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The Government Says "Die Quickly"

I was incredibly saddened to read this article in the New York Times which explains that
Having a patient live longer Actually means Less Money for Hospice Providers

Basically, MediCare expects Hospice to be to only cost so much, and thus if someone lives longer, thus costing more money, the government wants their money back. I can truly understand the desire for saving money, but in reality, ethics should play a role in decision making. Those who are dealing with a disease process which could kill them shouldn't have to suffer simply because they don't die quickly enough. This kind of policy takes away resources people need.

What angers me most about this, and many other things involving painful and/or life-altering diseases and the government or society's responses to them is that there's an underlying assumption that people want to need these resources. It says "Wow, someone might get (insert terrible disease here), just to use these resources." It's similar to the assumption that people with RSD are just in it for the drugs. Most people I've known who needed hospice services are not in it for the hospice services. They're truly suffering. Some of them are ready to die, some aren't. But either way, hospice services provide that needed help to make the quality of life good.

A person can generally not control their need for resources any more than we can all control our need for water. There may be things you can do to help prevent diseases, but you can't completely prevent anything. If you can't prevent disease, how can you decide when you're going to die? If we truly knew when six months was coming up, it would probably allow many people to do things they can't currently do. People could say their good byes with just the right amount of time, get all of their affairs in order, decide or designate someone to decide when their funeral would be, figure out how to control their pain and get help lined up for all of their life needs until that day comes. But we don't know when we're going to die, and it's unreasonable to expect our doctors to know eather.

Yes, there are exceptions. There are people who would intentionally use these services inappropriately. But we need to insure that we don't become distrustful, just because we can.

This entry was written for
LJ Idol, Week #4

Comments

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kl1964
Nov. 30th, 2007 03:51 am (UTC)
This notion that people are somehow sick because they want certain services is, I believe, somewhat a myth generated by Medicare and other insurance companies in their continuing effort to pay as little and as infrequently as possible. Sadly, it also plays into the idea many more narrow-minded individuals have that somehow sickness or pain is "all in your head", and if you can't make yourself well than you must really not want to get better. Whatever. You wrote very eloquently here. I know I don't comment a whole bunch here, but I do read your journal complete with all its ups and downs. Keep hanging in there, I'm cheering you on even if I don't show myself too much.
puppybraille
Dec. 1st, 2007 05:51 pm (UTC)
Thanks for commenting! We probably have similar LJ reading styles, because I read what you write and just don't get to commenting either. I know you've had a ton happening lately, and hope things are looking up.
anamacha
Nov. 30th, 2007 06:40 am (UTC)
good entry, and it sort of ties in with mine -- like your entry is the dark underbelly of my entry. Odd, that.

In other news, I have a friend who is a hospice nurse. She continually says it's the most fulfilling job she's ever had.
puppybraille
Dec. 1st, 2007 05:52 pm (UTC)
Thanks, I'd imagine it's incredibly rewarding. I'll be doing a lot of reading today, and your entry is definitely on the top of the list.
anamacha
Dec. 1st, 2007 10:39 pm (UTC)
thank you! Well, you certainly have my vote :)
belenen
Nov. 30th, 2007 10:34 pm (UTC)
I really liked this entry, especially your compassionate tone. ♥
puppybraille
Dec. 1st, 2007 05:53 pm (UTC)
Thanks, I'm glad you liked it!
kittenboo
Dec. 1st, 2007 03:01 pm (UTC)
very good points, good entry!
puppybraille
Dec. 1st, 2007 05:53 pm (UTC)
Thanks, I'm glad you think it's good!
n_decisive
Dec. 2nd, 2007 05:01 am (UTC)
Unfortunately, the only way I can see to eliminate this problem is to revamp the guidelines hospice uses. They have time and illness limitations, so even if someone is on their deathbed today and not exactly so the next day, but expected to be there again shortly? They can't stay.

I really hate that kind of thing.
lacombe
Dec. 3rd, 2007 11:32 am (UTC)
I'd love to know how that policy even came into existence! I mean, what the heck were they thinking when they put a time limit on this? "Oh, let's be reasonable! They've lived long lives already and we've done our part!"????
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