TERMINAL ILLNESSES ONLY

TERMINAL ILLNESSES ONLY

(Bernice Yeung, Medicine Net, Washington Post, Peter Hudson)

(Huffington Post, Peter Whoriskey, Dan Keating, Patricia Sullivan, Henryk Szeloch)

(California Watch, Florence S. Wald, Robert Kastenbaum, Cicely Saunders, Frazer Chronicle)

Hospice care: Care designed to give supportive care to people in the final phase of a terminal illness, focusing on comfort and quality of life, rather than a cure.  The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used, and the hospices programs usually are home based, but sometimes provide services away from the home, in nursing homes, extended care facilities or within hospitals. The philosophy of hospice is to provide support for the patients emotional, social, and spiritual needs as well as medical symptoms as part of treating the whole person.

I’ve never been involved with a hospice situation, thank God, but the above, which came from MedicineNet.com, explained the goals and services pretty much as I envisioned them. I suppose the philosophy part might be a bit much for me, but hey, who am I to question the dying wishes of patient or family.

Like I said, never having been around a hospice situation, how they operated was pretty much what I expected as laid out above. However, there’s more here, actually a hell-of-a lot more, to the story than meets the proverbial eye. Hospice programs generally use a multidisciplinary team approach, including the services of a nurse, doctor, social worker and clergy in providing care. Additional services provided include drugs to control pain and manage other symptoms: physical occupational and speech therapy.

Medical supplies and equipment; medical social services; dietary and other counseling; continuous home care at times of crisis; and bereavement services are all a part of hospice care. There is also a volunteer program that can be offered by trained folks who can take over care of a patient’s needs so that care giving family members can get away for a few hours at a time.

HOSPICE IS LATIN FOR HOSPITUM MEANING GUESTHOUSE

Originally described as a place of shelter for weary and sick traveler returning from a religious pilgrimage, hospice was established in the 1960’s. During the 60’s, Dr. Cicely Saunders began the modern hospice movement by establishing St. Christopher’s Hospice near London, England. The first United States hospice was established in New Haven, Connecticut in 1974.

The nitty-gritty of hospice care really is very simple, patients are expected to die: The treatment focuses on comfort for the terminally ill…..not to find a cure. Hell, to enroll a patient in a hospice program, he’s gotta be at death’s door, or no longer than six months out…..from death, and be certified as such by two licenses doctors.

Where there’s a will, there’s usually some green-backs involved, at least in America, and that’s exactly what has happened to the hospice program that is approaching 40^th birthday. Hospice which was once headed by religious and community help organizations has evolved into a $17 billion dollar industry, dominated by for-profit companies. Much of that price tag is paid for by the U.S. government…..roughly $15 billion of the industry revenue comes from Medicare.

Hospice care today has next to no relationship with the 1974 model, without exception for-profit companies have completely taken over the industry. There’s currently a FBI investigation into what in the hell is going on with a program that is paid for mostly by Medicare which is funded by the taxpayer, and is not a bottomless pit.

AN INGENIOUS IDEA FOR FRAUD

There is a hospice company, based out of San Francisco; California that is, if not the biggest in the industry, is one of the largest, they are located in 19 states and are a subsidiary of an equity firm, and have been in the business of hospiceing since 1978.

In a complaint filed by the United States Department of Justice, this hospice company is accused of bilking Medicare of millions of dollars, and has been since 2007. Here’s how it’s been working; the U.S. Department of Justice alleges that the company, through its reckless business practices, admitted and retained individuals who were not eligible to receive Medicare hospice benefits, because it was financially lucrative…..and did so even after the company auditor alerted them, (company) to the troubling problem. The company misspent millions of Medicare dollars intended for Medicare recipients.

Medicare allocates more than $13 billion annually on hospice care, and the industry serves about 1.5 million people throughout the United States. The current legal problems are the result of a whistleblower lawsuit filed by the company’s former executive director.

I’ve omitted the company name because I might have a conflict of interest…..but I’ll say this, the plan, although not fool proof, is really a nifty piece of larceny. You could almost say that clients were dying to become customers!

WHAT WE HAVE HERE IS A FAILURE TO COMMUNICATE

So I get it, people nearing the end times of their lives need some sort of program to ease them 6’ under, more to the point, the caregivers need this type of help to cope. Not only are they losing a loved one…..and know it, but the event completely screws up their lives. From family relations, to personal obligations, to work and bill paying duties, a lingering death, can be tough. I saw it last year with my brother-in-law and cancer.

However the innocent here isn’t the patient, or the family, or probably the hospice caregivers, it’s us…..the taxpayers. Medicare taxes pay for part A Medicare hospital benefits…..employers and employees pay these taxes, taxes that you paid in the past provide benefits to others. About 99% of Medicare beneficiaries do not pay a premium for Medicare Part A since they have at least 40 quarters of Medicare covered employment.

There are other particulars involved here, but the gist of this conversation is that what “some” of these hospice companies are doing…..taking on patients that’ll linger on…..maybe for years, are denting the hell out of the Medicare fund.

And I’m wondering about doctors that sign off on some of these people who live eight, ten, twelve months, or, as in several cases…..years. Is there a kick-back going on here…..after all, we’re not talking about penny-ante stuff here, its billions.

Just a final political shot here, for all you conservatives who feel that the Federal Government needs to keep its nose out of people’s private business and affairs…..look the story up on-line…..the company is AseraCare…..you might just be surprised at AseraCare’s plan to defraud us taxpayers.

HAVE A NICE DAY!