Date: Thu, 30 Jan 1997 20:06:56 -0500 (EST) From: louisgodena-AT-ids.net (Louis R Godena) Subject: M-I: Hospice patients living too long: A problem of capitalist health care HEW Secretary Donna Shalala threatened to cut "substantially" government aid to hospice providers because their terminal patients are responding too well to the program of in-home health care, and are not dying as quickly as expected. Medicare generally pays for the last six months for visits by hospice nurses during the last six months of a patient's life. The cost to the government is about one-fourth of that of skilled nursing home care and less than *10%* of that of hospitalization. Yet the total bill for the hospice program came to nearly 2 billion dollars last year. Under the hospice program, the terminally ill patient is entitled to one paid visit per week by a health professional -- usually a nurse practitioner -- and daily visits from a "home care specialist" to assist in the daily routines of cooking, cleaning, bathing and the like. The problem of course is that patients are responding so well to the personal care and attention they receive in their last months that they are finding new reasons --- and new strength -- to go on living, often months and even years beyond their expected departure date. This is creating problems not only for Medicare; the private insurance industry which has long eyed this sector of the health care industry as a candidate ripe for privatization is also growing increasingly concerned. Recently, Barry Haller of Prudential HealthCare Systems (and a member of Hilary Clinton's ill-starred health care panel) put it without squeamishness: "We must be careful," he intoned, "not to pamper the terminally ill. Our task should be to make their final time as comfortable as possible as economically as possible". What does a humane person due with a society where horse's asses like Barry Haller and Donna Shalala are allowed to consign an entire generation of suffering human beings to the oblivion of some corporate bottom line? Where's the Shining Path when you need them? Louis Godena --- from list marxism-international-AT-lists.village.virginia.edu ---
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