Letters to the editor - 01-12-2014

January 12, 2014 

Hospice care

I found the article originally published in the Washington Post very typical. People get all worked up over the increase in spending for hospice services. However they never compare that amount to what would have been spent if those people had not had hospice. I guarantee the amount would be astronomically higher. As the owner and administrator of a for-profit hospice agency, I see our nurses helping patients and families at all hours of the day and night. Times when they would otherwise go to the ER. At least four months of hospice (under Medicare) can be paid for by avoiding one ER visit!

The comparison between nonprofit and for-profit hospices is also interesting. No one ever says the truth! For-profit hospices actually bring in more money than nonprofit ones. They are paid the same, but for-profits do fund raisers also! They make more, but we provide more charity care than the nonprofit does! Interesting.

As to discharging patients alive, a big reason is the intensive and excellent care they receive on hospice. We monitor meds, educate, provide care, and surprise, they stabilize or improve!

A quality hospice does not "recruit" patients or push families — for us it's about the patients!


The recent article attributing the growth in Medicare hospice spending to unethical financial motivation without deeper consideration of cost avoidance in other areas paints a completely erroneous picture. Medicare A hospice beneficiaries effectively never access their outpatient (B) benefits, nor do they utilize significant emergency department, hospitalization, or post-hospitalization skilled nursing facility benefits. Irrespective of length of stay, Medicare is saving significant dollars by avoiding these costs - savings directly related to care and services hospice provides in the place of residence. Additionally, people who would otherwise require Medicaid nursing home care are able to die in their homes. To decry hospice expenditures without consideration of concomitant cost savings/avoidance is entirely inaccurate.

While, unfortunately, some of the data in the article are irrefutable — the vast majority of hospice providers in Idaho apply the benefit fairly and admit patients appropriately. Hospice/Palliative Care is as important a medical specialty as any other in the healthcare system. Unethical practices exist in any medical specialty you can name.

Referring physicians and families are well-served to consider the professionally skilled, thoroughly compassionate care that hospice provides to individuals facing life-limiting illness.


Did it ever occur to you to talk with local hospices and present the other side? You know, the one that truly makes a difference to people who are dying and the heartbroken families they leave behind? I didn't see mention of the 13 months of follow-up bereavement care that hospice social workers and chaplains provide to the families. I saw no quotes from families about the burden it took off them financially and emotionally to have hospice take care of their loved ones.

Have you experienced a family in crisis when they learn their loved one is dying and they don't know where to turn? It might be helpful for you to witness firsthand what happens when a doctor refers a person to hospice and that person lives alone, is bed-ridden, has no way of fixing themselves a meal or taking their regularly prescribed medications and then the hospice team comes in and provides loving care, bathing, meals, med reminders, spiritual and emotional comfort, companionship for the lonely and the patient begins to thrive. That's not a scam or an inconvenience, that is what we in hospice call a miracle!


Utah judge's ruling

I was bewildered by Don Adair's letter regarding a Utah judge throwing out one of Utah's laws regarding people living together. This ruling, despite Don's claims, did not legalize polygamy. All it did was throw out that part of the Utah constitution that criminalized an adult living with two or more adults of the opposite sex. "Polygamists" traditionally have one legal wife and all subsequent "wives" are simply women with whom the man "shacks up." The ruling simply made that legal … just like it is in every other state. The U.S. Supreme Court's Lawrence vs. Texas ruling had already thrown out laws prohibiting relations between unmarried, yet consenting, adults.

The ruling did not legalize bigamy or polygamy, which involve someone having legal marriages with more than one person. Those are still illegal.

It didn't legalize underage marriage.

It didn't legalize human trafficking.

It simply allows three or more adults of differing sexes to live together.

The ruling is not nearly as exciting and controversial as the headlines portrayed it to be. Let's all take a deep breath. Everything is just fine.


Airline charges

Why are airlines getting so greedy with charges for checked bags, carry-on bags, window seats, aisle seats, fuel charges, taxes, $60 for eight inches of extra leg room, and $10 for a little box lunch? What's next? A $10 charge to raise or lower the window shade? A $50 charge for a seat belt?

If you're serious about cashing in, partition the back 30 seats of the airplane and call it the Cellphone Parlor. I can see you easily charging the blabber set double for a ticket.

However, the most ludicrous charge is already in place: pay-to-view TV. Gimme a break! TV is so bad the airlines should pay me to watch that trash. Yes, I know, the airlines just want to contribute to the joy of flying. Makes me want to power yawn.


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