was more common in the long ago.
Today's politicians are full of talk about costs and how health care expenses are out of control.
I wonder, is "health care' the right phrase to use when discussing the cost of servicing terminally ill patients?