It's not 'Death Panels'...it's individual rights

[Bfgrn]

Promoting advanced directives puts decisions in proper hands

It’s hard to imagine how a compassionate, family-friendly measure — a measure that ultimately respects individual rights — could be twisted so grossly into the erroneous phrase “death panels.”

But, prepare yourself for more lies and more nonsense, because President Barack Obama has decided to do the right thing — and his critics already have resorted to fear-mongering and name-calling.

The concept of advanced directives was pioneered in La Crosse, thanks to our two first-class health care institutions.

It’s a simple concept: An individual, with the help of family, should have the ultimate say in the type of end-of-life care the individual receives. The best way to do that is through a careful consultation, with family and physician, before there is a health crisis — while the individual is still capable of having a rational voice in the decision.

Too often, those decisions are made when it’s too late for the individual to make the decisions. Instead, grieving family members are left to make the decision — and at times it’s nothing more than a guess.

Would the individual want extraordinary measures taken when the end is near? Why wouldn’t we trust the individual — in advance and when thinking clearly — to make that decision?

For those who crusade for the rights of the individual, here’s the question: Why are you so opposed to the individual being able to set down on paper, with help from family and physician, the standards and wishes for end-of-life care?

More

La Crosse Wisconsin Has Highest Rate Of Living Wills, Lowest Cost Of Care

Nearly all adults who die in La Crosse, 96 percent of them, die with a completed advance directive.

La Crosse health care systems offer a model of efficiency

Medicare spent 30% less on average for each beneficiary in the La Crosse area than the national average in 2006, the most recent year for which data is available, according to the Dartmouth Atlas of Health Care.

It spent 64.5% less than in Miami and 61% less than in McAllen, Texas, the two most costly areas. And it spent 23% less than in the Milwaukee area.

 

[CensoredRed]

Promoting advanced directives puts decisions in proper hands

It’s hard to imagine how a compassionate, family-friendly measure — a measure that ultimately respects individual rights — could be twisted so grossly into the erroneous phrase “death panels.”

But, prepare yourself for more lies and more nonsense, because President Barack Obama has decided to do the right thing — and his critics already have resorted to fear-mongering and name-calling.

The concept of advanced directives was pioneered in La Crosse, thanks to our two first-class health care institutions.

It’s a simple concept: An individual, with the help of family, should have the ultimate say in the type of end-of-life care the individual receives. The best way to do that is through a careful consultation, with family and physician, before there is a health crisis — while the individual is still capable of having a rational voice in the decision.

Too often, those decisions are made when it’s too late for the individual to make the decisions. Instead, grieving family members are left to make the decision — and at times it’s nothing more than a guess.

Would the individual want extraordinary measures taken when the end is near? Why wouldn’t we trust the individual — in advance and when thinking clearly — to make that decision?

For those who crusade for the rights of the individual, here’s the question: Why are you so opposed to the individual being able to set down on paper, with help from family and physician, the standards and wishes for end-of-life care?

More

La Crosse Wisconsin Has Highest Rate Of Living Wills, Lowest Cost Of Care

Nearly all adults who die in La Crosse, 96 percent of them, die with a completed advance directive.

La Crosse health care systems offer a model of efficiency

Medicare spent 30% less on average for each beneficiary in the La Crosse area than the national average in 2006, the most recent year for which data is available, according to the Dartmouth Atlas of Health Care.

It spent 64.5% less than in Miami and 61% less than in McAllen, Texas, the two most costly areas. And it spent 23% less than in the Milwaukee area.

I have never understood how a nation of people, most of whom would do the right thing and put a suffering animal out of its misery, have the nerve to say that a suffering person does not have the right to die. It makes no sense to me at all. I have placed in the hands of my loved ones a document with instructions on what I want in terms of care and what I consider quality of life and what I want if the burden of treatment would out-weigh the expected quality of life. I am not leaving it to chance that I could end up like that poor woman Terri Schiavo.

 

[tinfoil]

@Bfgrn

If you purchase a product (health insurance), you abide by the rules of the insurer.
This is why I would rather not have to buy insurance.

The moron liberals are either too stupid or too blinded by ideology to see that the health bill was a corporate written big business win. Captive customers FTW! No price controls FTW!

I wish you were either smarter, or more honest

BTW, I don't even read your posts

 

[Bfgrn]

@Bfgrn

If you purchase a product (health insurance), you abide by the rules of the insurer.
This is why I would rather not have to buy insurance.

The moron liberals are either too stupid or too blinded by ideology to see that the health bill was a corporate written big business win. Captive customers FTW! No price controls FTW!

I wish you were either smarter, or more honest

BTW, I don't even read your posts

Why am I not surprised you don't even read my posts. It might put a small dent in your ignorance and the overwhelming fear that controls your life. Your screen name is so appropriate.

The Individual Mandate is a Republican/conservative idea whose genesis was the Heritage Foundation. The purpose of requiring individuals to buy insurance is based on personal responsibility to prevent what they called 'free riders'... people like YOU who are either too stupid, self centered or fearful to buy insurance, and when you get sick or hurt you sponge off the rest of us.

Every person who has health insurance pays over $1,000 per year to cover the cost of people like you, the welfare queens of health care who receive medical care for free and stick the rest of us with THEIR bill.

If you can be well without health, you may be happy without virtue.
Edmund Burke

 

[apple0154]

@Bfgrn

If you purchase a product (health insurance), you abide by the rules of the insurer.
This is why I would rather not have to buy insurance.

The rules of the insurer are the rules the government sets down such as covering pre-existing conditions and not being allowed to drop someone who contracts a major illness.

The moron liberals are either too stupid or too blinded by ideology to see that the health bill was a corporate written big business win. Captive customers FTW! No price controls FTW!

Hello? If covering pre-existing conditions and continuing coverage for those with major illnesses were what the insurance companies wanted they would have had that in force before the government mandated them.

If automatic coverage for offspring untill they are 26 was what the insurance companies wanted they would have included that coverage, also.

I wish you were either smarter, or more honest

You're hardly one to comment on another person's intelligence when you're unable to comprehend the obvious.

The whole idea behind the health bill is it's a start to universal coverage or a single payer system or government health care....health insurance/coverage for everyone. Simple as that. Just like the dozens of countries which already have a plan.

It's more economical and efficient and, most importantly, the citizens in every country with a government plan insist on keeping it. Not one country has reverted to the "pay or suffer" system. Not one country. Not one exception.

There is no justifiable argument, financial or moral, against government medical. Just the fact the Repubs refer to HRC as "job-killing", placing the importance of one making money above the ability of another to receive medical care, shows the dark place where their collective heads are at.

 

[Mott the Hoople]

Promoting advanced directives puts decisions in proper hands

It’s hard to imagine how a compassionate, family-friendly measure — a measure that ultimately respects individual rights — could be twisted so grossly into the erroneous phrase “death panels.”

But, prepare yourself for more lies and more nonsense, because President Barack Obama has decided to do the right thing — and his critics already have resorted to fear-mongering and name-calling.

The concept of advanced directives was pioneered in La Crosse, thanks to our two first-class health care institutions.

It’s a simple concept: An individual, with the help of family, should have the ultimate say in the type of end-of-life care the individual receives. The best way to do that is through a careful consultation, with family and physician, before there is a health crisis — while the individual is still capable of having a rational voice in the decision.

Too often, those decisions are made when it’s too late for the individual to make the decisions. Instead, grieving family members are left to make the decision — and at times it’s nothing more than a guess.

Would the individual want extraordinary measures taken when the end is near? Why wouldn’t we trust the individual — in advance and when thinking clearly — to make that decision?

For those who crusade for the rights of the individual, here’s the question: Why are you so opposed to the individual being able to set down on paper, with help from family and physician, the standards and wishes for end-of-life care?

More

La Crosse Wisconsin Has Highest Rate Of Living Wills, Lowest Cost Of Care

Nearly all adults who die in La Crosse, 96 percent of them, die with a completed advance directive.

La Crosse health care systems offer a model of efficiency

Medicare spent 30% less on average for each beneficiary in the La Crosse area than the national average in 2006, the most recent year for which data is available, according to the Dartmouth Atlas of Health Care.

It spent 64.5% less than in Miami and 61% less than in McAllen, Texas, the two most costly areas. And it spent 23% less than in the Milwaukee area.

Front Line had a program about end of life health care programs. It was very informative. Peoples lack of knowledge about end of life decisions have an extraordinary high cost both at a personal and public level. All to often unwanted extraordinary measures are taken to extend life that is not wanted by the patient or family but because they did not prepare properly to make these decisions then extraordinary measure are taken to maintain life in patients whose condition is obviously hopeless at a staggering cost to them, both emotionally and financially, and to the public. To give you an idea how much that cost can be for many seniors who are dying and did not make the appropriate living wills, their end of life health care can amount to more then half the cost for health care they spend for their entire lives! Much of that cost, in many cases, is picked up by Medicare-Medicaid.

 

[Mott the Hoople]

I have never understood how a nation of people, most of whom would do the right thing and put a suffering animal out of its misery, have the nerve to say that a suffering person does not have the right to die. It makes no sense to me at all. I have placed in the hands of my loved ones a document with instructions on what I want in terms of care and what I consider quality of life and what I want if the burden of treatment would out-weigh the expected quality of life. I am not leaving it to chance that I could end up like that poor woman Terri Schiavo.

That's the problem. What about those who haven't made that information known? What if your mother has a stroke and is in a coma and has no living will. How do you proceed? Do you take her off life support? Can you legally take her off life support? What if she has a heart attack while in a coma? Do you have her resusitated or not or do you even have the authority to make that decision for her? What if hypoxia during the stroke has completely destroyed all higher brain function and she cannot live with out extraordinary measures (i.e. ventilation) and what if you decide to keep her alive by these extraordinary measure but cannot pay the cost. Who foots the bill? You or the State? This isn't a "Right to Die" issue. It's an issue of "how best to prepare for the end of life."

Both sides of this issue make a huge mistake if they try to politicize this as a right to die vs death panels issue. This is a real problem that needs real solutions. This is a problem technology has created that technology can't solve. One hundred years ago this wasn't a problem. You died because these extraordinary and expensive technologies were not available to keep one alive. They do exist now but how are they best to be used and how should we consider the wants, needs and desires of those affected with these end of life issues that modern technology has created?

 

[evince]

How horrilbe to turn this need into a political football.

People have lost their minds and souls.

 

[Dixie - In Memoriam]

Why am I not surprised you don't even read my posts. It might put a small dent in your ignorance and the overwhelming fear that controls your life. Your screen name is so appropriate.

The Individual Mandate is a Republican/conservative idea whose genesis was the Heritage Foundation. The purpose of requiring individuals to buy insurance is based on personal responsibility to prevent what they called 'free riders'... people like YOU who are either too stupid, self centered or fearful to buy insurance, and when you get sick or hurt you sponge off the rest of us.

Every person who has health insurance pays over $1,000 per year to cover the cost of people like you, the welfare queens of health care who receive medical care for free and stick the rest of us with THEIR bill.

If you can be well without health, you may be happy without virtue.
Edmund Burke

This is just a plain outright LIE. The Individual Mandate is not a "republican/conservative idea" ...certainly not on the basis of a Heritage Foundation finding that nationalized health care CAN'T WORK without it! No, the IM is a necessary component of the LIBERAL idea for socialized medicine.

 

[Mott the Hoople]

This is just a plain outright LIE. The Individual Mandate is not a "republican/conservative idea" ...certainly not on the basis of a Heritage Foundation finding that nationalized health care CAN'T WORK without it! No, the IM is a necessary component of the LIBERAL idea for socialized medicine.

You don't know what the fuck you're talking about Dixie. The idea is neither a liberal idea (you're little Goebelesque bogey man) nor the idea of the Heritage Foundation. It is a position that the Heritage foundation has advocated in the past.

All modern industrialized nations except the US have implemented the individual mandate as a financial reform for reducing health care costs and most of them do not have socialized health care. Japan, France, Tawain, Singapore, Switzerland, Germany for example do not have socialized health care but have implemented this one of the three cornerstones of health care reform. It's hardly a new idea Dixie. It's used by all other modern capitalist countries but ours and it works. So much for your liberal bogeyman.

Boy I tell you Dixie, you're such a partisan lap dog. What ever Fox News or Rush Limbaugh says you believe with your entire right wing little empty head.

 

[Dixie - In Memoriam]

How horrilbe to turn this need into a political football.

People have lost their minds and souls.

What need???

I want you idgits to look out your fucking windows! Do you see millions of people in the street with banners and signs, rioting in protest over the lack of medical care they have available? I don't see it, I never have seen it in this country! This ENTIRE "crisis" is a concoction of liberal niwits who support socialism in any form! There is no crisis! There never has been a crisis! There is no need! Most Americans have insurance coverage, who want insurance coverage! It is against the law for ANY hospital in America to deny emergency care, and Wal-mart is selling prescriptions for $4... WHERE is the fucking crisis? Where are the massive protests in the streets?

We don't have a health care crisis, we never have had a health care crisis! If you made a list of things that are priorities for America, the health care system would be about 20th on the list of problems we need to address. But knee-jerk reactionary fuckwitted liberals, can get an emotive rise out of moderates by invoking the image of poor sick people who are dying in the streets.... so they do! WHERE are these poor sick dying people who can't get health care? Do you see them out there in the streets protesting? Do you see hoards of sick poor people who are demanding help? I DON'T... I NEVER HAVE!

Are insurance companies a major pain in the ass to deal with sometimes? SURE!
Are insurance companies total dicks about paying claims sometimes? YEP!
Are doctors very proud of the services they provide that money can't buy? Oh yeah!

Of course there are problems which need to be looked at, that is the case with virtually anything. Should we seek reforms in health care laws? Maybe. But as soon as the "moderate" thinker entertains the idea that MAYBE we need to reform, the liberals have a hand to play, and they do so! ...Next thing you know, we have individual mandates to buy a product.

 

[Bfgrn]

This is just a plain outright LIE. The Individual Mandate is not a "republican/conservative idea" ...certainly not on the basis of a Heritage Foundation finding that nationalized health care CAN'T WORK without it! No, the IM is a necessary component of the LIBERAL idea for socialized medicine.

The individual mandate is a Republican idea. It's genesis was the Heritage Foundation during the Clinton health care debates. The leading GOP alternative plan known as the 1994 Consumer Choice Health Security Act included the requirement to purchase insurance. Further, this proposal was based off of a 1990 Heritage Foundation proposal outlined a quality health system where “government would require, by law every head of household to acquire at least a basic health plan for his or her family.”

Len Nichols of the New America Foundation: "the individual mandate was originally a Republican idea. "It was invented by Mark Pauly to give to George Bush Sr. back in the day, as a competition to the employer mandate focus of the Democrats at the time."

The 'Free-Rider Effect'

Pauly, a conservative health economist at the University of Pennsylvania's Wharton School, says it wasn't just his idea. Back in the late 1980s — when Democrats were pushing not just a requirement for employers to provide insurance, but also the possibility of a government-sponsored single-payer system — "a group of economists and health policy people, market-oriented, sat down and said, 'Let's see if we can come up with a health reform proposal that would preserve a role for markets but would also achieve universal coverage.' "

The idea of the individual mandate was about the only logical way to get there, Pauly says. That's because even with the most generous subsidies or enticements, "there would always be some Evel Knievels of health insurance, who would decline coverage even if the subsidies were very generous, and even if they could afford it, quote unquote, so if you really wanted to close the gap, that's the step you'd have to take."

One reason the individual mandate appealed to conservatives is because it called for individual responsibility to address what economists call the "free-rider effect." That's the fact that if a person is in an accident or comes down with a dread disease, that person is going to get medical care, and someone is going to pay for it.

"We called this responsible national health insurance," says Pauly. "There was a kind of an ethical and moral support for the notion that people shouldn't be allowed to free-ride on the charity of fellow citizens."

Republican, Democratic Bills Strikingly Similar

So while President Clinton was pushing for employers to cover their workers in his 1993 bill, John Chafee of Rhode Island, along with 20 other GOP senators and Rep. Bill Thomas of California, introduced legislation that instead featured an individual mandate. Four of those Republican co-sponsors — Hatch, Charles Grassley of Iowa, Robert Bennett of Utah and Christopher Bond of Missouri — remain in the Senate today.
-----------------------------------------------------------------------------

The Democrats basically passed the 1993 Republican health care proposal. That includes a BIG Republican idea...THE INDIVIDUAL MANDATE

Chart: Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993 - Kaiser Health News

 

[Mott the Hoople]

What need???

I want you idgits to look out your fucking windows! Do you see millions of people in the street with banners and signs, rioting in protest over the lack of medical care they have available? I don't see it, I never have seen it in this country! This ENTIRE "crisis" is a concoction of liberal niwits who support socialism in any form! There is no crisis! There never has been a crisis! There is no need! Most Americans have insurance coverage, who want insurance coverage! It is against the law for ANY hospital in America to deny emergency care, and Wal-mart is selling prescriptions for $4... WHERE is the fucking crisis? Where are the massive protests in the streets?

We don't have a health care crisis, we never have had a health care crisis! If you made a list of things that are priorities for America, the health care system would be about 20th on the list of problems we need to address. But knee-jerk reactionary fuckwitted liberals, can get an emotive rise out of moderates by invoking the image of poor sick people who are dying in the streets.... so they do! WHERE are these poor sick dying people who can't get health care? Do you see them out there in the streets protesting? Do you see hoards of sick poor people who are demanding help? I DON'T... I NEVER HAVE!

Are insurance companies a major pain in the ass to deal with sometimes? SURE!
Are insurance companies total dicks about paying claims sometimes? YEP!
Are doctors very proud of the services they provide that money can't buy? Oh yeah!

Of course there are problems which need to be looked at, that is the case with virtually anything. Should we seek reforms in health care laws? Maybe. But as soon as the "moderate" thinker entertains the idea that MAYBE we need to reform, the liberals have a hand to play, and they do so! ...Next thing you know, we have individual mandates to buy a product.

Dixie go back and read the original post you moron. This isn't about health care reform. It's about the impact end of life decisions has on health care costs.

 

[Dixie - In Memoriam]

You don't know what the fuck you're talking about Dixie. The idea is neither a liberal idea (you're little Goebelesque bogey man) nor the idea of the Heritage Foundation. It is a position that the Heritage foundation has advocated in the past.

All modern industrialized nations except the US have implemented the individual mandate as a financial reform for reducing health care costs and most of them do not have socialized health care. Japan, France, Tawain, Singapore, Switzerland, Germany for example do not have socialized health care but have implemented this one of the three cornerstones of health care reform. It's hardly a new idea Dixie. It's used by all other modern capitalist countries but ours and it works. So much for your liberal bogeyman.

Boy I tell you Dixie, you're such a partisan lap dog. What ever Fox News or Rush Limbaugh says you believe with your entire right wing little empty head.

All other industrialized countries don't have a U.S. Constitution and Bill of Rights. Therein lies the rub!

 

[Mott the Hoople]

The individual mandate is a Republican idea. It's genesis was the Heritage Foundation during the Clinton health care debates.

I have to correct you here BF. This is not an idea of the Heritage Foundation. It would be more correct to say it was a position that the Heritage Foundation first advocated in our nation. The Individual Mandate was been a primary principle of health care reform in many other wealthy industrialized nations for over 40 years now. In fact, were the only modern industrialized nation in the world who hasn't adopted it. I can assure you, it's not an original idea of either the GOP or the Heritage foundation.

 

[Mott the Hoople]

All other industrialized countries don't have a U.S. Constitution and Bill of Rights. Therein lies the rub!

Well there you may or may not have a point. The courts will determine that but the idea that an individual mandate is either a socialist or liberal bogeyman concept is just plain bullshit. It's a practical reform that works and all modern nations who have adopted it have succeeded in substantially reducing both cost and improved outcomes and not one single nation who has adopted it in the last 40 or 50 years has discarded it, not one!

 

[Dixie - In Memoriam]

The individual mandate is a Republican idea. It's genesis was the Heritage Foundation during the Clinton health care debates. The leading GOP alternative plan known as the 1994 Consumer Choice Health Security Act included the requirement to purchase insurance. Further, this proposal was based off of a 1990 Heritage Foundation proposal outlined a quality health system where “government would require, by law every head of household to acquire at least a basic health plan for his or her family.”

Len Nichols of the New America Foundation: "the individual mandate was originally a Republican idea. "It was invented by Mark Pauly to give to George Bush Sr. back in the day, as a competition to the employer mandate focus of the Democrats at the time."

The 'Free-Rider Effect'

Pauly, a conservative health economist at the University of Pennsylvania's Wharton School, says it wasn't just his idea. Back in the late 1980s — when Democrats were pushing not just a requirement for employers to provide insurance, but also the possibility of a government-sponsored single-payer system — "a group of economists and health policy people, market-oriented, sat down and said, 'Let's see if we can come up with a health reform proposal that would preserve a role for markets but would also achieve universal coverage.' "

The idea of the individual mandate was about the only logical way to get there, Pauly says. That's because even with the most generous subsidies or enticements, "there would always be some Evel Knievels of health insurance, who would decline coverage even if the subsidies were very generous, and even if they could afford it, quote unquote, so if you really wanted to close the gap, that's the step you'd have to take."

One reason the individual mandate appealed to conservatives is because it called for individual responsibility to address what economists call the "free-rider effect." That's the fact that if a person is in an accident or comes down with a dread disease, that person is going to get medical care, and someone is going to pay for it.

"We called this responsible national health insurance," says Pauly. "There was a kind of an ethical and moral support for the notion that people shouldn't be allowed to free-ride on the charity of fellow citizens."

Republican, Democratic Bills Strikingly Similar

So while President Clinton was pushing for employers to cover their workers in his 1993 bill, John Chafee of Rhode Island, along with 20 other GOP senators and Rep. Bill Thomas of California, introduced legislation that instead featured an individual mandate. Four of those Republican co-sponsors — Hatch, Charles Grassley of Iowa, Robert Bennett of Utah and Christopher Bond of Missouri — remain in the Senate today.
-----------------------------------------------------------------------------

The Democrats basically passed the 1993 Republican health care proposal. That includes a BIG Republican idea...THE INDIVIDUAL MANDATE

Chart: Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993 - Kaiser Health News

Bfoon, I think your argument is absurd on its face. You are claiming, since the Heritage Foundation said the plan could not work without an individual mandate, that this makes the individual mandate a "republican" idea? Okay, but your plan will not ever work without it, so what does that leave you with... abject stupidity? I fail to see where you have an argument here. The Heritage Foundation did not say they favored a health care reform with an individual mandate... that is how you seem to interpret things, but far from reality here. The Heritage Foundation made NO determination on whether or not the system was in need of sweeping reforms, what reforms were appropriate, or whether any of this was constitutional. They simply looked at the plan, and determined it will not work unless there is an individual mandate to purchase insurance. That doesn't mean "it's a republican idea" ...it means, the entire idea of nationalized health care, depends on an individual mandate to buy insurance, and can't work without it.

 

[Dixie - In Memoriam]

Well there you may or may not have a point. The courts will determine that but the idea that an individual mandate is either a socialist or liberal bogeyman concept is just plain bullshit. It's a practical reform that works and all modern nations who have adopted it have succeeded in substantially reducing both cost and improved outcomes and not one single nation who has adopted it in the last 40 or 50 years has discarded it, not one!

That's why we have so many wealthy Americans going to those countries for their surgeries and stuff, right???

 

[apple0154]

Bfoon, I think your argument is absurd on its face. You are claiming, since the Heritage Foundation said the plan could not work without an individual mandate, that this makes the individual mandate a "republican" idea? Okay, but your plan will not ever work without it, so what does that leave you with... abject stupidity? I fail to see where you have an argument here. The Heritage Foundation did not say they favored a health care reform with an individual mandate... that is how you seem to interpret things, but far from reality here. The Heritage Foundation made NO determination on whether or not the system was in need of sweeping reforms, what reforms were appropriate, or whether any of this was constitutional. They simply looked at the plan, and determined it will not work unless there is an individual mandate to purchase insurance. That doesn't mean "it's a republican idea" ...it means, the entire idea of nationalized health care, depends on an individual mandate to buy insurance, and can't work without it.

Perhaps it should be noted an individual mandate to buy insurance is not necessary for government medical to work. One Province in Canada does not require anyone to buy anything.

Whether you have a job or are on unemployment or welfare or married or single or have children or.....everyone is covered. No monthly payments. No yearly payments.

Now, if some folks want insurance to pay for a private room or a motorized wheel chair or some other "extra" they are welcome to purchase additional, private insurance. Otherwise, obtaining government medical is as simple as offering what is similar to a credit card to the medical personnel and the government pays the bill.

Economical. Efficient.

What more can one ask?

 

[apple0154]

That's why we have so many wealthy Americans going to those countries for their surgeries and stuff, right???

Why would they go if they can afford it at home?