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American Pie: The Price Of Staying Alive - And The Problems Of Dying

"Whether they are willing to admit it or not, I suspect that the majority of American people over seventy spend a lot of time thinking about how long they are going to live, and whether their-nest egg, along with social security, will last them until the end. It’s a dilema,'' says John Merchant.

For more of John's clear-eyed commentaries on the 21st Century scene in the USA please click on American Pie in the menu on this page.

The cost of health care and of the insurance premiums to pay for it is like a running sore in the US; it never gets any easier nor does it attract a solution. The topic ranks high on most political agendas, and comes to a crescendo each time an election approaches, like now. This is when the parties pull out and dust off their proposals for medical insurance coverage.

In the end, these proposals never come to anything because all plans would involve a change in the tax laws and some sort of cap on medical liability claims, and no party wants to mess with the status quo. The Republicans stand on less taxation not more, and the Democrats are leery of their reputation as the “tax and spend party”.

As an older person and a retiree, one becomes much more fearful of the possibility that either the cost of premiums will become prohibitive or that taxes will increase significantly beyond one’s ability to pay. There is also the concern that the national budget will no longer be able to afford the cost of the government-run Medicare and Medicaid programs, as the graying of America evolves and a larger proportion of the population qualifies for benefits.

Whether they are willing to admit it or not, I suspect that the majority of American people over seventy spend a lot of time thinking about how long they are going to live, and whether their-nest egg, along with social security, will last them until the end. It’s a dilemma.

Should you live life comfortably the way you’d prefer, or conserve your savings against the possibility that you may live longer than you anticipate or suffer some catastrophic health problem or accident that will prematurely drain your reserves? This sets aside whether you plan to leave something to your descendants or not, but that has to be dealt with too.

It seems to me that, at one time, people were more confident about whether or not they had enough money to last out their lives, and also had a better idea of how long they would live, barring accidents. In my own case, the males in my family either died in their forties and fifties or lived into their late seventies or very early eighties. The women did better, mostly lasting into their mid-to-late eighties.

So I figured that once I had passed fifty I had a good chance of getting to my late seventies, but probably not much beyond that. Now I’m not so sure. At 74, I have no life-threatening diseases, I’m strong and active, and still have most of my marbles, at least by my own accounting. All the medical testing I’ve had in this past four years seems to indicate that my heart and lungs are in good shape. So I have to face the real possibility that my lifespan may exceed those of my ancestors.

This isn’t a particularly attractive prospect for me. Through visiting my wife’s aged relatives in various care facilities, I have seen first hand what that can be like. The angry shouting and wailing of the demented, the frightened helplessness of the infirm, the constant card and game playing to fill the days, the waiting to be fed or bathed or to have one’s diaper changed, the TV that’s always tuned to a snowy picture of an evangelical program that no one watches.

So what are we to do about the uncertainty of life, finances and taxes? How can we avoid the frustrating irony of dying before we have spent all our money, or the agony of outliving our savings? The simplest answer, though probably not the most acceptable to many people, is planned death; euthanasia, doctor assisted suicide, or whatever euphemism you want to label it with.

The Dutch and the Belgians have legalized it, and so have a few US states, but in America at least it’s still a can of worms. The Karen Ann Quindlan and Terry Schiavo cases, both involving women in a persistent vegetative state, have made doctors leery of becoming involved in what can turn out to be a media, political and legal circus. The doctors’ vow, “To do no harm,” coupled with fear of prosecution, would probably deter most medical practitioners from helping a patient end his or her life.

Much is made of the, so called, “Living Will,” and each time I have been admitted to hospital I have been asked if I have one. I do, and I wrote it myself. If I have any lawyers among my readers they are probably throwing up their hands in horror. But despite the adage, “The person who represents themselves in court has a fool for a lawyer,” I happen to think that I know best what I want for myself when it comes to dying.

I believe I was able to express it in writing such that only the most malicious reader would try to controvert it. And in any event, some of the best legal minds in the US weren’t able to satisfactorily settle the two cases I mentioned above, or many other, lower profile controversies, so what price legalese?

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