As much as I sympathize, the title is clickbait and I'm not entirely sure what the point of the article is.
From what I can gather, the $145K cost was the cost of medical care over the months (years? the article never says) at the end of the grandmother's life -- not the cost of "dying at home".
The bulk of the cost seems to come from:
> the total monthly cost was $16,200: $13,000 a month for the 24-hour care, plus $3,200 to rent the apartment
It seems silly to include rent, and then of course round-the-clock private care is going to be $$$.
As far as I can tell, the grandmother needed hospital-level care, but the family didn't want to keep her in a hospital. It's not surprising that hospital-level care at home costs a small fortune.
It only looks like clickbait because you're used to a system that costs $$$ to get medical care.
In the UK when my mother got told she was terminal and had a couple of months left, she chose to spend them at home. In the end she left hospital in mid-December and died the following May. 5 months at home in a specialist bed, provided by the hospital, all of the equipment required to keep a dying person comfortable again provided by the hospital. Nurses and doctors there every day.
Because of her illness, the government paid her rent, it paid my father a carers allowance, so he was able take time off work.
Total cost: £0.
5 months of excellent at home care for £0.
You shouldn't be dismissing the article as clickbait, it shouldn't cost $145k to die, there shouldn't need to be a discussion here.
You should be so very angry that a country that takes in $3tn a year in federal taxes won't support a working healthcare system
Possibly a little clickbaity, but it was a first hand experience from the author. There are likely thousands of examples of this exact scenario playing out every year: $old_family_member needs assistance and all of the options cost $small_fortune. What do we do? I think the theme is important rather than the _exact_ details of this particular situation.
thats how I read it to - the family didn't want the burden of doing the care, and also don't think anyone should have to pay for it - who are these magical fairies that are going to show up in your final days and take care of you for free?
If the deceased person owed the medical bills - well guess what? she is dead and won't have to pay them unless the creditors go after her estate - if the family's complaint that now their inheritance is going to be less than they thought - too bad.
Typically not - you're looking at nursing home care. That means you'll pay $300+ a day for care that is awful at best and horrific more typically. Sometimes hospice patients have a better experience because the outside entity (the hospice) has eyes on the patient and (in)competence of the nursing home staff.
The tragedy of modern medical care if you're over 65 is that it's hard to die. Medicare only pays hospitals for results, so there are powerful incentives to limit hospital stays as much as possible - unless you're in an ICU or similar scenario, if you are hospitalized more than a week it's likely because someone fucked up, and Medicare will reimburse the hospital next to nothing as a result.
It's easy to get sick or become incapacitated, but people can and will "save" you and leave you in a situation where you are not well, but not dead. The options are 120 days of Medicare nursing home coverage, followed by a slow drain of all of your assets and ultimately Medicaid enrollment. Nursing home means you're effectively warehoused, and the more help you need, the less care you get as you become a cost center.
It's not just a matter of finances, it's a matter of humanity. The harsh reality is your disabled loved one will be treated like cattle unless someone who cares is directly engaged in caring for you. After the horror that my father went through after a suffering a stroke, and the pain caused to my mother after she took on full-time care, I did what most doctors do and have DNR care instructions on file with every hospital in a 50 mile radius.
>Medicare should restructure hospice reimbursement to cover more of the hands-on caregiving, thus decreasing the financial burden of dying at home.
The main pitch is somewhat hidden in the middle of the article. Its a tough point to open with, but I think leading with the thesis statement is proper.
For all those in the US who hear nothing but horror stories about how bad it would also be if you lived in another country, particularly in Canada, I always feel it's important to relate stories like this.
My father died in Canada last year after a 9 month battle with cancer during which time he spent almost 2 months in cancer ward. He was not rich. He recieved cutting edge targeted chemo-therapy. He died peacefully with the aid of MAID in his small home town.
Cancer treatments typically falls under medical expenses, something a health insurance will cover. Assisted living or long-term care for the eldery in a nursing home usually does not, so I'm not sure what your example tells us about the differences.
While as a relatively healthy person I've been continuously disappointed at paying approximately $1500 a month in taxes[1] towards the Canadian public health care system (a quick google suggests ~30% of tax revenues), I also was happy to see that my grandpa spending ~6 months in palliative care cost them very little (if anything), compared to something like $180K in the US.
I think the biggest point of contention is that reasonably well kept and healthy people are receiving little to nothing for their money in the present. eg, I got tons of push back asking for simple lab tests like cRP or dermatology cancer screening which would have been less than 10% of what I contribute to the system. Another time I literally waited in a ER room until my loss of blood made me a triage priority. The amount of resources available due to the market distortions means they have to defer you until you're worse off than when you walked in.
Compare that to fast (always <1 hr, even for non emergency things like a dislocated finger) and reasonable waits anytime I've been to a hospital in the US. Mind you I've also probably spent a total of $40k (not my portion) in ~8 yrs of residency between insurance costs and copays, more than half due to a heart attack scare and ER trip that ended up being myocarditis from the vaccine.
So what's my point in all this rambling? I think there's a ton of unlocked value in the US system to do more preventative care, but the US is anti-paternalism and often lets people do stuff that costs them in the long run (unwittingly or knowingly). But there's a hidden truth to Canada's system appearing so rosy -- at least as the payer and consumer I feel I get more for less in the US. Whereas in Canada you have better average outcomes because you take marginal care (eg preventative tests) from those who pay, and give it to those who cannot pay but may have a marginally more improvable conditions (eg bleeding out, having a heart attack).
[1]: compare to about a quarter of that in medicare on much higher earnings
Sure, but by being taxpayers, your parents already paid a substantial portion of the cost forward by paying for the healthcare of other people. Perhaps they were net takers from the system, but presumably people on HN have parents that are net contributors to the system.
To be blunt, I do not think I desire to eek out a few more years of my life hooked up to life support, taking medicines that prevent me from being me, and pooping my pants. I remember my grandfathers last years (both in nursing homes, hooked to machines, drugged out of their minds) and I do not wish for that.
I would rather die a few years earlier than live my last few years this way. It'd sure cost less too.
This is the way a person that is far away from death thinks. No matter what you think now, you will still want to live when death is near. Even if the conditions are suboptimal.
Your thoughts mirror my own, however I should point out that thinking this now and making that choice when the time actually comes are quite different things.
Having seen this for other family members: I have a compressed nitrogen cylinder reserved in the garage for this purpose. I hope my wits are about me to use it, or that a DNR keeps any hospital stay as short as practical.
This reminded me of one of our society's most twisted and grotesque norms, forcing people on their deathbed to die "naturally", meaning to starve and dehydrate to death while being pumped full of opioids, instead of mercifully and humanely ending their life.
We treat animals better than this.
I hope by the time it's my turn my family is able to end my life once the outcome is certain instead of watching me waste away day after day in a hospital bed until my body finally fails.
We just moved to Mexico for this very reason. My mom now has 24 hour nurse care (at home) for 1,200 usd per month. In the US we were quoted 10k per month and not 24 hour. My mom receives a small pension which puts her in a spot where she qualifies for no government benefits but also cannot afford care at the current market rate.
It’s not for everyone but she is much happier here than in a nursing home.
Not a criticism of the action, but an observation. In the book The Elephant in the Brain by Kevin Simler & Robin Hanson, the authors observe that part of the reason healthcare may be so expensive is that we (unintentionally) communicate how much we love a person by acting as if money is not an issue. This means that despite last months of life often being the least pleasant for the dying, we expend a tremendous amount of money and resources intentionally to show them (and ourselves?) that we love them.
A really worthwhile read are some of the essays online with basically the same title: How Doctors Die. Doctors, who are familiar with the process of dying in a hospital, typically do not wish to die there (it is miserable), and choose to die at home.
I wish our society had a better ritual around death. Having an option for the dying person (if they are of sound mind) to choose euthanasia would be very merciful.
I'd like to know what this actually means. Where did the money come from? Was her grandmother destitute and so the money was pooled from other family members? Was this debt that her grandmother accumulated that was written off when she died? Or, was this paid out of her grandmother's retirement funds?
Can relate to TFA. Cost near the end of life are eye-popping the in the US, but the alternative is murky too. Just let elder relatives live in your home? Likely won't last 3-4 days, its hard. Cost of these facilities is astronomical and ironically the staff is usually underpaid and overstressed.
Assisted death will get a lot of callout as its becoming popular but its not 100% the answer either. Legitimately wondering how older generations dealt with this problem. Did old people just die randomly and then they were buried and that was that?
When my mother passed last September, about 30 miles (~50 kilometers) west of Boston, private onsite hospice care cost about $400-ish a day. It's about the cost of staying in a fancy hotel. The state also covers the cost when you are on your final days, (there's a specific medical term,) but for longer-term stays, (weeks, months,) you have to pay out of pocket.
Being "on hospice" when you are in your last months (again I don't remember the medical term), in Massachusetts is free. The family is responsible for the round-the-clock care, though. The real difficulty isn't the money: The state is very good at placing people who can't pay. The people who get squeezed are those of us who want an inheritance, or the spouses who need to keep money for their own end-of-life needs, yet are unable or unwilling to take time off from our lives.
In my case my dad was under quite a bit of emotional stress, and when he's in that state, he gets irrational and can't make a decision. My mom was clearly in her last few days, but he was afraid he'd have to pay for many weeks or months of onsite hospice stay out of his own pocket. Even if that happened, he still had her brand-new Lexus and his own 1-year-old Highlander, a much larger house than he needs...
This reminds me of the trend to value women's work at home on a per hour basis.
Then an inevitable conclusion is reached: being a homemaker is like being employed but not compensated.
The point is taking care of your family is something people want to do to maintain family relationship, connections between generations and self-identity. It's a choice, not a forced expenditure.
And it's not meant to be pleasant or easy. It's not a hobby. It's a fabric of a well lived life.
24h at home care isn't covered anywhere except with really expensive private insurance. In most European countries the family either covers the burden financially or they do it themselves. This post is more entitlement than anything else.
"How will you afford to spend your final years of life? How much will your death cost you and your family? Can you afford it?"
We've had this talk with both my parents and my wife's parents. All four of them insisted they do not want to be a burden to us and we should never allow them to move in with us. Most of our parents took care of at least one terminal person in their life and experiencing that changed their opinions radically. It can be an almost impossible burden, no matter how much you love someone.
Thankfully in our country we have both the law and basic insurance that takes care of all those costs in the last (terminal) phase of our lives, but you still have to design your testament and other documents in such a way that your money cannot be claimed for these costs.
When the time comes, i want to be put in the Euthenasia Coaster ( https://en.wikipedia.org/wiki/Euthanasia_Coaster ) , but if they have not built that yet i might settle for the $20 heroin overdose.
The question that society seems to be encouraging is "how are we going to pay people to take care of the old?".
The question we should be asking is "why are we paying strangers to take care of you when for most people, their children should be there at the end of life helping, showing love, and thanking mom and dad for all they've done?".
There's a significant cost to the direction that society has gone in the last hundred or so years.
> Deemphasizing the importance of family bonds by encouraging government to be the social safety net. This problem will only be exacerbated by increasing the social safety net further.
> Compelling nearly all women into the permanent workforce, ensuring that most families are in no position to be able to do anything other than maybe get in debt to pay a stranger to care for their elderly parents.
> Encouraging women to have fewer and fewer children even while encouraging mass migration to replace the existing population, ensuring that the problem will be even worse the more time goes on.
Life insurance can be writen with an LTC rider, standalone LTC policies have gotten very expensive since they were oversold throughout the 80's and 90's. SS kicks in upto a portion of the hospice and at home care, depending on circumstances.
In Canada a growing in popularity option is to kill yourself.
My father died at 83 at home, and the only cost was the funeral expense, which would have been the same. When he stopped coming at the hospital for regular blood work, they expected he'd die in two weeks, but he lasted six months. During those six months my mom acted as his caregiver and vigil, and the state compensated her financially. She was allowed to continue working, and since she worked from home, she did work a little next to looking after him. Once a day for those six months, a nurse from the public health system would come by and check up on him.
I agree that this is clickbait, but then I come from a family that just doesn't think this way. I've been through this twice now, for both my parents. They died at home. Not in a rented apartment. At home. We, their children and grandchildren, were their caregivers. We did everything a nurse would have done. We took shifts. We spread the burden among us.
Yes it was a sacrifice. But it was a sacrifice that was worth it, and nothing less than what we owed to our parents.
> As a clinician, I’ve been trained to explain hospice to patients as “an extra layer of support” at the end of life.
Offering advice on the provision of goods and services without cost information is stupid. It’s like one grade schooler telling another “yeah, you should totally buy that real life Ferrari.”
> The problem is that the bulk of the hands-on care in hospice — including changing diapers, feeding and giving medications — still falls to the family.
Amazingly, she acted as a salesperson for services whose service level she didn’t understand. On top of that, instead of learning a lesson and sharing better approaches with others she promoted additional subsidies to the existing dysfunctional system.
As someone who has had two older people who were at home virtually till the end - my mother-in-law (she finally died in the hospital after a very short stay) and her mum (who died at home) who were both terminally ill and bedridden for a while before they died, I have to say that the inconvenience to the rest of us was worth it because it enabled them be with the family, be part of what the family was doing etc.. And so also the family benefited from being with them till the end.
It did require having nursing help at home and it did cost some money - but it was still cheaper than being admitted in a hospice or a hospital.
"dying at home is often unattainable for many, unless they have family members who are willing to give up their own lives to be caregivers or the patient is willing to spend down their life savings to qualify for Medicaid to pay for around-the-clock help."
You mean like what Grandma or Grandpa did to bring life into this world. Your life I might add. You owe them so much and you haven't clue. It is worthless and shameful.
I realize this may seem like a tangential point, but this story highlights the dire shortage of caregivers, especially elderly care workers. This shortage is a factor behind high costs and substandard care. Many of these jobs don’t necessarily require extensive medical training; a caring hand is literally the most valuable gift, especially near end of life. Immigrants can help fill these roles, but the United States restrictive immigration policy prevents this. The problem is only going to get worse as the Boomers continue to age, and as US demographics tilt towards an older population. Immigrants can help avert this crises while at the same time beginning a better life for themselves. We should do a better job of welcoming immigrants.
[+] [-] crazygringo|3 years ago|reply
From what I can gather, the $145K cost was the cost of medical care over the months (years? the article never says) at the end of the grandmother's life -- not the cost of "dying at home".
The bulk of the cost seems to come from:
> the total monthly cost was $16,200: $13,000 a month for the 24-hour care, plus $3,200 to rent the apartment
It seems silly to include rent, and then of course round-the-clock private care is going to be $$$.
As far as I can tell, the grandmother needed hospital-level care, but the family didn't want to keep her in a hospital. It's not surprising that hospital-level care at home costs a small fortune.
[+] [-] RansomStark|3 years ago|reply
In the UK when my mother got told she was terminal and had a couple of months left, she chose to spend them at home. In the end she left hospital in mid-December and died the following May. 5 months at home in a specialist bed, provided by the hospital, all of the equipment required to keep a dying person comfortable again provided by the hospital. Nurses and doctors there every day.
Because of her illness, the government paid her rent, it paid my father a carers allowance, so he was able take time off work.
Total cost: £0.
5 months of excellent at home care for £0.
You shouldn't be dismissing the article as clickbait, it shouldn't cost $145k to die, there shouldn't need to be a discussion here.
You should be so very angry that a country that takes in $3tn a year in federal taxes won't support a working healthcare system
[+] [-] bthrn|3 years ago|reply
[+] [-] kickout|3 years ago|reply
[+] [-] newshorts|3 years ago|reply
In fact it even motivates me to start planning out costs with them.
Sometimes the point of articles can simply be to relate one’s own experience to other people.
[+] [-] ejb999|3 years ago|reply
If the deceased person owed the medical bills - well guess what? she is dead and won't have to pay them unless the creditors go after her estate - if the family's complaint that now their inheritance is going to be less than they thought - too bad.
[+] [-] Spooky23|3 years ago|reply
The tragedy of modern medical care if you're over 65 is that it's hard to die. Medicare only pays hospitals for results, so there are powerful incentives to limit hospital stays as much as possible - unless you're in an ICU or similar scenario, if you are hospitalized more than a week it's likely because someone fucked up, and Medicare will reimburse the hospital next to nothing as a result.
It's easy to get sick or become incapacitated, but people can and will "save" you and leave you in a situation where you are not well, but not dead. The options are 120 days of Medicare nursing home coverage, followed by a slow drain of all of your assets and ultimately Medicaid enrollment. Nursing home means you're effectively warehoused, and the more help you need, the less care you get as you become a cost center.
It's not just a matter of finances, it's a matter of humanity. The harsh reality is your disabled loved one will be treated like cattle unless someone who cares is directly engaged in caring for you. After the horror that my father went through after a suffering a stroke, and the pain caused to my mother after she took on full-time care, I did what most doctors do and have DNR care instructions on file with every hospital in a 50 mile radius.
[+] [-] TheHypnotist|3 years ago|reply
[+] [-] peteey|3 years ago|reply
>Medicare should restructure hospice reimbursement to cover more of the hands-on caregiving, thus decreasing the financial burden of dying at home.
The main pitch is somewhat hidden in the middle of the article. Its a tough point to open with, but I think leading with the thesis statement is proper.
[+] [-] mhb|3 years ago|reply
Yes. Where are all the people who were apoplectic about the Nord Stream post?
[+] [-] xipho|3 years ago|reply
My father died in Canada last year after a 9 month battle with cancer during which time he spent almost 2 months in cancer ward. He was not rich. He recieved cutting edge targeted chemo-therapy. He died peacefully with the aid of MAID in his small home town.
It cost my mother $150.
[+] [-] mhb|3 years ago|reply
You're welcome.
[+] [-] FpUser|3 years ago|reply
[+] [-] refurb|3 years ago|reply
[+] [-] luckylion|3 years ago|reply
[+] [-] maerF0x0|3 years ago|reply
I think the biggest point of contention is that reasonably well kept and healthy people are receiving little to nothing for their money in the present. eg, I got tons of push back asking for simple lab tests like cRP or dermatology cancer screening which would have been less than 10% of what I contribute to the system. Another time I literally waited in a ER room until my loss of blood made me a triage priority. The amount of resources available due to the market distortions means they have to defer you until you're worse off than when you walked in.
Compare that to fast (always <1 hr, even for non emergency things like a dislocated finger) and reasonable waits anytime I've been to a hospital in the US. Mind you I've also probably spent a total of $40k (not my portion) in ~8 yrs of residency between insurance costs and copays, more than half due to a heart attack scare and ER trip that ended up being myocarditis from the vaccine.
So what's my point in all this rambling? I think there's a ton of unlocked value in the US system to do more preventative care, but the US is anti-paternalism and often lets people do stuff that costs them in the long run (unwittingly or knowingly). But there's a hidden truth to Canada's system appearing so rosy -- at least as the payer and consumer I feel I get more for less in the US. Whereas in Canada you have better average outcomes because you take marginal care (eg preventative tests) from those who pay, and give it to those who cannot pay but may have a marginally more improvable conditions (eg bleeding out, having a heart attack).
[1]: compare to about a quarter of that in medicare on much higher earnings
[+] [-] fortran77|3 years ago|reply
[deleted]
[+] [-] Danieru|3 years ago|reply
Cheap though.
[+] [-] ErikVandeWater|3 years ago|reply
Sure, but by being taxpayers, your parents already paid a substantial portion of the cost forward by paying for the healthcare of other people. Perhaps they were net takers from the system, but presumably people on HN have parents that are net contributors to the system.
[+] [-] pard68|3 years ago|reply
I would rather die a few years earlier than live my last few years this way. It'd sure cost less too.
[+] [-] x86x87|3 years ago|reply
[+] [-] nebulous1|3 years ago|reply
[+] [-] rainbowzootsuit|3 years ago|reply
[+] [-] mhb|3 years ago|reply
What's your plan?
[+] [-] Y_Y|3 years ago|reply
[+] [-] parrot987|3 years ago|reply
[+] [-] mbfg|3 years ago|reply
[+] [-] rizach8|3 years ago|reply
You can now chose to be on life support for 2 more year at the cost of pooping pants and being on drugs. I bet, life support does not sound so bad.
[+] [-] standardUser|3 years ago|reply
We treat animals better than this.
I hope by the time it's my turn my family is able to end my life once the outcome is certain instead of watching me waste away day after day in a hospital bed until my body finally fails.
[+] [-] dnndev|3 years ago|reply
It’s not for everyone but she is much happier here than in a nursing home.
[+] [-] yboris|3 years ago|reply
A really worthwhile read are some of the essays online with basically the same title: How Doctors Die. Doctors, who are familiar with the process of dying in a hospital, typically do not wish to die there (it is miserable), and choose to die at home.
I wish our society had a better ritual around death. Having an option for the dying person (if they are of sound mind) to choose euthanasia would be very merciful.
[+] [-] irrational|3 years ago|reply
I'd like to know what this actually means. Where did the money come from? Was her grandmother destitute and so the money was pooled from other family members? Was this debt that her grandmother accumulated that was written off when she died? Or, was this paid out of her grandmother's retirement funds?
[+] [-] kickout|3 years ago|reply
Assisted death will get a lot of callout as its becoming popular but its not 100% the answer either. Legitimately wondering how older generations dealt with this problem. Did old people just die randomly and then they were buried and that was that?
[+] [-] gwbas1c|3 years ago|reply
Being "on hospice" when you are in your last months (again I don't remember the medical term), in Massachusetts is free. The family is responsible for the round-the-clock care, though. The real difficulty isn't the money: The state is very good at placing people who can't pay. The people who get squeezed are those of us who want an inheritance, or the spouses who need to keep money for their own end-of-life needs, yet are unable or unwilling to take time off from our lives.
In my case my dad was under quite a bit of emotional stress, and when he's in that state, he gets irrational and can't make a decision. My mom was clearly in her last few days, but he was afraid he'd have to pay for many weeks or months of onsite hospice stay out of his own pocket. Even if that happened, he still had her brand-new Lexus and his own 1-year-old Highlander, a much larger house than he needs...
[+] [-] karol|3 years ago|reply
Then an inevitable conclusion is reached: being a homemaker is like being employed but not compensated.
The point is taking care of your family is something people want to do to maintain family relationship, connections between generations and self-identity. It's a choice, not a forced expenditure.
And it's not meant to be pleasant or easy. It's not a hobby. It's a fabric of a well lived life.
[+] [-] Zetobal|3 years ago|reply
[+] [-] b3lvedere|3 years ago|reply
We've had this talk with both my parents and my wife's parents. All four of them insisted they do not want to be a burden to us and we should never allow them to move in with us. Most of our parents took care of at least one terminal person in their life and experiencing that changed their opinions radically. It can be an almost impossible burden, no matter how much you love someone.
Thankfully in our country we have both the law and basic insurance that takes care of all those costs in the last (terminal) phase of our lives, but you still have to design your testament and other documents in such a way that your money cannot be claimed for these costs.
When the time comes, i want to be put in the Euthenasia Coaster ( https://en.wikipedia.org/wiki/Euthanasia_Coaster ) , but if they have not built that yet i might settle for the $20 heroin overdose.
[+] [-] logicalmonster|3 years ago|reply
The question that society seems to be encouraging is "how are we going to pay people to take care of the old?".
The question we should be asking is "why are we paying strangers to take care of you when for most people, their children should be there at the end of life helping, showing love, and thanking mom and dad for all they've done?".
There's a significant cost to the direction that society has gone in the last hundred or so years.
> Deemphasizing the importance of family bonds by encouraging government to be the social safety net. This problem will only be exacerbated by increasing the social safety net further.
> Compelling nearly all women into the permanent workforce, ensuring that most families are in no position to be able to do anything other than maybe get in debt to pay a stranger to care for their elderly parents.
> Encouraging women to have fewer and fewer children even while encouraging mass migration to replace the existing population, ensuring that the problem will be even worse the more time goes on.
[+] [-] ecommerceguy|3 years ago|reply
In Canada a growing in popularity option is to kill yourself.
[+] [-] sshine|3 years ago|reply
This is Denmark.
[+] [-] teilo|3 years ago|reply
Yes it was a sacrifice. But it was a sacrifice that was worth it, and nothing less than what we owed to our parents.
[+] [-] adolph|3 years ago|reply
Offering advice on the provision of goods and services without cost information is stupid. It’s like one grade schooler telling another “yeah, you should totally buy that real life Ferrari.”
> The problem is that the bulk of the hands-on care in hospice — including changing diapers, feeding and giving medications — still falls to the family.
Amazingly, she acted as a salesperson for services whose service level she didn’t understand. On top of that, instead of learning a lesson and sharing better approaches with others she promoted additional subsidies to the existing dysfunctional system.
[+] [-] pkphilip|3 years ago|reply
It did require having nursing help at home and it did cost some money - but it was still cheaper than being admitted in a hospice or a hospital.
[+] [-] freedude|3 years ago|reply
You mean like what Grandma or Grandpa did to bring life into this world. Your life I might add. You owe them so much and you haven't clue. It is worthless and shameful.
[+] [-] BenFranklin100|3 years ago|reply