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Open Hospice

Posted Aug 26 2008 4:08pm
I have always been unhappy with the US approach to hospice care. It seems to be the final resting place, where we can forget about the dying and medicate them to within an inch of oblivion. This is not the purpose of hospice care.

Palliative medicine is a better term, and it applies to providing total care to people with terminal diagnoses. It is care that is focussed on comfort and well-being, not cure. But it is not putting a human being out to pasture.

The NYTimes features a new approach to palliation , but it is really the way the rest of the world does it. Maybe we have gotten so caught up in how to pay for it and prevent cheating and abuse that we took our eye off the purpose of hospice programs. There is a lesson here for all policy wonks, managers and regulators... abuse potentially leads to regulation that can defeat the purpose . There will always be cheaters and abuse, but the question is what are we accomplishing and at what cost. In the presence of too many regulatory requirements the train will never leave the station.
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