Shortsighted, stupid...and cruel

Some of the best people I know are Nurses and Social Workers who deliver end of life care to Hospice patients. By their good works they allow patients to be at home, in the warm embrace of their families and friends and to meet their inevitable deaths with dignity.

I've seen the inevitable end come, in hospitals, homes and residential hospice centers. The work these actual Angels of Mercy do is largely unnoticed, except for by those who benefit as a result.

And now that work is threatened, by the "compassionate conservatism" of the bu$h presidency.

Today the Centers for Medicaid and Medicare Services (CMS) announced that reimbursement rates to Hospice programs and providers will be slashed. The cuts are to take effect October 1st, and they will hurt the most vulnerable and least able to fight back...the terminally ill. (Approximately 80% of Hospice patients are Medicare recipients.)

In issuing this rule, the CMS under the bu$h administration is taking a shot at decency itself.

"The government's reason for its decision that would effectively cut rates -- the need to save money -- simply isn't true," noted Jonathan Keyserling, executive director of the Alliance for Care at the End of Life. "Research has shown that hospice saves the Medicare system money, is highly rated by family members of hospice patients, and enables the patient to die at home in most cases," says Keyserling. "This rule defies logic, and will have a direct, negative impact on care at the bedside."

According to a study conducted by Duke University in 2007, the amount saved by delivering end of life care in Hospice settings saves Medicare an average of $2,300 per patient, for a total savings of about $2 billion a year. Last year, the number of patients that received Hospice care exceeded 1.3 million, and that number is expected to rise as the baby-boom generation ages.

Polling routinely finds that nine out of ten Americans, if faced with a terminal illness, would want to remain in their homes and receive Hospice care. More than 80% of Hospice care is delivered in the patients home, and patient satisfaction approaches 100% as has been revealed in study after study.

Historically, Congress has rejected requests to reduce the level of hospice reimbursement, realizing the harmful impact such cuts would have on care at the bedside. "And this time is no different," says Keyserling. "Congress should intervene to stop the Administration's cut to hospice care, before the rule goes into effect."

Sentiment on Capitol Hill remains tilted in favor of Hospice, and a bicameral and bipartisan group of more than 90 members of Congress has sent a letter to Health and Human Services Secretary Mike Leavitt in opposition to the proposed rule. "It is in our nation's fiscal and moral interest that high-quality hospice care remains an option for all who need these unique services and support," said Keyserling.

There is one thing that is certain...nothing is sacred to these people. It is almost as if they are determined, in the waning days of this administration, to attempt the most outlandish and mean-spirited things they can dream up, just because they have a little bit of power left, and although it is waning, they are determined to use it as a cudgel to hurt someone, anyone, no matter how weak, defenseless and undeserving the people hurt.

These people can't be run out of town fast enough, and cleaning up after them will take at least a decade.