為什么美國(guó)的療養(yǎng)院和臨終關(guān)懷醫(yī)院如此昂貴

@Baiyoubai
What is not expensive in the US, especially anything that has to do with medical care?

美國(guó)有啥不貴的？特別是和醫(yī)療沾邊的東西。

@llamalover02
A reminder to parents: don't just plan to rely on your kids for elder care unless you discuss it with them beforehand and they are very willing.

提醒各位父母：別光想著靠子女養(yǎng)老，除非提前商量好且孩子真心愿意。

@Jimmy-ph8xn
This is going to get worse with underpaid, under qualified staff. Ive been at high end luxury homes that scare me. These are jobs nobody wants.

低薪低素質(zhì)員工會(huì)讓情況更糟。我去過(guò)所謂高端養(yǎng)老院，環(huán)境嚇?biāo)廊恕@種活根本沒人愿意干。

@dronegirl7539
Senior care in the US is expensive because private equity wanted to make a whole bunch of money. In fact, all healthcare in the US is expensive because of private equity. See the problem here?

美國(guó)養(yǎng)老貴就貴在私募股權(quán)想賺大錢。說(shuō)白了，全美醫(yī)療貴都是私募搞的鬼，現(xiàn)在看出問(wèn)題了吧？

@Michael-tg4oh
The United States allocates $968 billion to its defense budget, a figure exceeding the combined total of the next ten countries' defense spending. If the U.S. were to cut one-third or even more of this budget and reallocate that portion toward infrastructure and domestic prioritiessuch as healthcare, education, or public servicesits citizens would likely benefit from improved quality of life and essential services

美國(guó)每年國(guó)防預(yù)算高達(dá)9680億美元，比后面十個(gè)國(guó)家的軍費(fèi)總和還多。如果能把其中三分之一甚至更多的資金轉(zhuǎn)投到基建和國(guó)內(nèi)事務(wù)——比如醫(yī)療、教育或公共服務(wù)——老百姓的生活質(zhì)量和基礎(chǔ)保障絕對(duì)能大幅提升。

@veronicafuller4353
And us younger people cant afford to take time off To help our parents. Im burnt out.

我們這代年輕人連請(qǐng)假照顧父母的時(shí)間都沒有，真的已經(jīng)精疲力盡了。

@eckankar7756
I'm 70 and still work as a Pediatric Hospice RN now for 18 years. I do it because I love it. We have such a specific need and so few wish to do this work. It's who I am to support others.

我70歲了，在兒科臨終關(guān)懷病房當(dāng)了18年護(hù)士。堅(jiān)持做這行純粹因?yàn)闊釔邸@類特殊護(hù)理需求量大卻少有人愿做，而幫助他人就是我的人生意義。

@4ryan42
As usual, profit is more important than people.

老樣子，利潤(rùn)永遠(yuǎn)比人命重要。

@SorbetandCo
Arent these the fb commenters that say that they had babies to look after them when theyre older? And how youngsters will end up with cats LOL? Why do they need care homes then?

當(dāng)初在臉書說(shuō)"養(yǎng)兒防老"的是不是這群人？還嘲笑年輕人老了只能養(yǎng)貓哈哈？那他們現(xiàn)在怎么還去養(yǎng)老院？

@kemar1997
Nope, most of them did nothing for their kids and told them to get out at 16-18. Let them figure it out

得了吧，這些人當(dāng)年對(duì)孩子不管不顧，16-18歲就趕出家門自生自滅，現(xiàn)在報(bào)應(yīng)來(lái)了。

@D_Winds
"Just save 165k." How deluded...

"存夠16.5萬(wàn)就行"——這想法也太天真了吧...

@lucristianx
Maybe instead of running everything like a business. Run it like a public service.

或許不該把所有事當(dāng)生意經(jīng)營(yíng)，而應(yīng)該作為公共服務(wù)來(lái)運(yùn)作。

@hannahpatten7226
Wild cuz they dont pay the people who work in elderly care well at all, and yet it costs SO MUCH.

離譜的是護(hù)工工資低得可憐，但養(yǎng)老費(fèi)用卻高得嚇人。

@timothymf7638
Very sad , all about money. Healthcare should NOT be about profit. Every person deserves healthcare regardless of how much money you have. BT

太可悲了，全是錢的事。醫(yī)療就不該追求利潤(rùn)，每個(gè)人都該享有醫(yī)療保障，不管有沒有錢。

@maytons
My ex-wife does in home care. Of the 40perhourpaidforherservicessheonlygets14 per hour.

我前妻做居家護(hù)理，每小時(shí)收費(fèi)40美元，到她手里只剩14塊。

@Kronk-rp3jf
Let them sell their 5 million dollar homes they bought for a nickel.

讓他們賣掉那些價(jià)值五百萬(wàn)的房子唄——反正當(dāng)初花幾個(gè)銅板買的。

@Shapeshift39
Same story in the UK. Successive Government's failed to properly implement a sustainable long term affordable solution .

英國(guó)情況也一樣，歷屆政府都沒能制定出可持續(xù)的平價(jià)養(yǎng)老方案。

@dznrboy
it's disgusting how the US makes money on healthcare, when people are at their most venerable CEO's/companies are like how can we make money on this.

最惡心的是美國(guó)在醫(yī)療上撈錢的方式——當(dāng)人們處于最脆弱時(shí)，CEO和公司卻在盤算怎么趁機(jī)發(fā)財(cái)。

@damiangramm
and what exactly is affordable in the US?

美國(guó)到底有什么是普通人負(fù)擔(dān)得起的？

@BookofFuture
Cuts to Medicaid would be catastrophic

削減醫(yī)療補(bǔ)助絕對(duì)會(huì)造成災(zāi)難性后果。

@pragueexpat5106
Elderly patients are ranked based on their "profitability".., isn't late-stage capitalism just lovely?..

養(yǎng)老院居然按老人的"盈利能力"分級(jí)...晚期資本主義可真"美好"??？

@TL-s1b
Some elders need help bathing, showering, getting dressed, putting their shoes on, opening cans and jars, frail elderly cannot take out trash or carry a gallon or liter of milk, some with failing eyesight cannot read medication bottles, some cannot open them, dementia patients are not allowed to cook in the kitchen and the list goes on. 1 in 3 elders in the US will suffer a fall, many breaking hips, arms, legs and concussions. This sounds dreadful and morbid, but working in healthcare this is the honest-to-goodness truth of things that NOBODY TALKS ABOUT. Ask any nurse, PCA, physical or occupational therapist, or anyone that works in skilled nursing, rehab, long term care facilities, nursing homes, etc..

很多老人需要協(xié)助洗澡、穿衣、穿鞋、開罐頭；體弱者倒不了垃圾也提不動(dòng)牛奶；視力衰退者看不清藥瓶標(biāo)簽；失智患者不被允許進(jìn)廚房...三分之一的美國(guó)老人會(huì)跌倒并導(dǎo)致骨折或腦震蕩。這些事實(shí)聽起來(lái)可怕，卻是醫(yī)療從業(yè)者每天面對(duì)卻無(wú)人討論的真相——隨便問(wèn)個(gè)護(hù)士、護(hù)理員或康復(fù)治療師都知道。

@WINMAN39
We need more news reports about topics like this.

媒體應(yīng)該多報(bào)道這種現(xiàn)實(shí)問(wèn)題。

@djpuplex
The problem in the industry is by the time someone ends up in nursing homes they are financially tapped.

這行業(yè)最殘酷的是：人們住進(jìn)養(yǎng)老院時(shí)，積蓄早就榨干了。

@daveicc495
Why we need Medicaid and Medicare as is

這就是為什么必須保留現(xiàn)行醫(yī)療補(bǔ)助和醫(yī)保制度。

@karenhardie1132
It gets so expensive at the end. Medicare doesn't cover everything. Then, when you are poor enough for Medicaid, when you die, they take any assets left and your house.

臨終關(guān)懷貴得離譜，醫(yī)保不全包。等窮到符合醫(yī)療補(bǔ)助標(biāo)準(zhǔn)，死后連房子和遺產(chǎn)都會(huì)被收走。

@FilthyGopher
Constant consolidation and vertical Integration goes unchecked in the healthcare industry leading to crony capitalism

醫(yī)療行業(yè)不斷兼并壟斷卻無(wú)人監(jiān)管，徹底淪為裙帶資本主義。

@TravisMcMurray
8% of the Pentagons budget is 50 BILLION dollars. Im not going to give a lecture. Just consider that information as you will.

五角大樓預(yù)算的8%就是500億——我不多說(shuō)，各位自己品。
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@thomasrogers9146
I WAS A NURSE FOR 20 YEARS. AFTER I LEFT NURSING I STARTED A RESIDENTIAL ASSISTED LIVING HOME COMPANY.. EXTREMELY LUCRATIVE BUT LACK OF STAFF WAS PURE HELL.. THESE FOR PROFIT HOSPICE AND NURSING HOME ARE HORRIBLE, DUE TO STAFF SHORTAGES COST CUTTING BY THESE PSYCHOPATHS...I WORKED IN NURSING HOMES AND I USE TO CALL THEM THE (.BIG NASTY). THIS IS BAD NEWS AND THESE COMPANIES ARE REAPING OFF OUR GOVERNMENT AND THE SAVINGS OF OUR ELDERS. THIS IS BAD NEWS.

我當(dāng)了20年護(hù)士，后來(lái)開了家輔助生活機(jī)構(gòu)——利潤(rùn)高但招不到人簡(jiǎn)直是噩夢(mèng)！這些營(yíng)利性養(yǎng)老院和臨終關(guān)懷機(jī)構(gòu)太可怕了，資本家為省錢瘋狂壓榨員工...我以前管這些地方叫"大爛攤子"。現(xiàn)在的情況更糟，這些公司正在榨干政府補(bǔ)貼和老人的畢生積蓄。

@movdqa
My mother wanted to live out her life in her own home. It was difficult but we kids made it happen providing care, delivery services and home services (in person). She grew up in The Great Depression and generally worked two full-time jobs to support a household. She took care of her parents and she expected us to take care of her; which was a reasonable expectation. I'm not a fan of this private equity thing to make money off of care. I would prefer non-profits in hospice care and in hospitals generally. After watching Stewart Healthcare doing a lot of damage in Massachusetts by failing financially while enriching its corporate officers, I'd never choose private care over non-profit.

我媽堅(jiān)持要在自己家終老。雖然很難，但我們幾個(gè)子女通過(guò)輪流照顧、送貨上門和親自服務(wù)實(shí)現(xiàn)了她的愿望。她在大蕭條時(shí)期長(zhǎng)大，打兩份工養(yǎng)家，也照顧了自己父母，所以要求我們照顧她是合理的。我反對(duì)私人資本從護(hù)理行業(yè)牟利，更支持非營(yíng)利機(jī)構(gòu)運(yùn)營(yíng)臨終關(guān)懷和醫(yī)院。見過(guò)Stewart Healthcare在馬薩諸塞州搞垮機(jī)構(gòu)卻肥了高管后，我絕不選私營(yíng)機(jī)構(gòu)。

@jchastain789
We have some retirement communities here. They aren't nursing homes but provide that too. That all have to be rich to be able to live there it's expensive af

我們這有些高端養(yǎng)老社區(qū)，雖不是傳統(tǒng)養(yǎng)老院但收費(fèi)貴得離譜——只有富人住得起。

@kevin-e5h5t
They want your house and your pension. No one wants to work there, because of the neglect by "for profit" billionaires.

資本家盯上了你的房子和養(yǎng)老金。沒人愿在這種地方工作，畢竟"營(yíng)利至上"的億萬(wàn)富翁根本不在乎服務(wù)質(zhì)量。

@huevofrita
THEY HAVE BEEN SAYING THIS BEFORE I WAS A NURSE. now I am a nurse and they are still saying this and we are going through it now. Healthcare staff pay is not enough. Sometimes these boomers also are abusive. Sometimes the family is unbearable. Sometimes the SNFs are underserved greedy and understaffed.

我當(dāng)護(hù)士前就聽人說(shuō)這些，現(xiàn)在自己成了護(hù)士問(wèn)題依舊存在。醫(yī)護(hù)人員工資太低，有些嬰兒潮世代老人脾氣暴躁，家屬難纏，護(hù)理機(jī)構(gòu)又貪婪又缺人手。

@kal2487
24 hour home care is close to $250k per year.

24小時(shí)居家護(hù)理一年要25萬(wàn)美元。

@bn8530
All we are doing is working our ass off for someone to clean our ass when we are old. Keep saving and not enjoy your life, your accounts will be drained by private companies who will take care of you when you are old. Find a balance and have fun now.

我們現(xiàn)在拼命工作，就為了老了有人幫忙擦屁股？拼命存錢不享受生活，等老了賬戶又被私營(yíng)公司榨干？還是趁現(xiàn)在找平衡及時(shí)行樂吧。
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@jeretso
Need Nurses who actually care and not on their phones the whole time. American nursing home patients rarely get visitors might as well go to tropical countries near the beach. Your relatives wont visit you anyway.

我們需要真正用心的護(hù)士，而不是整天玩手機(jī)的。反正住美國(guó)養(yǎng)老院也沒家人探望，不如去熱帶海島——橫豎都是孤獨(dú)終老。

@Misaka-gt5yj
It's always private equity screwing over people FFS

怎么又是私募基金在坑人，真是夠了！

@kenyup7936
This is a heartbreaking, depressing, unhappy story

這故事看得人心碎又壓抑。

@ddc2343d
We are currently trying to keep my mom at home. She suffers from dementia but is still mobile. My parents rely on their social security benefits and a small pension. We have been seeking someone to come in several times a week to help my dad, particularly with tasks like bathing my mom. My dad is 90 years old and has been taking care of my mom full-time for several years. Unfortunately, Medicare does not cover home care services, so they are having to pay out of pocket for these services, which is causing financial strain for them.

我們正努力讓患癡呆癥但還能走動(dòng)的媽媽居家養(yǎng)老。父母靠社保和微薄養(yǎng)老金生活，想找護(hù)工每周幫忙幾次——特別是幫我90歲的爸爸給媽媽洗澡。但醫(yī)保不報(bào)銷居家護(hù)理，自費(fèi)壓力讓他們不堪重負(fù)。

@vianeyvasquez1713
Lord help us all cause we are not ready

上帝保佑吧，我們根本沒準(zhǔn)備好面對(duì)這些。

@amanchoudhury8135
Don't boomers have a good savings? What else do they need

嬰兒潮世代不是存了不少錢嗎？還要怎樣？

@chrisaycock5965
The one thing we should have socialism for above all else is education and healthcare. Private equity has ruined these spaces these are a need for people who are not dollars but are living breathing people with emotions and feelings.

最該實(shí)行社會(huì)主義的就是教育和醫(yī)療。私募基金毀掉了這些本應(yīng)服務(wù)于人——而不是美元——的領(lǐng)域，畢竟這里關(guān)乎的是有血有肉有情感的生命。

@neddreadmaynard
Vultures circling the corpse.

禿鷲圍著將死之人打轉(zhuǎn)。

@ttban1988
Baby Boomers got the money to pay

反正嬰兒潮世代有錢付賬。
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@ttban1988
Baby Boomers got the money to pay

嬰兒潮一代有的是錢買單

@telescopicS627
What do you mean young people don't want to make me T-bone steak for the price of French fries?

年輕人憑什么不愿意用薯?xiàng)l的價(jià)格給我煎牛排？這要求很過(guò)分嗎？
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@leokins2536
Its a cultural shift. Lower birth rates and the decline of intergenerational households in the last 100 years.

這是文化斷層——過(guò)去百年間生育率持續(xù)走低，多代同堂的家庭模式也逐漸消亡。

@khc8800
What they gloss over is that, in hospice care, once the money is secured and services begin, theres hardly any outcome-based oversight the patient simply dies as expected. Thats why its so lucrative for private equity. 6:41

他們刻意回避的是：臨終關(guān)懷行業(yè)一旦錢款到賬服務(wù)啟動(dòng)，就幾乎沒有效果監(jiān)管，反正病人最后都會(huì)按預(yù)期離世。正因如此，這行當(dāng)簡(jiǎn)直是個(gè)金礦，私募資本自然趨之若鶩。

@minimalistic_banhaus
No discussion of how poor diet and lack of exercise is leading people to need additional care. No discussion of resuscitation of 90 year olds with CPR so they can spend 1 month more alive on a breathing tube.

沒人討論垃圾食品和缺乏運(yùn)動(dòng)如何加劇護(hù)理需求，更沒人質(zhì)疑給90歲老人做心肺復(fù)蘇、插管續(xù)命一個(gè)月的合理性。

@thothfund
We must prepare for the risk of living longer.

我們必須為"活得太久"的風(fēng)險(xiǎn)做好預(yù)案

@Erik_The_Viking
Two words: private equity.

答案就倆字：私募資本
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@Mooooty
"Greed is Good" Gordon Gekko

"貪婪無(wú)罪"——戈登·蓋柯（電影《華爾街》角色）

@RossD189
Baby boomers been through the most. But my parents are still thriving.

嬰兒潮一代經(jīng)歷夠坎坷了，不過(guò)我父母現(xiàn)在過(guò)得挺滋潤(rùn)

@danielcasey7862
Because in America we dont plan for the future.

因?yàn)槊绹?guó)人壓根不做長(zhǎng)遠(yuǎn)規(guī)劃

@luisarroyo8111
The Entrepreneur community MUST focus on developing a new sustainable business model to assist with dignity, compassion, understanding and mercy our Seniors.
Just imagine those countries that don't even have a health safety net for Seniors.
That should be the focus of every innovation hub around the world.

創(chuàng)業(yè)者們必須開發(fā)出兼具尊嚴(yán)、同理心和可持續(xù)性的養(yǎng)老新模式。想想那些連基本醫(yī)療保障都沒有的國(guó)家吧，這才是全球創(chuàng)新機(jī)構(gòu)該攻克的方向。

@daanstam6697
i really hate seeing for profit structures in healthcare.

醫(yī)療行業(yè)搞營(yíng)利模式真讓人作嘔

@AluisoJonathan
Not sure why. They had 70 plus years to save up. They purchased homes for 2 raspberrys.

搞不懂有啥可抱怨的，這群人攢了70多年錢，當(dāng)年買房就跟買倆樹莓似的便宜

@Ayo22210
When it all financially fails in about 7 years we should wined it down and roll it out.

等這套體系七年后徹底崩盤，就該推倒重來(lái)了

@SullyAfgarshe
same story happening throughout the economy
enshittifaction everywhere
remember folks, we dont have a shortage but a low wage problem and a corporate America problem

全美經(jīng)濟(jì)都在上演相同劇本——萬(wàn)物皆可擺爛。記住朋友們，我們?nèi)钡牟皇琴Y源，而是合理薪酬和正常運(yùn)作的企業(yè)體系

@davidef7773
In the EU, Northern Countries let's say, they put Elderly Parent's, in a Home... In Italia, for example, you have Bandantes, pay 1000 Euro a month, 24 hour care, in your OWN HOME... I believe, cuz, I have no kid's, so, I believe, when I still had my Parent's, was a plane crash, I was 13, if they would be here, I will take care of them, I will even shower them, you know, that is what you are supposed to do, cuz, when I was a kid, I could not take care of myself, so, my Parent's, so, once the roles are reversed, if I still had them, I will take care of my Parents, and be ON SPOT, check everyday, do everything, clean, everything, I will do everything, just be happy you HAVE PARENTS, everyday I have nightmares, from the plane crash, yeah, I wish they we're here, let it be, cannot change what happened...

北歐國(guó)家習(xí)慣把老人送養(yǎng)老院，但在意大利，每月花1000歐就能請(qǐng)護(hù)工在家提供24小時(shí)看護(hù)。作為獨(dú)居者，我常想：如果13歲時(shí)沒經(jīng)歷那場(chǎng)奪走雙親的空難，現(xiàn)在定會(huì)親自照料他們，就像他們?cè)B(yǎng)育幼時(shí)的我。可惜現(xiàn)實(shí)沒有如果——所以請(qǐng)珍惜尚有父母可奉養(yǎng)的日子吧，這比噩夢(mèng)纏身的我幸運(yùn)太多。

@Steven-xf8mz
huh? childcare is expensive, living is expensive, senior care is expensive, etc. Everything is just expensive in a stable society, and that's how it works. if a society is stable, therefore, large population are paid decently well (some may disagree but US dollar goes very far elsewhere, and is one of the best ones around). If people are decently paid, then cost of things are elevated based on basis that management level are well paid, and profit/retain earning has to meet shareholder expectation (both the riches people & everyone else with a 401K). It's natural things are expensive, the idea that childcare exist means there are a lot of people who make more than enough to offset childcare cost after accounting for all taxes.
If it can't be good and cheap unless it's not legal. We can't be complaining about things being expensive, then in another video talking about how wages too low. any increases to wage will further make things more expensive. Higher minimum wage increase living cost for all, that's just a fact. It's debatable if higher minimum wage is called for, but it's not debatable fact that cost of end product is higher if cost basis is higher when all else remain constant. Perhaps there is a way to achieve a better outcome through method such as 100% on corporate earning higher than $x dollar. I'm not arguing that it's not doable or doable, i am just saying that cost basis impacts end production sticker price.

哈？育兒貴、生活貴、養(yǎng)老貴...穩(wěn)定社會(huì)里萬(wàn)物皆貴才是常態(tài)。社會(huì)穩(wěn)定意味著多數(shù)人收入尚可（別杠，美元購(gòu)買力在全球仍屬頂尖），而體面薪資必然推高商品服務(wù)價(jià)格——管理層要高薪，企業(yè)要滿足股東預(yù)期（包括普通人的401K養(yǎng)老金）。存在育兒服務(wù)本身就說(shuō)明：很多人稅后收入足以覆蓋育兒開支。想要物美價(jià)廉除非走非法途徑。我們既抱怨物價(jià)高又要求漲工資根本自相矛盾——漲最低工資必然推升生活成本，這是鐵律?；蛟S該對(duì)企業(yè)超額利潤(rùn)征重稅？不過(guò)成本決定售價(jià)這點(diǎn)毋庸置疑。

@garetthewitt9976
Youre the only country who doesnt have free health care . Unreal the best country on earth with the most expensive healthcare

全球唯一沒有全民醫(yī)保的"最偉大國(guó)家"，卻有著最昂貴的醫(yī)療系統(tǒng)——魔幻現(xiàn)實(shí)主義的完美寫照

@NoNg-o4z
So it's vecause the greed of Murican corporations!

所以都怪美國(guó)企業(yè)太貪婪！

@miken7629
I bought LTC for yield and is already in this business. For me personally, i am going to hire a Girl Friday to assist me.

我投資長(zhǎng)期護(hù)理行業(yè)是為賺錢，但等自己老了就雇個(gè)全能助理——公私分明嘛

@jensteffes1887
All health care should be non-profit. Making money off the sick, elderly, and dying should be illegal.

醫(yī)療就該全搞非營(yíng)利！靠病人、老人和將死之人發(fā)財(cái)簡(jiǎn)直該判刑

@zhulindizi
I hope I do not live this long. It's miserable..

但求別活那么久，太遭罪了

@buriedmatters
We need to take some notes from Midsommar....

或許該學(xué)學(xué)《仲夏夜驚魂》里的操作...

@thomasrogers9146
THERE IS HOPE FOR OUR ELDERS. AFTER I SOLD MY ASSISTED LIVING HOME COMPANY I STARTED A MODULAR CONSTRUCTION COMPANY AND WE ARE NOW BUILDING AFFORDABLE ADU,S IN MY STATE SO ELDERLY FAMILY MEMBERS CAN STAY AT HOME USE HOME HEALTH CARE AND SAVE THOUSANDS OF DOLLARS LIVING IN AN ADU.. OUR ADU,S ARE AFFORDABLE..700 DOLLARS A DAY FOR HOSPEIC CARE IS A REAP OFF FROM HELL.

老年人還有救！我賣掉養(yǎng)老院后轉(zhuǎn)行模塊化建筑，現(xiàn)在本州推廣經(jīng)濟(jì)型附屬住宅單元（ADU）——讓老人住自家后院，既享受家庭護(hù)理又省下每天700刀的臨終關(guān)懷黑心錢，我們的ADU方案才是真·實(shí)惠

@gumby7919
You didnt have childrenyou are toast

沒子女？那你完?duì)僮恿?/b>