The Role of Death in Life

The Grim Reaper Image Credit: The Wikipedia
The Grim Reaper Image Credit: The Wikipedia

"Nobody should have to die..." Lately I have been hearing lots of sentences that start like that. "Nobody should have to die just because they don't have enough to eat." "Nobody should die because somebody else didn't care." "Nobody should have to die just because they don't have enough money to pay someone else to keep them from dying." Nobody should have to die.

But the fact is that all of us are going to die, sooner or later. We're not going to die because we did something wrong, necessarily. (That can happen, but it's not the usual case.) We're not going to die because somebody else did something wrong, necessarily, either. (Yes, that, too, can happen, but not usually.) Death isn't a result of negligence or malfeasance or a gross social injustice, in most cases. We're all going to die, and it's nobody's fault, and nobody can stop it. We're going to die because that is the way of all flesh.

Death is a normal part of life. Sooner or later, we will all pass that way.

Death and Money

Is it true that you can use money to keep death at bay? Can the grim reaper be bribed? If you had an infinite amount of money, could you live forever? If you had an indefinitely large income, could you postpone death indefinitely?

No, not really. The human life span has a pretty inflexible outer bound. But sometimes, a wise use of resources can come in handy in trying to prolong life. Why? Because while it's almost certain that you will not live beyond 120 years, you could die much younger. It's all about risk management. We know that we will die eventually, but by reducing risk and taking precautionary measures, we might be able to live a little longer.

What sort of risk reduction is available?

  • avoiding dangerous activity
  • saving resources for tomorrow instead of spending all today
  • engaging in hedging behaviors, such as using sea belts or paying for insurance


Avoiding All Danger: Is that Possible?

You could stay home all day long, reduce your activity, and hide from the neighbors, avoiding all potential injury or even contagious disease, and you would still not live forever. What's more, it would be a pretty dull life.

The quality of life suffers when too much attention is given to avoiding risk. A life with minimal risk is not worth living, at least for most people. Each person determines what "a reasonable risk" is for him. Some are daredevils who live for the thrill of danger, and some are more sedate and cautious. Only you can know what is the level of risk taking that makes your life worth living.

Saving versus Spending and the Actuarial Table

People can and do die of hunger. In order to live we have to eat. In order to eat, we have to find a way to get food. Whether the resources we are expending are in the form of money, or labor or natural mineral deposits that we allow someone to mine from the land that we own, all of us pay for our food one way or another. When we have a stockpile of something valuable, one way to make sure that we will have enough to eat tomorrow is not to spend it all today.

However, if you stockpile too much, you may end up dying before you use it all. Unless you have heirs you want to leave it to, you may be cheating yourself of a pleasant life, by spending too little. Death is the deadline for earthly pleasure. Miscalculating -- either by assuming you will die earlier or later than you actually do -- can cost you!

Hedging your bets

Maybe you are aware of the risks, and you decide to take them, but you want to make sure that even if something goes wrong, you will still not pay the ultimate price. For instance, you may be aware of the statistics of death and injury in traffic accidents. Nevertheless, you want to drive or be driven. You decide you will reduce the risk, in the event of an accident, by wearing a seat belt. When you do this, you are willing to give up a bit of comfort in the present, so that you can reduce the chances of death and injury in the event of an accident. The loss of comfort in the present is a certainty. The possible pay-off in the future is a gamble.

The same goes for safety helmets, protective goggles and body armor. In each case, the safety measure is going to cost you something in monetary expenditure, maneuverability, comfort and pleasure. After each use of the safety device, you will know whether it paid off to use it on that particular occasion. Every time we come home safely from a drive during which we were not in an accident, we know, for instance, that on that particular occasion, wearing a seat belt did not pay off. If at the end of your life it turns out that you were never in a car accident, then all those times you wore a seat belt will have been in vain, and you will know on your deathbed that that particular gamble did not pay off.

Catastrophic health insurance is another kind of hedge. The insurance company gambles that you won't get terribly, terribly sick, requiring hospitalization and surgery and drugs and other things that will cost lots and lots of money. You, on the other hand, gamble that you will get terribly sick and will need all those things. Every year that goes by and you pay your premiums, if you don't get terribly, terribly sick, the insurance company gets to keep your money. They win. You lose. But if one day you get terribly, terribly sick, then you win and they lose.

It's a funny kind of game we play, betting against our own health.

Is it worth it?

Is private health insurance worth the gamble? In order for insurance companies to stay solvent, they have to charge more than they pay out. This means that the game has to be rigged so that most of the time, the house wins. In one sense, the insurance company is a kind of parasitic entity, feeding on the mass of people that use its services. If the people who are insured had only pooled their resources, they could have cut out the middleman, and then health insurance would have collectively not cost them more than it would have cost to wait and see who was going to get sick and then pay for the care.

Some people who argue in favor of socialized medicine are banking on this kind of interpretation of the data. However, allowing the government to be the middleman is not going to reduce costs -- and it completely ignores the fact that the only thing that keeps health insurance affordable is that people don't have to buy into it at all.

If people see that the cost of health insurance is considerably higher than the risk of expenditure due to illness, they can simply keep their money in savings, to be used on catastrophic health care, if necessary, and on other things, if not.

The Feed-back Loop

If people buy their own health insurance, the natural mechanism of self-interest and weighing costs and benefits can keep the price of insurance down. This has the side benefit of keeping doctors from racking up charges that nobody is going to pay for. But when individuals are not using their own money to purchase health insurance, then the very availability of insurance can cause medical costs to rise.

There is a conflict of interest between the insurer and the insured. There is also a conflict of interest between doctors and patients. There is a third conflict of interest between insurance companies and doctors.

Patients who are not paying for their own treatment want to get well at whatever the cost, but using the least invasive procedure.

Doctors want to make as much money as they can for the least amount of effort. If they know no one will pay for an expensive procedure, they may not order it done. If they know a deep pocket is available,they will perform the most invasive procedure that they can while getting paid for their time. (Invasive procedures pay more per hour.)

Insurance companies want to make sure that their balance is in the black. (This can be done in two ways: by paying out very little or by paying out a lot and charging even more for the premiums.)

When the patients are not the ones paying the doctor, they can't tell the doctor to perform the least invasive procedure. When patients aren't the ones paying the insurance company, the insurance company has no incentive to keep costs down, based on the reasonable price of a premium. As a result, medical care becomes very expensive.

Medical costs have skyrocketed through the feedback mechanism of de-coupling the beneficiary of the medical care from the provider. Nowadays, not only is there catastrophic medical insurance available, but many people covered by government sponsored programs and through federally mandated benefits from employers also receive routine medical care as part of their "insurance."

When insurance becomes mandatory and is paid for collectively then this affects both the duration and the quality of life of all.

Quality of Life versus Duration

Even when no other person is involved in decisions over life and death, the issue is always this: quality of life versus duration. When deciding whether to use a seat belt you have to ask yourself this: is the risk of death or injury equal to the certainty of the inconvenience? When deciding whether to pay for insurance, the question is the same: is the risk that I will need this equal to the amount of money I will surely be out if I pay the premium? When deciding whether or not to undergo medical treatment, you have to ask yourself this: is the chance of prolonging my life for a few months or years worth this much pain and suffering? This is a decision that only you can make for yourself, and that only a parent can make for a child. The answer isn't the same for everybody. The right answer is the answer you give when you are spending your own money and risking your own life.

There is no absolute safety, and death, someday, sooner or later, is the one thing in life we can all be sure of.

(c) 2009 Aya Katz

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Comments 21 comments

Jerilee Wei profile image

Jerilee Wei 7 years ago from United States

I think you really nailed this subject. I particularly liked the "parasitic entity" comparison.


Storytellersrus profile image

Storytellersrus 7 years ago from Stepping past clutter

Okay, I agree with much of what you have here, but I have a question and that is, what kind of insurance do you have? Do you get it through work or do you pay out of pocket?

Because if you have catastrophic insurance, it costs a family of five over $800 for the right to pay the first $5800 in health care costs. Does this make sense? This is where our private health insurance companies have brought us. And this is for a family who can actually get some kind of coverage due to no significant preexisting conditions.

IN other words, my family is spending $15,400 annually on health insurance and getting NOTHING, ZERO, NADA. So if we survive another ten years, we will have paid $150,400 in insurance costs with nothing to show for it.

Are you arguing for this? I'm not sure many Americans are in a position to pay this kind of money. Certainly not the working poor.

So many are whining about whether illegals will get coverage under the Obama plan. Well guess what? They get coverage now! Complete coverage and FREE in fact.

A homeless friend of ours went to the emergency room last week because a branch hit his eye. He is a citizen and so he was bumped ahead of the roomful of illegals. And the doctor told this man-- a Republican, I might add, "These folk are bleeding us dry. But we have to help them. We can't turn them away."

They gave our homeless friend a CAT scan and top care for nothing. While we, with our HSA still owe $4800 to the emergency room that did a CAT scan on our daughter last summer. Certainly not in our budget, considering my husband has been unemployed for nearly ten months.

So tell me again, what is your point?


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Jerilee, thanks! I'm kind of relieved that you agree. I know that you have been through a lot with health care in your family lately.


Ef El Light profile image

Ef El Light 7 years ago from New York State

Storytellersrus

Doctors much prefer cash payments, which can be negotiated to your advantage. Put that 15000 in the bank and learn to bargain with your doctor over price. Even ER officials will accept an offer.

Did your daughter truly need the scan? She would have survived without it.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Storytellersrus, I'm a similar position. I pay for my own insurance. (I don't have an employer.) I only have catastrophic insurance. The first $5,000 of medical come out of my own pocket. We have never, ever used up the deductible -- and I'm thankful that my daughter and I are in good health. I do notice, though, that the insurance company negotiates the doctor's fee down, so I end up paying $64.00 for every $100.00 that I would be charged if I were uninsured. That's money the doctor is paying -- or another way to put it: the doctor discriminates against the uninsured. I think all of this is insane!

I don't think any of the things you pointed out are okay. My point is that is that it's better to pay our own way with the doctors. I keep paying the insurance company, not because I believe in the service they provide, but because I'm adraid of being discriminated against by hospitals and doctors in the event of an emergency.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

F.L. Light, I'm sorry to say that my experience has been that the uninsured at the clinics in this area pay a higher fee per visit. (I am not uninsured, but I get one bill before the insurance company haggles with the doctor, and another afterwards.)


Rochelle Frank profile image

Rochelle Frank 7 years ago from California Gold Country

One of the options you mentioned-- paying into your own fund to use for medical emergencies-- is what my parents did years ago. I wrote a hub about it. After they had more then they thought they might need (and it was earning interest for them) they spent the extra on traveling the world.

I don't know if that strategy would work today.

Medical costs have skyrocketed since then, partly because doctors have to charge more to make up for the uninsured people they treat and partly because of the huge investments in all of the diagnostic technology that is now available.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Rochelle Frank, it sounds like your parents had a good idea and were good at managing money.

Doctors are actually charging the uninsured more. It's just that not all the uninsured are the same. Some uninsured are judgment proof and others are responsible people who pay their bills. The doctors don't seem to be making the distinction.


abeer 7 years ago

Aya i really like your hub and yes u have described the greatest fact of life in a very practical way. But i do believe that precautions can prevent untimely deaths though if not death itself.else how would you explain the lower mortality rate of todays world and that of people before us.We should be glad that we do have a "health Plan" as opposed to nothing like the people in thirdworld.today we have cures, medicines and more researches to curb health problems.But i like the original idea that "you cannot avoid death by hiding from it" Your time comes when your time comes.keep up the good work.


ngureco profile image

ngureco 7 years ago

Hello, Aya Katz.

I very much like your reasoning in this hub.

It is true more than 75% of the populace are not able or willing to discipline themselves into managing their money such that they can pay into their own fund for medical emergencies. When the emergencies come they just have to go without treatment and will suffer and eventually die. These people could have been a source of cheap labor for my business or consumers of my products.

When these people are not treated for diseases, the whole nation is unhealthy including those who have means because diseases will spread very fast to me and you. When these people do not use the medicine, the drugs will become very expensive as drug manufactures are not able to reach workable breakeven costs.

Providing affordable health care is the responsibility of every good government and it would be fair if Americans would support the government’s socialized healthcare. Why? It is because nature and or God are never fair to all, including to the same species of plants in the same ecological zone. We can not all afford medical care without insurance, and if we can not all afford to pay insurance premiums for medical care then its only fair the government takes over.

When somebody spends $15,400 annually on health insurance, then something is terribly wrong in the entire setup. Companies are telling lies to the people. Is there any logic for someone to tell you that you are paying $64.00 for every $100.00 cash money that you would have paid were you not insured? Doctors would certainly prefer cash payments and which you can negotiate to your advantage. When you are insured, doctors end up performing many unnecessary tests and operations to compensate several times – the insurance companies have actually given doctors and drug manufactures blank cheques to insert their fees at the expense of the common man.

Yes, governments are never the best middlemen in reducing costs but when people talk of paying $15,400 annually to get medical care, then I feel it’s necessary for the government to bulldoze the whole healthcare setup. Unfortunately the cartel in and outside government is so powerful for the government’s socialized healthcare to ever succeed unless the entire populace is in support of the government.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Abeer, thanks for your comment. Sometimes we get so carried away thinking about the precautions we can take to keep death at bay, that we forget that life is only temporary, and we need to make the most of each day.

Of course, we can and should act wisely, but each person has to make the decisions for himself. Some risks are not worth it to some people, but for others, if they are not allowed to take the risk, their life will have little value for them. The big point here being that we are not all the same. We don't all enjoy the same activities, and we are not all comfortable with the same degree of risk.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Ngureco, modern medicine is a strange gift. It's true that it can work miracles to save an individual and it has done much to lower infant mortality and to increase the human lifespan.

On the other hand, populations that have free access to modern medicine are by and large less healthy than populations who don't have access to it. So it's a mixed blessing.

Take the practice of giving newborns oxygen to breathe if they don't breathe on their own. In one sense, it saves the life of a baby who otherwise might have died. In another sense, it makes the parents invest in a child who did not even pass the first test of life: breathing on his own.

If the child had died, the parents would have had another child, and maybe that one would not have needed oxygen. But because the child lived, the parents are going to have to pay for medicine many times more, because their parental investment of love and affection is in a child who depends on modern medicine to survive.

The needs of the individual to save himself and those he loves and the health of the population are sometimes at odds.

It is better for people to pay their own way, so that they do not create a dependency on complicated medical procedures that ultimately nobody will be able to pay for.


ngureco profile image

ngureco 7 years ago

Hello, Aya Katz.

I can very well see your facts and they are very good but unfortunately the public seems not yet ready for them. Every politician and policy maker knows that for them to survive in office, they must give the public sweet pills. The pills you’ve prescript seems a bit bitter and many people may not take them - and certainly your pills are the ones that would cure what’s ailing us.

But what do we do if the public is not willing to take the bitter pills?


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Ngureco, I appreciate your honesty. I'm not sure, however, if it's the public that is unwilling to swallow the bitter pill of reality -- or the politicians!


Storytellersrus profile image

Storytellersrus 7 years ago from Stepping past clutter

I pay for catastrophic insurance because I live in fear that something will happen to my husband or my kids or myself and our family will end up bankrupt covering it. This is the unfortunate reality in the US. We are forced to support fear.

I would NEVER support a system that said it was okay to NOT save a baby's life because it needed oxygen. Oh my God! Surely this is not what you are implying??? Intelligence is a gift. Certainly we can apply it to the insurance system as well as to saving the life of a newborn.

It is presumptuous to suggest the mother can simply bear another child. I must have misinterpreted what you said. Certainly you are not implying that it would have been better to let the baby die? It MAKES the parents invest??? What are you talking about? Is this the bitter pill you are discussing?

What do you mean by healthy? Lots of sickly children have grown into contributing members of society and enjoyed longevity. http://books.google.com/books?id=N0cAAAAAMAAJ&pg=P...


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Storytellersrus, thank you for your comment and for your continued input on these important issues.

People can have different reasons for paying for catastrophic health insurance. You live in fear that something will happen to a member of your family and you will go bankrupt paying for medical services. I don't believe in bankruptcy. I worry that something may happen, and we might end up in a hospital and not have the right to refuse medical treatment.

When I talk about how bankruptcy should be abolished, people tell me not to stand in judgment, because maybe somebody couldn't help incurring medical expenses. Maybe the decision was completely out of their hands. I know people who have been in these situations, so I can see it could happen. It's not their fault.

Not allowing people to pick and choose which treatments they will undergo is one way in which medical care is kept artificially expensive.

I also worry that if I were uninsured and I needed treatment, a hospital might assume that I was insolvent and give me or my daughter substandard treatment -- even though we might have money in the bank to pay the full fee. So, that is one of the reasons I pay for insurance, even though I know it's a bad deal.

The stigma against the uninsured is growing. The president, I understand, spoke out against people who have money for insurance but are choosing to keep it in the bank. He doesn't want them to be able to do this. Have you asked yourself why?

Even the clinic where my daughter and I go for routine medical care discriminates against the uninsured. An insured person pays $64.00 for every visit. Someone who is uninsured, but perfectly solvent, pays $100.00 for the same visit. Can't you see that doctors and insurance companies are colluding against the uninsured?

You misunderstood what I said about babies and oxygen. I never said that treatment should be withheld from the baby. What I said was that it is a matter for the parents to decide. I also wanted to make it clear that medical treatment benefits those who receive it and their loved ones -- but not society at large. That's why we should each make our decisions about ourselves and our children. Nobody else should have any say in the matter.


James A Watkins profile image

James A Watkins 7 years ago from Chicago

I have observed that people who manage their money according to age-old sound principles never seem to ever be destitute. I know quite a few people set for retirement who never made over $35,000 a year—but their home is paid for and they have money in the bank. The kind some people used to make fun of because their home was not big, their clothes were not in fashion—in fact seemed to be the same ones they wore 20 years earlier—they brown bagged their lunch.

We live in a age—in this country—where every desire must be gratified and now (or so it seems). And tomorrow be damned. I think the Cold War started some of this. I remember as a young hippie there was a lot of talk that we may as well cram in all the fun we can today because we may all be annihilated tomorrow. Thank God it didn't happen. So, now we have tens of millions of old, self abused, flat broke baby boomers. Whoops!

I like all your ideas about health care.


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

James A. Watkins, thanks! "Eat, drink and make merry, for tomorrow we die" is a bad motto to live by, if we don't die tomorrow. Glad to see we agree on this one.


kartika damon profile image

kartika damon 7 years ago from Fairfield, Iowa

Very wise and I agree with your observations about insurance companies! Kartika


kartika damon profile image

kartika damon 7 years ago from Fairfield, Iowa

Very wise and I agree with your observations about insurance companies! Kartika


Aya Katz profile image

Aya Katz 7 years ago from The Ozarks Author

Kartika, thanks!

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