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In Hospice Care, Longer Lives Mean Money Lost (Patients Refuse To Die)
NY Times ^ | 27 November 2007 | By KEVIN SACK

Posted on 11/27/2007 6:50:27 AM PST by shrinkermd

Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected.

Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors.

One is Hometown Hospice, which has been providing care here since 2003 to some of the most destitute residents of Wilcox County, the poorest place in Alabama.

The locally owned, for-profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker-Butts said.

Hometown paid its first assessment with a bank loan. When the bank declined credit for the second year, the hospice structured a five-year payment plan with the Centers for Medicare and Medicaid Services, the federal agency that administers the program, at 12.5 percent interest.

(Excerpt) Read more at nytimes.com ...


TOPICS: Crime/Corruption; Culture/Society; Extended News; Unclassified
KEYWORDS: abortion; death; dutytodie; endoflife; eugenics; euthanasia; hillarycare; hospice; hospices; moralabsolutes; murder; nannystate; nationalhealthcare; prolife; righttolife; romney; romneycare; rtl; singlepayersystem; socialism; socializedmedicine; theywentthataway
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To: Abathar

Well put. I agree with you there.


81 posted on 11/27/2007 10:31:31 AM PST by reagan_fanatic (Ron Paul put the cuckoo in my Cocoa Puffs)
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To: Abathar
I never want to be a burden on my family or society when it becomes obvious that the cost/comfort ratio becomes too one sided I will go in peace, with my family and friends with me.

UH OH...That's the secret handshake to be deemed a member of the CULTURE OF DEATH here.

82 posted on 11/27/2007 10:34:44 AM PST by Hildy (Faith is the bird that sings when the dawn is still dark.)
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To: long hard slogger; FormerACLUmember; Harrius Magnus; Lynne; hocndoc; parousia; Hydroshock; ...
Socialized Medicine aka Universal Health Care PING LIST

FReepmail me if you want to be added to or removed from this ping list.
83 posted on 11/27/2007 10:35:44 AM PST by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: Hildy; wagglebee
You’re a very creepy human being. I can certainly see why you’re so concerned about people dying alone.

*************

There's the Hildy we know and love.

84 posted on 11/27/2007 10:44:10 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: underbyte

“Hospice is nice if done well, but it sucks getting old - Massive heart
attack is the way to go”

I’m not an MD...but from what little I gather from two friends
that have witnessed such a thing...
a massive brain aneurysm seems to LIKELY be the quiet and painless route.

The father of a friend was a high-school principal in western Oklahoma.
A teacher came into the principal’s office, opened his mouth
to speak...
then just fell to the floor like a rag doll that a child had let go.
Doctors told my friend’s dad that the teacher was as good as dead
when he hit the floor.


85 posted on 11/27/2007 10:49:29 AM PST by VOA
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To: Hildy
He suggested operating b/c that is what he was trained to do...neurosurgery is what neurosurgeons do for hydrocephaly. Would you prefer that, instead of leaving the decision with the patient, doctors or maybe bureaucrats decide who gets offered medical procedures? Then everyone would be yelling and screaming that money is the bottom line and the poor get the short stick. Can't win. The doctor did the right thing; he explained all options and avenues and allowed you to decide.

More personal responsibility is needed in medicine....and in life.
86 posted on 11/27/2007 10:54:32 AM PST by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: Hildy
Pah, it’s my decision, not anyone else's. If the Holier Than Thou crowd wants to argue with me thats fine. Just because we CAN continue life doesn’t mean we always SHOULD.
87 posted on 11/27/2007 10:54:43 AM PST by Abathar (Proudly posting without reading the article carefully since 2004)
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To: trisham

I hope you are never faced with the necessity of considering hospice. I can only tell you that it was a wonderful facility that made the process as peaceful and painless as possible for my mother. I know that she is experiencing an eternity with Christ and I look forward to seeing her someday.

I don’t think death is the worse thing that can happen to an individual who knows the Savior.


88 posted on 11/27/2007 10:58:18 AM PST by GOPPachyderm
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To: GOPPachyderm

Thank you. I hope I don’t either.


89 posted on 11/27/2007 10:59:48 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: Dick Bachert
Hillary has a plan for solving the problem:

SOYLENT GREEN!

Hey, I resemble that remark.

90 posted on 11/27/2007 11:03:00 AM PST by -=SoylentSquirrel=- (I'm really made of people!)
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To: -=SoylentSquirrel=-

91 posted on 11/27/2007 11:04:32 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: Abathar
The “Holier Than Thou, culture of life” (not my label) crowd is being misrepresented here; they have no argument with YOU making the decision of when to let go.... they take issue when the decision leaves your hands and ends up in the hands of a bureaucrats or someone else whose agenda may not be yours. When someone else decides that it is time for you to die and withholds food from you then there is a problem.

Put your intentions/wishes in writing.
92 posted on 11/27/2007 11:05:06 AM PST by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: trisham

We helped my father fight off hospice to his final day. The surgeons messed up his surgery, the doctors didn’t want to become involved, and they all tried to throw him away into hospice. We fought and fought them for months. Dad was pleading with them all to try a treatment. Finally, we found doctors willing to treat him, and the hospital’s ethics committee tried to stop them. After all the fighting, they gave him one treatment, but, by then, it was too late. The cancer was too far gone. He fought like a warrior to his last moment.


93 posted on 11/27/2007 11:06:20 AM PST by Tired of Taxes (Dad, I will always think of you.)
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To: shrinkermd

The cancer patients are living longer because they’re pushing them into hospice early. The answer is “open access” hospice. Some insurance companies have plans that cover it now - open access means doctors have determined you have six months or less to live, but you won’t be denied treatment or the chance to survive.


94 posted on 11/27/2007 11:09:57 AM PST by Tired of Taxes (Dad, I will always think of you.)
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To: Tired of Taxes

I’m so sorry. Your Dad sounds like quite a guy.


95 posted on 11/27/2007 11:16:19 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: shrinkermd; 2Jedismom

I gotta say...I’m amazed at some of the vitriol on this thread.

My mother passed away of cancer a few years back, and at the end, we had home hospice care. We had help from about three different hospice nurses, and all of them were wonderful, gentle, caring people. Thanks to them, Mom was as comfortable as was possible at that stage in her illness, she was able to be in familiar surroundings, and her death was peaceful - I’d even say beautiful.

It isn’t easy work, caring for the dying. And I’ll always, always be grateful that they were there to do it.


96 posted on 11/27/2007 11:20:37 AM PST by RosieCotton ("Anything worth doing is worth doing badly." -- G.K. Chesterton [NaNo Count 50400/50000])
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To: Hildy
You’re a very creepy human being. I can certainly see why you’re so concerned about people dying alone.

You, like most liberals, have a very serious problem with projection. Where have I ever talked about people dying alone? Are you referring to the 50 MILLION babies that you and your ilk have killed in the past 35 years? Are you talking about people like Terri Schiavo when you and your ilk supported her loving family being removed from her bedside at gunpoint so she was forced to die alone with her murderer?

97 posted on 11/27/2007 11:22:47 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: shrinkermd

socialism does not work, socialism does not work, socialism does not work, socialism does not work, socialism does not work, socialism does not work,...


98 posted on 11/27/2007 11:24:38 AM PST by PGalt
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To: socialismisinsidious
No, many times they object even when it’s a spouse or parent that makes the decision to end the life of a loved one, knowing the wishes of that person or having been given the authority to decide for them. Not just a Dr. or the Nanny State, but family as well.
99 posted on 11/27/2007 11:28:05 AM PST by Abathar (Proudly posting without reading the article carefully since 2004)
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To: shrinkermd
I don't think all Hospices are alike but I am certainly no fan of the one that "helped" my Mother....we kids would do everything for her, which is what we wanted, and their aide would come give Mom a brief bed bath and change the sheets....Mom dreaded her coming....

we liked the social worker/spiritual person.....she actually sang songs for my mom and my dad....they really liked her and she was an inspiration for both my mom and dad, and she promised she would be back....well, she never came back....

she and the chief nurse promised as well to be at the funneral to give support to my father.....of course, neither showed up nor did either ever talk to my dad again, and he really needed the emotional support...

for my mom to lie there for close to 3 months, knowing she was dying, yet still waking up every morning....that must have been so very hard on her...she was the type that would have liked to "get on with it"....

I am rethinking Hospice myself....okay, so let's not do chemo or radiation but can we at least talk HOPEFUL and that Jesus can perform miracles?????<

but to lie down without hope, ever....that is cruel and inhumane....

100 posted on 11/27/2007 11:34:05 AM PST by cherry
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