The American Way of Dying
While palliative care is available to give patients a chance to die without being tormented by excessive medical care, statistics suggest that in New York, the world center of academic medicine, aggressive treatment is still the rule.
Nationally, nearly 32 percent of dying patients had hospice care….for an average of 11.6 days…. [However,] at Montefiore, only 12 percent of dying patients from 2001 to 2005 entered hospice care, for an average of 4.9 days, during their last six months of life…. At Mount Sinai, it was 14 percent of patients for 4.6 days; at NewYork-Presbyterian, 15 percent for 5.2 days; and at New York University Medical Center, 20 percent for 6.7 days.
Wait until Obama Care kicks in. Almost everybody will be headed toward a hospice.
This article does not put the hospital averages in context. It makes little sense to compare hospice use in these teaching hospitals to the national average without knowing how their patient populations differ from the national average.
Maybe the people who go to these hospitals want to try all the remedies there are. Maybe they are younger. Maybe they are wealthier. Maybe they enjoy living more. We don’t know, and this article doesn’t tell us.
The article does succeed in making the Obama government supported end-of-life counseling seem like a perfectly reasonable way to help people.
Never mind that hospice owners naturally want to increase their revenues and have for years decried the fact that many patients with terminal illness “for whom hospice care would be appropriate” enroll very late and that such short stays “don’t allow a hospice program to give a dying patient the full spectrum of care they and their families deserve.”
The article also fails to mention the fact that in 2008 the news was all about the fact that people admitted to hospice weren’t dying soon enough, and that hospice care was one of the fastest growing Medicare budget items. A lot of hospice patients had the temerity to outlive Medicare’s 6-month hospice benefit, putting severe financial strain on hospices.
And, cynics might observe, setting up a knotty conflict of interest in the process.