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“Let me tell you about the very rich. They are different from you and me,” wrote F. Scott Fitzgerald. The accompanying graph shows one way that they are different. The spend a ton more money at the end of life. Not that it gets them anywhere.

The New York Times reports on a paper than found, “out-of-pocket health care spending in the last year of life amounted to $11,618 on average, with the 90th percentile equal to $29,335, the 95th percentile $49,907, and the 99th equal to $94,310.”

The actual study did find that such spending did lead to longer lives. However, such spending was not related to surgeries or drastic end of life medical care. Instead, spending that increased the lifespan (of those with the money to spend) went toward “large expenditures on home modifications, helpers, home health care, and higher-quality nursing homes.”

So, it’s too bad that this is exactly where governments are making cuts, due to budget constraints. The New York Times elsewhere reports that,”Since the start of the recession, at least 25 states and the District of Columbia have curtailed programs that include meal deliveries, housekeeping aid and assistance for family caregivers, according to the Center on Budget and Policy Priorities, a research organization. That threatens to reverse a long-term trend of enabling people to stay in their homes longer.”

James A. Davis, a gerontologist at Marylhurst University and executive director of United Seniors of Oregon, calls the cuts “a death spiral.”

“So often the programs to go are the early interventions that save money and keep people healthy,” Professor Davis said. “That comes back to bite you.”

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