Does any country do a decent job of retraining 70 year old men for developer positions? This does not need to be a high priority for a society if the 70 year old can afford a roof of their head and a meal.
I don't think that's the issue. The issue is that the United States provides such a poor safety net for those with health issues that one person's failing health destroys the economic potential of one or more people around them.
From a sheer utilitarian perspective, healthcare and safety nets are positive ROI. Imagine the job-producing startups that don't exist because "how do you pay for insurance?"
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.
> 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 .
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.
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.
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.
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’.
> 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.
> 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.
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.
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.
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.
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).
In a whole lot of cases dying is, whether we like it or not "I/we/We[0] don't want to pay for it anymore". I have the experience of pulling the plug on my dad, not for financial reasons, but because it was very clear that he was going to die anyways and it wasn't worth the emotional energy to keep him around (luckily for us, everyone important had time to say their goodbyes and several annoying people had said their goodbyes too [1]). But it also brought into focus to me that we COULD have spent/forced the system to spend millions of dollars in extraordinary resources to keep him alive.
Medical technology is quite advanced these days. Advanced != free. And there's a thing where the longer you try to prolong someone's life the more progressively expensive it becomes, not just from a "price of care" perspective but an "[externalized] cost of care" perspective. Is it worth X carbon dioxide emissions to keep a person on a "level-III dialysis machine"? Is it worth X acres of rainforest to extract an anticancer drug to keep someone's cancer at bay?
Anyways the political divide, in the US, between the left's clueless utopianism and the right's underhanded support of market-distorting profitmongers, has become so farcical that it's impossible to question if humans should have "a general right to have their life extended" even if there are actual, difficult questions to go around.
[0] capital We, as in "the state"
[1] if you ever have the experience of being by the bedside of someone who is dying (n=2 for me), you will see people who come to visit, and have so much pathos, I suspect largely due to their own hangups about death. To be at your best in your role, you will want to shoo them away as quickly as possible.
> The only reason I see expenses really causing massive debt is if you choose to accept/request medical procedures you can't pay for
Have you ever been to a US hospital? They don’t have a menu where you browse treatments and prices. You get your treatment and then later on you get a massive bill
That’s all putting aside the fact that a society allowing people to suffer from treatable illnesses is completely unnecessary and cruel considering that providing free care to everyone is something many countries do successfully
That's false. America has probably the most advanced healthcare in the world. Almost every new treatment is invented and made available there. Other countries don't provide that cutting edge stuff for free, they simply don't provide it at all. I live in New Zealand which has free healthcare but we sometimes hear about people pressuring the government to pay for some expensive new drug, or a dying person using crowdfunding to pay for what the government won't, or complaining they have to spend their own money flying to America for private treatment because no doctor in New Zealand is capable of that special thing. But those are the exceptions that get into the news. Mostly people just die when it's too expensive. Our standard for "treatable illnesses" is lower than the reality of what technology can do.
At the extreme end of diminishing returns, I'd guess that most deaths of elderly people in hospital are preventable because machines to perform the function of failed heart, lungs, kidneys, GI tract, etc. exist. But it's expensive, and countries with socialized healthcare don't pay for it for everyone because they don't have infinite money. My dad died this way when his lungs filled with fluid while in hospital.
Excuse me. It was this "a society allowing people to suffer from treatable illnesses is completely unnecessary and cruel considering that providing free care to everyone is something many countries do successfully"
I'm saying no country provides free healthcare for all treatable illnesses. And not providing it is necessary because the cost would be too great.
not always. you obviously don't get to choose if you're unconscious and someone calls an ambulance for you. or if you get a concussion or injure yourself while intoxicated, you might not be able to fully consent to being taken to the hospital. even DNRs are not always respected.
A friend of mine has terminal cancer and is in a place like this - DNR’s pasted everywhere as the worst fear he has is he’ll get rescucitated and be even worse off.
My thought was around those lines: 60/70 year olds shouldn't be struggling to get retrained. They should be able to live the rest of their lives in retirement. Society should take care of their elders. That's where I would start a UBI program if I could.
Sure, if anyone wants to use their time to learn something new that would be a plus for them.
Well, we sort of do. It's called social security. Now, you could argue that social security by itself only supports a pretty spartan lifestyle. But any UBI proposal is probably even less money.
Your social security benefits are calculated based on your 35 highest income years; which includes 0 income years. The guy quit in 2001 in his 40s-50s, so he may only have 20 years of income for SSA benefits.
That said, the formula is a political choice just as the UBI benefits are a political choice. We could give everyone the same SSA benefits regardless of prior income and index the amounts to age instead. UBI and SSA could be the same administration with lower amounts for younger people and higher amounts for retirees.
