Or just die when you're old? Maybe that sounds harsh, but being bedridden for 12 years doesn't sound like any idea of a good life to me.

The old die to make way and free up resources for the young. That's the way it's supposed to work.

Someone's a fan of Logan's Run.

Enjoy your manadatory execution when you're forty you old bastard.

False dichotomy. There's a pretty big difference between dying after having a stroke that leaves you permanently disabled in your 70s vs. mandatory execution of healthy 40-year-olds.

There's a huge gradient between being a vegetable and virtually dead and suffering a minor injury that leaves you permanently crippled but in a way that isn't a big deal.

Where along that spectrum will you draw the line? Is that even possible to describe without being needlessly cruel, like someone who lost the use of both hands due to a stroke is killed but someone who lost the use of one hand and one leg gets to live?

These sorts of decisions should be left in the hands of those who are most impacted by it: The person in question. I'm a supporter of more dignified end-of-life options, of people being able to opt-out of life-saving treatment if they think it's not worth the fuss or the outcome is undesirable.

There's still a huge difference between someone electing to die with dignity because their cancer treatment has a 10% chance of delaying the onset by a few years, but a 100% chance of making their life a living hell for the duration, and someone who's told they're too ill to live and has their life abruptly terminated.

And you're trusting someone else to make that decision.

We should enable a culture where people are free to make that decision for themselves. California and several other US states allow for this - not sure about internationally.

I wouldn't want to live on life support. I'd rather my wife/kids get a nice (well managed) trust fund for the remaining savings and just go in peace early.

As I recall, the age of execution in the film was thirty, in the original novel it was 21.

Oh, didn't see your reply. Nice to know about the novel, need to check that out.

In Logan's Run the mandatory execution was at the age of thirty not forty ;)

Remember when this scenario was trotted out as an argument against reforms? Hell, why not establish death squads?

For people like this, it's always better for the free market to figure out how to deliver bad news to other people.

I had a coworker who was a hardcore Ayn Rand type who had a real harsh point of view like this, until his infant was born with a congenital heart defect that resulted in hospitalization for 3-4 months.

Frankly, my own experience gave me a similar perspective, although I was more "meh" on the issue. I had a serious back surgery at 25, and spent a lot of time in PT around people whose lives were falling apart due to expenses and lost wages. Meanwhile I had a great employer with generous benefits and leave. The trucker I was around was struggling to live with workers comp and disability coverage. He was selling most of his possessions to keep his house. It was chilling.

Let me know how you feel about that when your old

As a younger person having watched/lived through at least 3 members of my immediate family die with dementia/mental health problems, I lose more sleep at night over the prospect that euthanasia won't be legal and managed properly where I live by the time I get old.

I'm actually hoping that our shared generational suffering with respect to our baby boomer parents makes us get our generations' butt in gear and do something about it.

Got to use all that unnecessary suffering for something positive :/

My buddy and I have a pact: if one of us needs a piece in a hospital, the other will furnish one.

Yes, seriously.

How would this be done, exactly? It would be horrible to find out that fulfilling the wishes of your friend (or vice versa) results in murder charges.

My grandfather had a stroke two weeks ago. It affected 3/4 of the left side of his brain, which means he couldn't speak (except for 'shit', 'god damn', 'yes/no') and couldn't swallow. Or walk, obviously.

He told us repeatedly while he was alive that he didn't want to be put in a home. He wanted to cut his grass, feed the birds and be left alone - and after the stroke there was no way he could do that. We respected his wishes and opted out of the feeding tube, but he essentially starved to death. No fluids, no food for two weeks. Those two weeks burnt up all of his savings.

Everyone in my family agrees that it'd be better if assisted suicide were legal. No starving, no pain - just a nitrogen mask, and you don't even know you're dying.

Frankly, I find your 'older-and-wiser' posturing disgusting. Obviously it should be their choice, but today it's not their choice - the government says they must suffer and starve to death.

edit for less meanness

Basicplus appears to be responding to imgabe's second paragraph, which seems to suggest that euthanasia should be an obligation, not a choice.

The legalization of euthanasia raises some moral questions with respect to coercion and self-serving misrepresentation, but in cases like your grandfather's, where a decision has been made, those concerns no longer apply.

Perhaps I was vague, but I'm not suggesting we start murdering the elderly if that's what you mean. Like everything else in the world, we have a limited amount of resources to spend on healthcare. A disproportionate amount of them are spent extending the lives of people who have already lived a long full life.

If we have to choose between helping someone who's already lived 70 years live another miserable 10 years in a hospital bed hooked up to a machine vs. helping a 30-40 year old person overcome cancer so they can go back to supporting their family, we should do the latter first. Just thinking off the top of my head maybe we could accomplish this with pricing, by making end of life care more expensive and using the cost to subsidize care for younger people.

It's been legal in California for a year [1], though I'm not sure if your grandfather would have qualified (would his condition be considered terminally ill?).

Regardless, this is the way we should allow it. Eating up the savings of the dying seems particularly ghoulish when the wishes of the afflicted and their family are not respected.

[1] http://www.npr.org/sections/health-shots/2016/03/10/46997075...

Most countries with decent healthcare are reluctant to accept retirees. They'll likely have to fund their own health insurance, at least. If you can gain citizenship of such a country, well in advance of retirement, it could be well worth it though.

You can go to developing countries. The health care I received in Southeast Asia was quite good and the full cost was significantly less than just the co-pays on my plan in the US. Thailand has a retirement visa that allows for 6-month stays and you can live quite comfortably there for under $20k/yr.

I'm sure care is adequate in many developing countries if you get the clap or get injured in a car accident. But I'm skeptical you're likely to get as good cardiac or oncology care.

Cardiac and oncology care is top notch in Thai and Indian facilities where Westerners would patron, based on my medical tourism research.

Dat arbitrage!

Sure, but is the same true for the Philippines or Thailand?

Thai = Thailand in my above comment.

I don't know about the Philippines, but happy to look into it.

That's an interesting visa, although the monthly income requirement of THB 65,000 would be beyond me.

65,000 THB = 1,885.17 USD

That is 37,760 USD / year. Too much?

edit: Whoops, should be 22,622.04 USD / year

Yeah, I make nowhere near that much as a retiree.

So the trick is to persuade your children to emigrate to those countries, and then sponsor your visa.

Not true. Retirees with generous pensions are a great opportunity for any country. They will bring money to your country without the need to produce anything. They won't consume a lot of public resources (no need of school or of police repression). They will reform a house, eat in your good restaurants, and enjoy all the services you can offer.

A lot of countries hunt for wealthy retirees, like Portugal and Australia. Sure you must have your health insurance.

Sure, they'll consume all the services you offer, and especially health care, as the parent suggests. But, yes, you need to have a generous pension, as well as meet another number of requirements that vary from place to place.

In order to emigrate and retire in New Zealand[1], for example, you need to

a) be healthy b) bring your own insurance c) bring ~$350k in savings and $40k annual income with you

The UK imposes an "independent means[2]" requirement, to prevent retirees from being a drain on the economy, as does Australia, Canada[3], etc.

[1] - http://www.investopedia.com/articles/personal-finance/072115...

[2] - http://www.dailymail.co.uk/news/article-1083052/Foreigners-6...

[3] - http://www.livingabroadincanada.com/getting-started/retireme...

Or, in the case of New Zealand at least, already be a permanent resident :D

> They won't consume a lot of public resources (no need of school or of police repression).

Either the host country's end-of-life medical care is not great by American standards (in which case what you write is true, but many Americans wouldn't care to move), or it is, and a retiree would consume considerable public resources. Unfortunately, there's no way to have it both ways.

There actually is a way: move to a country where the same level of care costs less even with no government subsidies. I think this would include most of Europe and the far East.

Or the doctors and hospital admins there only make a terrific salary instead of an obscene one.

This is the result of central planning on the part of government. It allowed the AMA to do insane things like stopping new medical schools from opening for DECADES. It allows the AMA to continue to artificially limit the practitioners in all medical professions to keep wages high.

As a specific anecdote of the problem of government in healthcare: in my city a new children's hospital opened up a few years ago. The other area hospitals petitioned the government to not allow them to build the hospital until certain concessions were met. Among the concessions I'm aware of are not allowing the new hospital to own a medical chopper for 8 years. It was also not allowed to build a Level 1 trauma center. And of course that's after YEARS of not even being able to break ground while all this negotiating and concessions were being figured out. This type of interference raised the cost of healthcare for everyone in my city while likely decreasing the quality of care.

There's more to that story. Typically the problem is that there are too many hospital beds, not too few.

Outpatient treatment is increasingly more popular and more cost effective. Hospitals often raise costs by introducing massive capital costs that need to be amortized as well as other overheads.

With the exception of lower-cost, higher value primary care, there are rarely any meaningful access issues to doctors in metro areas. Those shortages are largely being addressed with PAs and NPs.

>Typically the problem is that there are too many hospital beds, not too few.

I'd be interested in a citation for this because it's counter to basic economic theory of supply and demand. If the supply outpaces demand, then the price should be going down, not up.

ECO 101 fails all over the place.

Here's an example. A quick good will find you many more. http://www.modernhealthcare.com/article/20150221/magazine/30...

Medical services are a complex market. It's nonsensical to randomly apply basic economic principles without knowing what you are doing. (Good luck telling congress that) The smart thing to do is to make primary care more accessible -- you'd be able to close many hospitals and improve outcomes.

I see what you mean, but the over-priced beds are just a temporary phenomenon while smaller more agile competitors are killing the large facilities. In the end, cheaper service for health care is still being found from new competitors moving into the market.

Why does the government care what the other hospitals think? Would they stop a new burger bar opening too close to a McDonalds, if McDonalds petitioned them for long enough?

Yes, it's the way the world works. Homeowners vote against new developments (which decreases the cost of their homes). Everyone with a liquor license lobbies against more liquor licenses. Every grocery store lobbies against more grocery stores. Amusingly this causes big issues between state governments (who wants growth) and cities where most voters/business owners want to limit growth to protect themselves.

The cynical reason is because the hospitals are massive tax-bases and the owners of the hospitals are political donors.

The other reason is that the government has an interest in maximizing economic growth, among other things, which is why it has zoning power. Citizens in the area, including local businesses such as other hospitals, may raise any number of concerns about building projects. Further, any citizen (or corporation) can hold up just about any project for as long as it's willing to keep paying legal fees to fight projects based on trumped up bullshit about esoteric zoning laws that were written a century ago that they probably broke when building their own hospital.

> They won't consume a lot of public resources

If you ignore healthcare, nursing homes, etc., perhaps.

Those aren't public resources. That's why they typically only let you in if you're relatively wealthy.

> The trick is to move to a country with proper healthcare

The trick is to move to a country [where taxpayers are going to pay for your medical care]. Nice plan. Several people in this thread already noted that there are ways to make American taxpayer pay, without having to move.

Or press to build a proper healthcare in your country

You get fine healthcare for free when you are old in the US. You just gotta be broke first. So it's a fine line to work....

Anyone who wants to test this assertion - that "fine healthcare" equal to what a wealthy retiree gets is available to all - should go to a nursing home that offers care for normal and purely medicare-supported patients.

You don't have to study the situation really closely to get what I'm driving at. The patients will generally stay in separate areas. Just walk around and use your sense of smell.

Or if you want actual truth, interview people at said missing home.

Person A was rich, her 500k in savings was all spent to provide her care at a rate of 5k per month until it is gone.

Person B had 100k to her name. She paid the nursing home 5k per month until it was gone. Then care is free until the money runs out.

Person C had 0 money. They paid $0 from day 1.

All three got the same medical care. All three got the same food. Maybe person A spring for a private room vs a shared room... But otherwise all would be the same.

Nursing homes in general aren't great. Hopefully you can stay out of them. Eating well and exercising seem to help. If not, money won't do much.

You do not know what you are talking about at all.

> Person B had 100k to her name. She paid the nursing home 5k per month until it was gone. Then care is free until the money runs out.

> All three got the same medical care. All three got the same food. Maybe person A spring for a private room vs a shared room... But otherwise all would be the same.

Person b experienced a lower standard of care once the money ran out.

(I'm sure this isn't universally true, but in my experience it is. It's a free market...)