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July 10, 2013


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Debbie M

Wow. I had also decided I don't want LTCI, but it was because I couldn't afford it. (Or maybe I barely could if I really wanted to, but I don't want to live like that.) It never occurred to me that I might not even want what it provides. And that's even though I've never been a fan of expensive treatments that probably won't work or, if they do, probably won't improve quality of life much (not only for other people using my insurance and thus raising my rates, but also for me).

Many times people do recover from something that sends them to a nursing home. But maybe not usually.

I know medical professionals always look for medical bracelets. There should be some with compartments that can store a living will. Or you could just fold it up tiny and tape it onto the back of one in a waterproof way. I'm not currently willing to decide to self-terminate while I'm still healthy and happy, though (like in "Harold and Maude").


Hi Debbie. It's a very thorny question, because obviously one DOES want to be cared for during convalescence from an accident, illness, or surgery.

But given the gigantic proportion of our national health-care expenditure that occurs during the last two months of life, I just have to think No. Terminal illness of any kind means TERMINAL. It means you are on your way out, and for me, I think the most humane and dignified choice is a speedy exit (as painless as possible).

I am pretty adaptable and I think I can squeeze out some quality of life as long as I have the use of my brain, eyes, hands, and sphincters. But once any of those is going, there has to be a plan. If I can live independently - and I'll use whatever gadgets I can get my hands on - great.

If I can't, well ... I don't have kids to "take care of me" in my old age, so this is not something I can afford to avoid thinking about. Medical professionals are legally constrained from certain types of counsel and can get in serious trouble if they do less than the maximum possible. I'm trying to figure out a way to take the decision out of their legally-tied hands.

Dan @ Casual Kitchen

Really good thoughts here. Insurance sells a lot better if you can convince customers to rabidly fear the thing you're insuring: they'll pay more, they won't do the math, and they'll confuse having a policy with solving the actual problem.

Nice to see another person out there who's willing to share a sincere and non-fear-based perspective on insurance.



Thanks Dan!

It may be easier for me to be objective about this issue because I'm not afraid of death. :-)

I mean, I'll be pissed if I die before I've done a few more things I want to do. But for me, a long slow deterioration is much scarier than death itself. And being unable to control my own state of being is scariest of all.

Debbie M

Yep, no kids here, either. I AM scared of death but I try not to let that make me stupid.

As a kid, I thought I would always want to hold out as long as possible, just in case a cure was invented or something. (Why yes, I did watch a lot of "Batman." Something always made escape possible!)

Now I'm not willing to take that risk and I despise waste--the amount that is spent on one pointless expensive treatment could pay for so many things that can make a huge long-term difference. For example, I would rather that 100 asthmatics have inhalers for life than that I get pricy treatment for one ailment when I already have another untreatable fatal ailment.


Some may see LTCI akin to life insurance, no one wants to have to use it, and it's really intended to protect the interests of family members. I doubt that Medicaid will be able to handle the sharply increasing load over the coming decades, instead I suspect that filial responsibility laws will be getting enforced more vigorously.


Now see, filial-responsibility laws are something of which I am wholly ignorant. :-) But since I don't have kids they probably wouldn't apply in my situation anyway.

I too doubt Medicaid will be able to accommodate all of those in need. We may get some more action on "death with dignity" laws as people see their other options wither.

Debbie: I agree. Much better, in my view, for health-care dollars to go to helping young people live healthier lives than to keeping my decrepit corpus functioning for an extra two weeks!


The heart of your writing while sounding agreeable originally, did not sit perfectly with me after some time. Someplace throughout the paragraphs you were able to make me a believer unfortunately only for a very short while. I however have a problem with your leaps in assumptions and one might do nicely to help fill in those gaps. In the event you actually can accomplish that, I would definitely be amazed.

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