Life as an Extreme Sport

Open Access Hospice

The New York Times is doing a series of articles on new approaches to address common shortcomings in our health care system, and the first is on hospice. Interestingly enough, it’s the insurance companies who are starting to say what some of us have said (and known, empirically) for years: hospice can often extend the quality of life of the patient to the point that they actually live longer. It’s not uncommon for someone to enter hospice with the 6 months or less until death sentence on their head, only to beat those expectations and live much longer.

The problem is, until recently, hospice has required people give up conventional treatment. So if people are living better, and longer than expected in hospice without any treatment, just how would they do while still being able to receive treatment?

Seems that the least usual suspect stepped up to find out: insurance companies, and the results are promising. Promising enough that major insurance corporations will be changing the way they allow and pay for hospice care. Well, with the exception of one of the largest insurance companies in the country, Medicare, which is still making you choose between treatment and palliative hospice care.

Can you imagine being in that position, of being told that you can have the benefits of hospice – people coming to your house to help out, home nursing care, massage, even something as basic as cooking and cleaning for you – or you can keep being treated for your disease, but not have both? No wonder so many people choose to fight the disease until the very end, ringing up huge medical bills in the process. The current paradigm asks people to either fight or give up, and most of us are indoctrinated to not give up.

Shifting towards integrating palliative hospice care with traditional treatments for disease seems like it would, in the end, benefit everyone involved. It would make the patient’s quality of life ever so much better, appears that it would extend that life, plus would decrease the end of life ER runs, ICU stays, and other things that cause medical bills to skyrocket and makes death one of the most expensive medical conditions.

But it is still weird seeing the big insurance companies, so often painted as part of an evil capitalist conglomerate, doing something proactive and good.