Tragedies shed light on health care

For more than two decades the man tended to his son, who was in a permanent vegetative state.

Then, early on Monday morning, in what authorities believe was an act of desperation, the 55-year-old set fire to his farmhouse in Dangjin, South Chungcheong, killing himself and his 31-year-old son.

The local fire department managed to put out the fire after more than an hour and found the two men dead inside.

While the police will conduct autopsies to find out the exact cause of their deaths, investigators have concluded for now that the father, whose surname is Kim, set the fire to end their lives. A suicide note written by the man, apologizing to his son, was found in his car. The boy suffered irreparable brain damage after a car accident nearly left him dead 25 years ago, and his parents had dedicated their lives to his care.

The murder-suicide was just the latest in a series of tragic incidents involving low-income families, many of whom have spent years at home looking after loved ones suffering from terminal illnesses. And these are not isolated incidents in Korea, where the government is planning to spend 100 trillion won ($95 million) next year on welfare programs and health care.

In September, a man strangled his father, who was suffering from a terminal brain tumor, at their home in Pocheon, Gyeonggi. And in October last year, another man, in his 70s, strangled his wife after he watched her dementia grow worse and worse.

Again, in August 2007, a man in Damyang, South Jeolla, killed his son by removing his artificial respirator. The son had suffered from severe muscular dystrophy for 20 years.

A deeper look into the Kims’ welfare and health care benefits, however, reveals a number of loopholes in the country’s expensive system.

The Kims got a disability pension of about 116,800 won per month, which they had received since the system was first introduced three years ago.

Some patients with certain brain conditions are eligible for long-term care insurance for the elderly, even if they are younger than 65. However, because Kim’s state was the result of a car accident - and not a natural cause, like a stroke or an aneurysm - he did not qualify for the program.

Without long-term care possibilities, his parents had no other choice but to take turns looking after him. And with a 1 million won monthly fee, it’s doubtful the Kims could have afforded to admit their son to a convalescent care facility.

“Honestly, I have no information about that family,” said Lee Hye-jin, a civil servant of Songak Village, where the family lived. “They should have researched what welfare benefits they were qualified for, but they didn’t. We could not manage them, because they never registered for programs.”

According to those in the medical community, a significant number of terminally-ill patients are being cared for at home by their families either because of logistical problems or simply because they can’t afford health care.

When such patients stay at home, specialists add, they require around-the-clock care or special equipment to help them function.

“If you just leave the patient’s bed for a minute, they could die,” said Professor Heo Dae-seog, a cancer specialist at Seoul National University Hospital. “Someone in the family had to be there for 24 hours. The family often breaks apart, or in some cases they make an extreme choice.”

Experts say new health care measures are ultimately needed to address these kinds of situations.

“Society should take some responsibility,” said Shin Young-seok, vice president of the Korea Institute for Health and Social Affairs. “Long-term care insurance services must be expanded, and nursing fees should be covered by the state-run health insurance so that the families can send them to convalescent care facilities.”

BY SHIN SUNG-SIK, SER MYO-JA [myoja@joongang.co.kr]