Home help: The government wants you to have a comfortable (and cheap) death

Home help: The government wants you to have a comfortable (and cheap) death

Jan 18th 2014 | From the print edition

DEATH comes to all, but some are more sure of its timing, and can make plans. Kate Granger, a 32-year-old doctor suffering from an incurable form of sarcoma, has “very strong ambitions” for her last hours. She plans to avoid hospital emergency departments and die at her parents’ house—music playing, candles glowing, family by her side.Surveys show that over two-thirds of Britons would like to die at home. Like Dr Granger, they want to be with family and free of pain. Yet hospital remains the most common place of death. For some this is unavoidable—not every disease has as clear a turning point as cancer—but for others a lack of planning is to blame. The government, motivated by both compassion and thrift, wants to help.

In death, at least, public wishes align neatly with the state’s desire to save money. The NHS has calculated that if roughly one more patient per general practitioner died outside hospital each year, it would save £180m ($295m). In 2008 it introduced a broad end-of-life care strategy, which sought to increase awareness of how people die while improving care. Since then the proportion of people dying at home or in care homes (the split is about half-and-half between them) has increased, from 38% to 44%.

To steer patients away from hospitals, general practitioners have been encouraged to find their 1%—those patients likely to die in the next year—and start talking about end-of-life care. This can be difficult for doctors. “As a profession we view death as failure,” says Dr Granger. Yet when there is no cure to be had, planning for death can be therapeutic for patients.

Those who do plan ahead are much more likely to have their wishes met. A growing number of patients have electronic “palliative-care co-ordination systems”, which allow doctors to register personal preferences so that other care providers can follow them. A paramedic called to a patient’s home would know of a do-not-resuscitate order, for example. One study showed that such systems increase the number of people dying in their homes.

But savings for the government may mean costs for charities and ordinary folk. At the end of life it is not always clear who should pay for what. Although Britons can get ordinary health care without paying out of pocket, social care is means-tested. People must often shell out for carers or care homes—or look after the terminally ill themselves. Disputes crop up over trivial things, like responsibility for the cost of a patient’s bath.

A bill now trundling through Parliament would cap the cost of an individual’s social care. Still, some want it to be free for those on end-of-life registries. That would cut into the government’s savings—but allow more people to die as they want.

About bambooinnovator
Kee Koon Boon (“KB”) is the co-founder and director of HERO Investment Management which provides specialized fund management and investment advisory services to the ARCHEA Asia HERO Innovators Fund (www.heroinnovator.com), the only Asian SMID-cap tech-focused fund in the industry. KB is an internationally featured investor rooted in the principles of value investing for over a decade as a fund manager and analyst in the Asian capital markets who started his career at a boutique hedge fund in Singapore where he was with the firm since 2002 and was also part of the core investment committee in significantly outperforming the index in the 10-year-plus-old flagship Asian fund. He was also the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. Prior to setting up the H.E.R.O. Innovators Fund, KB was the Chief Investment Officer & CEO of a Singapore Registered Fund Management Company (RFMC) where he is responsible for listed Asian equity investments. KB had taught accounting at the Singapore Management University (SMU) as a faculty member and also pioneered the 15-week course on Accounting Fraud in Asia as an official module at SMU. KB remains grateful and honored to be invited by Singapore’s financial regulator Monetary Authority of Singapore (MAS) to present to their top management team about implementing a world’s first fact-based forward-looking fraud detection framework to bring about benefits for the capital markets in Singapore and for the public and investment community. KB also served the community in sharing his insights in writing articles about value investing and corporate governance in the media that include Business Times, Straits Times, Jakarta Post, Manual of Ideas, Investopedia, TedXWallStreet. He had also presented in top investment, banking and finance conferences in America, Italy, Sydney, Cape Town, HK, China. He has trained CEOs, entrepreneurs, CFOs, management executives in business strategy & business model innovation in Singapore, HK and China.

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