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Sunday, July 10, 2005

Mort a Credit

"When I was young I thought that money was the most important thing in life," Oscar Wilde once commented. "[N]ow that I am old I know that it is." A new study from the University of Michigan bears out the brutality of Wilde's observation in the starkest terms:
Wealthier elders are significantly less likely than poorer ones to suffer pain at the end of their lives...

Specifically, men and women age 70 or older whose net worth was $70,000 or higher were 30 percent less likely than poorer people to have felt pain often during the year before they died. This difference persisted after the researchers controlled for age, gender, ethnicity, education and diagnosis.

Wealthier elders also experienced a lower number of symptoms overall, the study found. Those in the wealthiest half of the elderly population not only had less pain, but were less likely to suffer from shortness of breath and depression...

The researchers for the study "were especially interested in symptoms of pain, depression, and shortness of breath at the end of life. 'These are treatable symptoms... and not an inevitable part of the dying process.'"

Given the hysterical denial with which American society circumvents any attention to abiding uncomfortable facts of life especially where matters of aging or class are concerned, one expects the modest and palpably helpful recommendations of any study focused simultaneously on both of these unpleasant realities to have less of an impact than one might otherwise wish.

Also likely to be ignored are manifestly sensible proposals that arrive immediately and inevitably on the heels of even cursory contemplation of studies like this, such as:
"To break the connection between wealth and suffering at the end of life, the government might consider expanding Medicare to include medications, or expanding the criteria for hospice [care] to include older adults with significant symptoms, regardless of their prognosis. Currently, hospice treatment is covered only for those whose physicians certify to have less than six months to live.

"This would enable older adults to access medications regardless of ability to pay... It would also improve access to services for underserved and vulnerable populations."

This provides another welcome argumentative avenue for advocating an expansion of Medicare. Although imperiled at the moment, Medicare is still such a popular and effective program I personally think advocating its ongoing expansion is probably better from both a practical and rhetorical standpoint than are proposals for sweeping, unweildily wonky "single-payer" and "universal coverage" schemes and the like to ameliorate the savage inequalities and breathtakingly pointless waste of American health care provision as is and to set the stage for a more equitable provision of rejuvination and modification therapies to come.

But I'll admit that in the present political climate, that is to say in this so-called "culture of life" that is all fists and elbows, I feel more despair than hope for the prospects of any reasonable recommendations in the near term. Although it's as true as ever that you can't take it with you, for now it remains just as true that, in America at any rate, what you have matters much more than it should on just how you have to take it when it finally comes.

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