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Big Business And Hospice Care

How dying became a multibillion-dollar industry.  We dig into the booming business in hospice care and big charges of fraud

Joe Takach, talks to his friend Lillian Landry, as she spends her last days in the hospice wing of an Oakland Park, Fla. hospital. (AP File)

Joe Takach, talks to his friend Lillian Landry, as she spends her last days in the hospice wing of an Oakland Park, Fla. hospital. (AP File)

When the end comes – and it comes for us all – we want it to be peaceful.  Dignified.  We want to be in calm and knowing hands.  Increasingly for Americans, that means turning, when death is near, to hospice care.  A generation ago, hospice was almost unknown.  A few non-profits here and there.  Today, hospice care has exploded into a huge, multi-billion dollar business.  With lots of distinctly, aggressively for-profit players.  Drawing billions from Medicare.  And charges of fraud and mistreatment.  This hour On Point:  what’s happened with American hospice care.

– Tom Ashbrook

Guests

Ben Hallman, senior financial reporter and investigative reporter for the Huffington Post. His investigative piece is called “How Dying Became a Multibillion-dollar Industry.” (@ben_hallman)

J. Donald Schumacher, President and CEO of the National Hospice and Palliative Care Organization. NHPCO represents both non-profit and for-profit hospices, including Vitas, one of the main national chains that reporter Ben Hellman highlighted in his report.

Dr. Diane Meier, Professor of Geriatrics and Palliative Medicine at Mount Sinai Hospital in New York and Director of the Center to Advance Palliative Care. She is Principal Investigator of a National Cancer Institute-funded study on palliative care services for cancer patients and on the Board of Directors of non-profit Visiting Nurse Service of New York. She received a MacArthur Foundation Fellowship in 2008. She is the author of: Palliative Care: Transforming the Care of Serious Illness.

From Tom’s Reading List

Huffington Post: How Dying Became A Multibillion-Dollar Industry – Mounting evidence indicates that many providers are imperiling the health of patients in a drive to boost revenues and enroll more people, an investigation by The Huffington Post found.

New York Times: Differences in Care at For-Profit Hospices – For the terminally ill and their families, the disenrollment issue seems troubling. Some hospices now discharge 30 percent or more of their patients, withdrawing the services they’ve come to rely on.

The Washington Post: Terminal neglect? How some hospices treat dying patients – For more than a million patients every year, the burgeoning U.S. hospice industry offers the possibility of a peaceful death, typically at home. But that promise depends upon patients getting the medical attention they need in a crisis, and hundreds of hospices provide very little care to such patients, a Washington Post investigation has found.

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  • Human2013

    Yet again, here is another shameful example of profit entities in healthcare.
    If we are going to accept this economic system of untamed capitalism, than we must accept that human dignity and compassion will continue to decline.

    There is an inherent conflict in capitalism and human good and it’s most notable in the healthcare industry. If a weakness exists, and it does among the elderly, than it will be exploited. Lately, my response to most of Tom’s shows is the same: “It’s Capitalism, Stupid.”

    Before my friends on the right respond with the same argument, “Capitalism has lifted millions out of poverty,” I’ll say that that statement is much too simplistic and lacks any serious foresight. This economic system hasn’t been around long enough to declare it a success and the projections don’t look good.

    • Acnestes

      Capitalism is essentially Darwinist and is exhibits only the shark ethic – eat the wounded. It would ultimately consume itself it were not regulated, a point about which conservatives, who seem to know the price of everything and the value of nothing, seem blissfully if not willfully ignorant. If health care is treated as a commodity instead of something essential to the public good than this shameful situation is not only to be expected but inevitable. Evidently death panels are hunky dory as long as they’re free market owned death panels.

    • harverdphd

      One again you have given credibility to a saying attributed to Abraham Lincoln…

      “Better to remain silent and be thought a fool than to speak out and remove all doubt.”

      • Matt MC

        Yeah, listen to the guy that got his PhD from “Harverd” … says so right on his usarneme

  • jefe68

    One has to ask, what the hell is wrong with this country?
    How is it that every aspect of living and dying has become a commodity to be bought and sold?

    • responseTwo

      The great american success story – “life is a big game and whoever dies with the most toys wins”.

    • hennorama

      jefe68 — don’t forget taxes, with Intuit, H&R Block, Jackson Hewitt, Liberty, et al.

    • tbphkm33

      From cradle to grave, someone is out to make a buck off you. Nothing is sacred. Even what you write online and where you take your smartphone is brought and sold. With the advance of wearable technology, like the wrist bands, soon a “medical” organization, contracted to your insurance company, will be calling if you go to the bathroom more than five times in a day.

  • HonestDebate1

    Maybe the death panels will expedite the process and lower costs as the IRS continues to be ignored.

    • jefe68

      What is wrong with you? Is there something so misplaced and misshapen in your makeup that you feel the need to post this kind of nonsense?

      • HonestDebate1

        It’s not about me.

        • jefe68

          That meme is getting old pal.

          • HonestDebate1

            Then quit talking about me and add some relevance to the topic at hand.

          • jefe68

            Don’t tell me what to think…

          • HonestDebate1

            I didn’t. Comprehend much?

          • Ray in VT

            That’s sick.

          • nj_v2

            Alrighty then.

          • 1Brett1

            We shouldn’t even try to figure this out; our collective heads will explode!

          • HonestDebate1

            NAh, NJ is a smart nasty ideologue. I am gratified by all of the sincere forms of flattery I am seeing though.

          • jefe68

            It’s called a quip. Comprehend much?

        • Human2013

          No, it’s not, so stop trying to distract critical thinkers.

    • jimino

      See, now THAT is a troll post. Stupid, nonsensical, uninformed and uninformative, designed solely to get a rise out of others. Excellent job at “show and tell”.

      You weren’t being serious, were you?

      • HonestDebate1

        ..

        • jefe68

          You forgot the problem of fraud, which is part of what this show is about.
          Did you even bother to glance and skim the articles about how these companies are ripping off government funds?
          How they are also delivering substandard care.

          You mentioned below about making comments that have substance, well it’s clear that you don’t know the meaning of the word as you don’t even bother to do one iota of reading before you post your Ayn Rand tinged memes. Talk about a lack of substance, man you take the cake here buddy.

        • anamaria23

          Did you read the article? Do you know or care what the show is about?
          As health care worker, I find your assumptions insulting. You really believe that nurses and physicians are complicit in
          expediting patient deaths to save the government money? You believe that DNR decision by patient a Death panel?

          • HonestDebate1

            I did not make that accusation at all. I just pointed out the undeniable paradigm that exists.

          • anamaria23

            Please reference the “undeniable paradigm that exists”

          • HonestDebate1

            Please see my reply to Jimino.

          • anamaria23

            Very clever.

          • HonestDebate1

            It’s just relevant, that’s all.

        • JGC

          I see you posted this well before the actual broadcast began. Listening now to the program and reading the articles reveals this is also concerning Medicare fraud. That has to concern you. These are not “HonestProfits”.

          • HonestDebate1

            Thank you for the reply JGC as I would rather address you than some of the below.

            I don’t get the show until 7PM so I have still not heard it. I did read the articles.

            What I gleaned is the hospice industry working within the system and the law. I am not sure where the fraud comes in. Maybe I missed it. Are laws being broken? If someone is standing on a corner handing out money and then complains about being broke then I blame them not the ones who took the cash.

            The HuffPo piece was particularly troubling to me. How could a family a mere 30 miles away not know their parent was in sharp decline? Our parents are owed more than being put in a facility and forgotten while we wait on a phone call. To be sure, these stories are heartbreaking. I don’t deny that at all but families have the power to intervene to see if standards are being met.

            There is serious medicare fraud going on in the system that makes this pale in comparison. Even if you want to label this as fraud I would posit the VA did engage in actual illegal fraud that resulted in premature death. I am much more concerned about that.

          • 1Brett1

            You make it sound as if neglect and fraud by professionals is only actual neglect and fraud if family members aren’t truly legitimately able to check up on the quality of care, otherwise it’s the family’s fault…Let the free market correct itself; amiright?! Go find care somewhere else if you don’t like what’s happening to your loved ones! Problem solved!

          • HonestDebate1

            Again, and I am an idiot so I may be missing something, what fraud? Are laws being broken, are documents being altered?

            “Go find care somewhere else if you don’t like what’s happening to your loved ones! Problem solved!”

            Well duh! That is the very least we can do. Better yet clean out the spare bedroom, turn your life upside down, seek emotional support from friends, sell assets and do what you must to take care of your family.

          • JGC

            What I gleaned was the for-profit hospice industry working the system and the law. Here is one area where the fraud comes in (from the Huff Post article): “Since 2006, the Justice Department has sued more than a dozen hospice companies for going too far in their pursuit of patients. The roster of companies accused of billing fraud includes Miami-based Vitas…” It is stated as plain as can be within the article: billing fraud.

            The investigation started in the last administration, but continues today, and is actually picking up speed due to, guess what, the ACA: “The government is only now starting to collect basic data to gauge the quality of care, more than 30 years after the benefit (Medicare coverage of hospice) was introduced. New measures, ushered in under the ACA, require hospice operators to submit data…” Now they have to account for their numbers in a database being compared to their local and national competition, so the jig is up. (Just like we are seeing in the hospital ratings nationwide, with hospital-acquired infection rates and so forth being forced down to protect their Medicare reimbursement.)

            I don’t know why you consider this type of Medicare fraud (hospice) as illegitimate or not serious. Hospice fraud as “good” fraud versus VA fraud as “bad” fraud? Similarities in both stories is 1.) pressure to keep the employees from blowing the whistle; 2.) theft from the taxpayers and 3.)physical and mental harm to the patients and their families.

            I think you are going to be disappointed about tomorrow’s schedule: it is on private trading/SEC and vampires. Will have to wait until Friday for any mention of IRS. There is always C-SPAN…

          • HonestDebate1

            I guess my confusion is, what is billing fraud? It seems to me that is what they are calling zealously pursuing patients. The allegation is they are being reimbursed for patients who don’t require Hospice. I’ll be honest JGC, I don’t now how all this works so I could be confused but don’t patients (or their legal guardians) have to chose Hospice? Are people being forced into it? If so then that is an order of magnitude worse than what it appears to me to be.

            If I go to a mechanic an ask for a new muffler even though I don’t need one, is the mechanic committing fraud if he complies with my request? Again, I may be completely misguided but that is the analogy that makes sense to me.

            Also, I did not see the results of the lawsuits. Do you know. The best i can tell these are just allegations. It is unclear to me that fraud is the appropriate word and if it is, that it has been proven.

            The VA is a completely different set of circumstances with out and out lawlessness. People have died, lots of them. The veterans are trapped with no choice. The promises are broken.

          • hennorama

            JGC — apologies for the interruption, but please allow a translation of the post below, from [Debates?NotHe]:

            “I did read the articles. . . . (Mind the gap) . . . I am not sure where the fraud comes in.”

            Translation: I ignored the 15 paragraphs discussing fraud, allegations and lawsuits, and the five uses of the word “fraud” in the HuffPo piece.

            “There is serious medicare fraud going on in the system that makes this pale in comparison. Even if you want to label this as fraud I would posit the VA did engage in actual illegal fraud that resulted in premature death. I am much more concerned about that.”

            Translation: This doesn’t appear to directly involve the Obama administration, so it should be ignored.

            Apologies again for the interruption.

        • 1Brett1

          Can you cite specific examples of “Obamacare” bureaucrats ordering clinicians to expedite a person’s death to save the government money?

          • Ray in VT

            Oh, it’s just around the corner. It’s coming. It’s a part of Obama’s revenge.

          • HonestDebate1

            No. It hasn’t been implemented yet although Obama did accuse doctors of such in 2008. You have to look at existing systems in other countries like Britain where examples are legion.

            But that’s irrelevant to my point. Under Obamacare, the quicker people die the more money will be saved. With hospice, the longer people live the more money will be made. I don’t know how you can disagree with that.

          • anamaria23

            How does the ACA facilitate these expedient deaths? Please be specific with references.

          • Ray in VT

            I have here in my hand a list of 205 “Obamacare” bureaucrats that have ordered clinicians to expedite a person’s death to save the government money.

        • keltcrusader

          “The longer they can keep someone alive, the more money they make. I don’t view that as a bad thing.”
          Really, you don’t see a problem with a business profiting off of someone WHO IS DYING and that they are supposed to be helping to pass on peacefully??? You are such a weirdo and your thought process is one a degenerate.

      • Kathy

        It’s the same group of trolls with the same three fake scandals every single day. BUR should ban them.

    • Ray in VT

      Ah yes, the death panels. Is there a way for me to get on one? Perhaps I can inquire on Friday when I take my wife to the doctor, and I am told that the IRS will be running my health care or something, so there should be someone from the IRS there, correct?

      • 1Brett1

        It’s true, Ray! I just had surgery to repair two rotator cuff tears, and when I came out of the operating room standing there was a black-robed individual (holding a long staff with a sickle on the end) and three bureaucrats (with buttons on their lapels that said, “we’re from the IRS”). They all had clipboards and asked me how I wished to be exterminated (checking off boxes on their forms as they asked). I told them that I was only 59…they apologized and told my doctor to keep them apprised of any complications. I couldn’t believe it! So, I think we all owe HD1 an apology in conjunction with a complete retraction. Of course, he should then exclaim, “victory is mine!” (Understandably.)

        • hennorama

          1Brett1 — the next complaint will be that your experience was an inefficient use of IRS resources, with three bureaucrats to work on a single potential harvest.

          • HonestDebate1

            While you guys yuk it up please realize the IRS hired tens of thousands of additional agents to enforce the mandate and they cannot be trusted as is nauseatingly clear by recent revelations. This is not a game, it’s very serious. Obamacare is disastrous enough without the IRS.

          • Ray in VT

            I know, right? They’ll probably be targeting Teabaggers to put them at the front of the line for the death panels.

            It’s so awful how millions more people now have health coverage. It’s doubly awful when one takes the biased GOP b.s., says that it comes from the CBO and witlessly repeats it ad nauseam.

          • Ray in VT

            Also, what is your evidence that the IRS, due to the ACA, is more than doubling the number of actual agents that it had in late 2009? Additionally, are such Obamacare enforcement agents armed, as former Representative Paul stated back in 2010?

          • 1Brett1

            I actually made that very complaint to the death panel, to which the doctor pulled out his pen, clipboard, etc., telling me that I was operating on thin ice as it was…I’m just thankful to be alive! I was in some pain at the first follow-up visit, but I cleverly said, “no, doc, everything is fine; I’m feeling better every minute!”

          • Ray in VT

            That was a close one. Bless you. I don’t know how you’re still with us after such an ordeal.

        • HonestDebate1

          The phrase is “victory is won” and is used when repliers jump the shark and babble incoherently in lieu of a thoughtful rebuttal. And they do it in front of Allah and everybody with their names on it. I love that.

          • Ray in VT

            Well, Brett isn’t wise enough to change his On Point handle so that the gub’ment can’t get him.

          • 1Brett1

            Inherent in the word “victory” is the concept of winning/defeating. “Victory is won” is redundant…you probably shouldn’t rely on Santana for your English usage needs. (I don’t care what Churchill said.)

            I doubt that many would see your comments to be of the caliber worthy of a “thoughtful rebuttal.” The only reason I joke with you is that I then get something amusing for wasting time. Besides, you are a self-admitted idiot; one would hope not so much so that the idea of being undeserving of a “thoughtful rebuttal” is reasonable.

          • Ray in VT

            “Victory” in a debate via a rebuttal, thoughtful or not, is not possible in an forum that does not adhere to rules. If dictionaries can be rejected because their definitions do not fit the belief of one of the participants, then there is no way to “win”, as facts don’t matter, and honest debate cannot exist in such an environment.

          • 1Brett1

            Pfft! Dictionaries! Pshaw!

          • Ray in VT

            Prob’ly written by lib’ruls.

          • jefe68

            With college degrees no doubt…

          • Ray in VT

            Prob’ly the same pinheads that conduct the polls and social science surveys that we also can’t trust, at least when they say things that we don’t like or don’t believe, because belief is far more important than facts and research.

          • HonestDebate1

            Victory can be lost too, look at Iraq. Whatever, I just like Chester.

          • Ray in VT

            Is it truly victory if if we aren’t there, holding down tensions with thousands of soldiers, then people end up at each others’ throats? Seems to me that we more forced a temporary cessation of hostilities, and even that was tenuous at times.

          • HonestDebate1

            Victory can be tenuous.

          • Ray in VT

            Keeping centuries of ethnic and tribal hostilities under wraps for short periods of time with American troops and cash payouts isn’t really victory in my book.

          • 1Brett1

            It went right over your head, as usual.

            Anyway, to address your antiquated reference: biblical language is archaic. Even Shakespeare mentioned something about “pride goeth before a fall.” Of course, you do use “thou,” “hast,” “is risen,” etc., in all of your comments; maybe you are just using your everyday language? Who knows? You did say you are Quaker or something…art thou? (was that you? I can’t remember).

            …I am of the opinion that “victory is won” is an odd expression and redundant. Sue me. It does have a haughty tone, though, which comports with your personality.

            But, hey, to each his own. Of course, when one is reminded of Santana, the keyboards come in third, behind the guitar and percussion…too bad…So, suffice it to say that in your case, “victory is lost!”

          • HonestDebate1

            What are you talking about? Quaker? Thou? Hast? Is risen?

            I just like making you dance to the song that’s all.

            https://www.youtube.com/watch?v=7D9nclZSs7A

          • 1Brett1

            It’s funny that you think I’m actually engaged…and you think you are making me dance (hehe). BTW, I made my last comment as absurd as possible, and here you are replying in earnest…and you wonder why I periodically do the “well, yuck, yuck, shut my mouth” routine, and so on.

            You are good for a laugh, I’ll give you that. (I’m just here for the jokes, for the most part.) Comprehend much? {Apparently not)

            P.S.-I don’t talk about musicians as one would athletes; it’s boring.

          • HonestDebate1

            If you reply, you’re engaged. Ditto if you dance. You’re a good dancer BTW.

            Please don’t tell me what I think.

            And if you ascribe words (or religions) to me that I have not uttered, it’s confusing. Why play silly games? I’m trying to get along here. I always reply in earnest, you know that. I am happy to ignore you from here on out if that’s what you want. Leave me alone, I don’t care. You have the obsession, not me.

            I don’t get the athlete analogy at all. Victory is not a verb, won is. Maybe that will help you. I think Santana records have some awesome Hammond work, sue me. And give me some credit, I could have posted me playing “Victory is Won” and kicking it in the ass to roaring applause, but I didn’t. I have no desire to impress anyone on a stupid blog.

            Sorry I hurt your feelings, maybe it’s time for you to go away (again) out of the frustration of being played like a fiddle. Another hiatus seems in order but that’s up to you. It will help to get me out of your head for a while, You used to comment much more until I made a fool of you over and over and over again. I do that. Look at what poor Hen is reduced to,. And I turned the once thoughtful Ray into nothing more that a pinballing troll. The nuance impaired Jeffe can’t even begin to pretend to rebut anything, it’s all about me. TFRX just talks about JAQing, whatever that means. He (or she) used to be sweet. NJ just stalks, never ads squat. Other liberals have moments of lucidity. Jimino makes me think but has become increasingly hostile and incoherent. J-O-H-N is actually insightful at times. Kelt Crusader is just plain nasty and shares the honor with you as being the only ones who actively voted to have me leave. Others are new and I’ll withhold judgement, but i’ll get to them eventually with unbridled truth. Liberals hate that.

            I have much respect for many liberals around here but i won’t mention names because I don’t want to taint their reputation by my liking them as we vehemently disagree. That’s possible you know.

          • 1Brett1

            You have an inflated sense of power.

            No, my presence is less because 1) I get busy with work. And 2) I am just tired of the forum.

            We used to have decent conversations on this forum; more and more low-hanging neocons have descended, not to have conversations but to rile, gang up on, and otherwise troll (trolling to get a reaction for the sake of getting a reaction).

            It is obvious that I am yanking your chain most of the time and making fun of you, yet your perception is that you are making me do these things, which is about as delusional and egotistical as a mindset can be.

          • Ray in VT

            Yes, at times you do have the ability to pull people down to your level. What’s that quote about not arguing with idiots? It’s entirely useless to attempt to argue facts with you or to get you to accept them, but I find it to be mildly amusing. Pinballing is, as far as I can tell, bringing up any of the vast array of incredibly moronic remarks made or advanced by you or those whose positions you advance, or pointing out your blatant lies, because I guess that the first rule of dishonest debate is that one can’t bring up what the dishonest debaters say. Try not to wet yourself too much today as the sky continues to fall.

          • 1Brett1

            I thought that [Iraq] was “mission accomplished”? Are you calling W a liar?!?!

            Churchill would have been a more modern reference than a biblical one, although I don’t think he even said it; it was just the name of one of his speeches.

          • HonestDebate1

            Funny you should mention that as I addressed just yesterday. It’s seems you have fallen for the meme.

            http://onpoint.wbur.org/2014/06/23/iraq-regional-responses#comment-1452521457

          • 1Brett1

            Again, you are having delusions in thinking I’m doing anything but poking fun/mocking. You seem to be keeping some kind of score, though; that’s so cute…adolescent, but cute. (Did you really think I care enough to reply seriously or click on a link to some comment you made on another topic?) I don’t care enough to do that, so you’ve wasted your time.

            Seriously, Gregg (and you yourself have said a few times before that “this is just a stupid blog” –although, not a blog, but I agree), I really do feel sorry for you (that’s not intended as a jab or a retort, it’s just is how I feel). It’s as if your life is unfulfilled and you spend your time arguing around in circles about politics, serving no one/nothing really. (But, hey, you aren’t the only one.) It’s just that you take yourself way too seriously. Hell, you don’t even get the Churchill joke…sorry, you’re just boring at repartee or banter.

            This forum lost any hope of reasonable discourse long ago. Notice how there’s a glut of wackos lately? Even ones who make you sound at least like a real person? I see this phenomenon increasing. Some of those new ones…whew.

            No point, really, just rambling..

          • HonestDebate1

            Whatever dude. The “Mission Accomplished” thing is just stupid as hell but widely touted. You’re no different. At least Brettearl was honest about it. I will definitely address it this weekend because it’s so delicious. Idiots look at a prop and ignore the speech which made clear the mission was not accomplished. That’s what the media told the sheep to do. Meanwhile Obama claims “Al Qaeda is decimated” (mission accomplished) some 30 times since Benghazi while Al Qaeda grows more powerful than ever and nothing. So your little snark is just plain stupid. But hey, don’t blame me, you said it.

            But you clicked my link and now realize that so you give me the desperate dodge of a loser. Your ideology is losing because it’s a disaster. You’re smugness is just an egotistical delusion. Have at it.

          • 1Brett1

            Sorry, dude but no I didn’t “click” on your “link.”

            The only “winning” or “losing” going on here is in your deluded mind, which is getting more deluded all the time.

            I stand by my statement that I feel sorry for you. Your only enjoyment seems to be hanging out at this forum, either bashing liberals in general, liberals specifically, or Obama/his administration.

            You say you listen to Rush with great frequency (plus coming here and presumably going to other sites), so your head is just filled with armchair conservative speak all day and night…that’s sad to me.

          • HonestDebate1

            The music from my last film project was received extremely well at the world premier in Milan Tuesday. That means I am now internationally acclaimed…. so I got that going for me. So happy was the production company, I was commissioned for the next project, Poe’s “The Cask of Amontillado”. I’m working on a pipe organ fugue. I have a couple of gigs this weekend with my ol’ buddy Freddie who I haven’t seen in many months. And if that isn’t enough, I took a friend with a high banker to my river property the other day and we prospected up a bit over a gram of gold in 2 hours. Whoda’ thunk?

            And that’s just this week. Don’t cry for me. I’ve got it made in the shade with a glass of lemonade… getting paid.

          • 1Brett1

            That’s great.

            However, I don’t care what you are doing in your life. Your need to tell me of your small accomplishments is interesting, as I am not your friend, nor do I show much more than contempt for your presence on this forum. You seem to be one who thrives on measuring yourself against those you conflict with. My interest doesn’t lie there.

            I made an independent film about 12 years ago that showed at some very small festivals (mostly in the US) in Europe. I wrote the screenplay, but I also helped to secure funding. I also have a song getting some attention in Nashville right now (although I don’t think anyone of importance will pick it up…who knows, though). SO? That only matters to me, my friends, my family, certainly not something I would wear like a shiny badge to someone I have disdain for on an online political forum.

            But, hey, nice accomplishments and continued success.

          • HonestDebate1

            I’m not measuring squat, for all I know you are Miley Cyrus. I’m saying quit concocting scenarios to pity me. It’s absurdly off base. I don’t do that sort of thing.

          • 1Brett1

            I never said you don’t spend your time doing other things. I don’t know you and have no reason to doubt you; we all have lives outside of this forum. So?

            No, I feel sorry for you because — as you’ve expressed more than a few times — you do and say things that indicate you feel you really are on some important mission to save America, and that you are some sort of amateur activist. It has an officious quality to it, and I always feel sorry for those kinds of people.

            Your time spent on this forum, in addition to listening to the show at night (and listening to Rush every day) would add up to at least a couple hours a day alone (not to mention other activities of this same nature that you probably spend time on). Don’t get me wrong, I don’t begrudge anyone his “hobby,” and how one chooses to spend one’s time is his business; it’s just an attitude that your commentary is something much more important than armchair political activism that is to be pitied.

            So, your idea that I am “concocting scenarios” where you don’t do anything but engage in your pseudo-political analysis is not reality, just a distortion of what I’m saying (as is typical).

            The other stuff you do in your life is cool, and I’ve never said otherwise, although I don’t think much about your driving up and down your street trying to steal someone else’s internet signal so you can avoid the government grabbing you and throwing you in a secret Gitmo due to your ruggedly American political voice. That behavior uses too much gas, wasting valuable resources, resources that could be given away as free stuff to liberulz with their hands out.

            You’re smarter than Obama, anyway, and could easily evade his SUV (especially since he drives blind drunk). He knows you could easily lure him onto your property then stand-your-ground on him if you wanted to; he’s older and wiser than Trayvon Martin, after all…So, I implore you; stay at home and do your part to reduce our dependence on foreign oil. Then, when Ben Carson is elected president and provides US citizens with a plethora of oil, you can go back to stealing internet services (of course, you won’t need to, as V.P. Rice will see to it we get our digital communication freedoms back — of course, while Carson is busy single-handedly beating up on all of the MIddle Eastern thugs who were emboldened by Obama’s mom jeans)! Who knows, maybe all of your efforts will keep Ms. Clinton out of the White House, then we’ll all be humbled by your greatness!

            -Miley Cyrus, er, Brett

          • HonestDebate1

            Whatever, I am opinionated and I have a radio on all day while I work, in my car, in my studio and in my shop. I don’t block out hours a day to listen to the radio. I listen to right wing radio, left wing radio, sports shows, NPR and even music. When I’m home I usually have my laptop in my lap. And I work at home so I’m in and out often. I breeze by make a comment or two (with the radio on) and move on. There are days when the weather is bad, or maybe just because I feel like it, that I might spend more time than I should. Again I’m passionate and very concerned about what is happening. So what you have laid out about me being alone with my radio for hours on end is just concocted silliness.

            And if you want to believe I truly think I’m on a crusade to save America, then feel free but that’s just more silliness. I’m just a tone deaf, rhythmless idiot as I have always maintained.

      • HonestDebate1

        What an odd comment. Are you denying the IRS is enforcing the Obamacare mandate or are you just being silly?

        • Ray in VT

          You can’t be serious.

          I just want to know that seeing as how I have often been told in this comment section that the IRS will be running our health care, then can I expect an IRS agent or employee to be at my wife’s appointment, as I have some questions as to how I can get myself on one of these death panels.

          • HonestDebate1

            I’ll take that as the latter.

          • Ray in VT

            Why won’t you just answer my simple question? You are not a serious person.

    • nj_v2

      Please, please Disqus, give us an Ignore-Selected-Useless/Trolling/Clueless-User function.

  • Roy-in-Boise

    Unbridled capitalism will monetized all that it can. We are now in the midst of the second gilded age.

  • X Y & Z

    Obama 2008: VA will be ‘leader of health care reform’

    http://www.wnd.com/2014/05/obama-2008-va-will-become-a-leader-of-health-care-reform/

    • nj_v2

      I know it’s hard for you, but try to stay on topic.

      • X Y & Z

        Keep making excuses for Obamacare.

  • James

    Let me remind my liberal friends that fraud and preventing people from leaving the premises are not fundamental principal of capitalism.

    • Human2013

      I beg to differ…..fraud is the name of the game, silly rabbit.

    • jefe68

      However, this is not happening in this sector.
      So something has clearly gone wrong here.
      In my opinion this is not a liberal, progressive, nor conservative based issue as health care and end of life care cuts across all political spectrums.

    • Matt MC

      Of course, your specific example of fraud is not fundamental to capitalism. Just as every single specific occurrence (by definition) is not fundamental to any basic system or concept. The quest for profit at the expense of other considerations, however, is fundamental to capitalism. Your reasoning is a little backwards my friend. I could say the same thing about payday loan stores. “Charging 450% interest is not fundamental to capitalism, so you’re going to have to find another excuse…”

      • James

        Well of course you can charge 450% interest, doesn’t mean I’ll take your loan.

      • TFRX

        Yep.

        It’s “No True Scotsman” time.

        • Matt MC

          Thanks for this. I wasn’t aware of this term. No True American would know about logic; therefore, you must be from elsewhere.

        • James

          I would note that according to Dr. Meier most people “appreciate” their experience.

    • Ray in VT

      Fundamental? No, as in it is not a required part of the economic model, but it is very often the case that fraud does occur when there are, among other things, financial incentives, and unfortunately people have long been shown to do unseemly things for, among other things, cash.

  • amazonjn

    Hospice started as a movement in the 1960s to allow people who choose to die at home to do so with palliative care (the latter rarely part of medical training in the day). It was 90% volunteer and 10% paid. Now that it is 90% paid, I see that we, volunteers, are used as shills or fronts for a very greedy business model.

  • crtum

    Sounds like a case of some investigating something when they already think they know the answer

  • Rick Evans

    The people writing in giving positive hospice care testimonials did not specify profit or non-profit. My sister-in-law died at a non-profit hospice and our experience was extremely positive. The volunteers there were not there for the money and the paid staff were super professional. It’s crucial to distinguish for profit and non-profit.

  • InActionMan

    It is not just hospice. Every aspect of elder care is filled with parasitic greed-heads preying on the infirm elderly and families in crisis.

    Many of the people doing the front line care, the nurses and aides are decent compassionate people. However, the management of nursing homes, VNAs, adult day care and hospices are the scum of the Earth. They prey on desperate families in crisis to suck the last dime of an old dying person’s life savings and when that is gone they stick it to the tax payer. I can tell you from personal experience, you have to be constantly vigilant against these predators who claim they are “here to help.”

  • Nancy Berault

    My mother is 86, losing her hearing, rejecting a bath, and still here.
    I work, and I leave her depending on her to take care of herself. I am there at night. She looks like she could be here indefinitely, but my friend told me that I should enroll her in hospice because hospice would provide some professional eyes to evaluate her. We need someone and hospice seems like that kind of gap care.
    I do not doubt that there are entrepreneurs who are making the most of people’s pain. So, what kind of regulations are in place already? Are they funded?

    • HonestDebate1

      I have a dear friend who is going through the same thing with his mother. It’s very hard.

      • jefe68

        Talk about a disconnect.

    • InActionMan

      You mother dosn’t need hospice either adult day care or an aide to come into the home while you are gone. Be advised this is EXTREMELY expensive $20.00 per hour and up and IS NOT covered by medicare unless your mother is BROKE.

      You will also see ads on TV where it looks like a nice student nurse will be coming to care for your loved one. You are most likely to get a marginally employable person of low intelligence that does not show up on time, uses your mothers phone for personal calls and eats her food. While the homecare companies are charging you a premium price they pay the aides almost nothing (minimum wage or less) to do dirty nasty work that often involves dealing with urine and feces on a regular basis. Caveat Emptor

      • HonestDebate1

        That is what my friend did but he interviewed many applicants and weeded out the riff-raff. Still yet, he had a bit of trouble with a couple of them who were quickly replaced. His father was able to live out his final days at home.

      • JGC

        I pretty much agree with your summation. My mother had an insurance policy that she paid for years that was meant to help cover in-home services in case she ever had that necessity. When the time did come, she was only permitted to choose from a very limited and insurance company-approved home health-care service list – just the service, not a particular health aide from the agency. She never knew who would be showing up at her door, plus she realized one of the people was stealing items from her, and generally it provoked anxiety instead of being helpful. We cancelled the policy, and hired a distant relative, who has been a blessing. She is paid well, and is worth every penny. Better all into her pocket than split between the insurance company and healthcare booking agency, with crumbs leftover for the actual worker.

    • Pleiades

      InActionMan has provided you some excellent information, but be reminded that if you do choose some type of hospice care, you need to look into the whether the hospices is “for profit”, “not-for-profit” or “non-profit”.

      A “for profit” or “not-for-ptofit” hospice may charge you as much as $115/visit. This visit will typically last 30 minutes or less to provide “some professional eyes” for your mother. it will typically take place once a week.

      Some times a network of neighbors and /or friends you trust you visit at various times of the day or even week are a better solution for your problem and will create community.

    • anamaria23

      It is my understanding that Hospice is put in place only after it is determined that the probability. of death is within the next six months. Day care is working out well for one family that I know in similar situation.

  • duffdance

    Dad went to the hospital before Hospice could come to the house for an interview. While in the hospital, Hospice kept telling us there were no Hospice rooms available. 20 minutes after he died they brought a cart of coffee & cups. We told them to take it away as he was dead & we were leaving. The Hospice bill for $780 arrived before he was buried. Thanks for the shaft after our loss.

  • hennorama

    This is an eye-opener.

    My awareness of hospice care began during the AIDS crisis in the US, when there was no real treatment available for patients. My only concept of hospice was that hospices were non-profit entities dedicated to easing the patient’s last days on Earth, and comforting their loved ones as they prepare for the end.

    The new reality of for-profit entities, and possible fraud and abusive practices is just disgusting. There’s no other word for it.

    Unfortunately, this is part of American cultural distaste for, and ignorance of, the process of dying. We avoid the process at all costs, and then demand change when problems crop up. We warehouse our ill and dying family members, but expect their care to be on par with what a loving family member might provide.

    Thanks for bringing up this important topic, On Point.

  • X Y & Z

    VA deaths covered up to make statistics look better, whistle-blower says

    http://edition.cnn.com/2014/06/23/us/phoenix-va-deaths-new-allegations/index.html

    • nj_v2

      Plus there’s those drone attacks. (As long as we’re trolling off topic.)

      • X Y & Z

        Keep ignoring the facts.

      • hennorama

        nj_v2 — the answer is obvious: use UAVs to take out the VA stat-padders.

  • Naty

    I heard a caller’s testimony about how she and her family were left
    alone to administer drugs when needed; that is extremely unfortunate.
    My father had late stage cancer and when it was apparent that the
    treatments were no longer working, we were told by the doctor that
    palliative care was needed and and within a few weeks my father
    transitioned into hospice. This was all done at home. We selected a
    non-profit at the doctor’s recommendation but we received home visits 3 times a week and the nurses checked vitals and administered the little medication that was needed. They were able to walk us through the physical changes that
    happened as his body was shutting down and it was a very positive
    experience. I could not imagine selecting a for-profit provider for
    this very intimate experience.

  • 75rt6

    At a population level 1/2 of hospice patients die within 17 days of admission, 1/3 die within a week. These short length of stays often prohibit the patients and families from taking advantage of the full scope of hospice services and frequently patients and families report they wish they had known about hospice sooner.

  • JGC

    “Medicare covers you – even at the end-of-life.” Here is the Vitas website, one of the hospice providers mentioned. They have many facilities throughout the country.

    http://www.vitas.com

    You can leave a message on the “Contact Us” page, or through their toll-free number 1.866.41.VITAS.

    Two things I noted as I just quickly scanned over their site: they are affiliated with the AARP (so maybe the AARP should also be contacted); and they provide another link “To Volunteer”: Vitas promotes their volunteer network, giving a thin veneer of self-less non-profit status to their profit-generating enterprise.

    • InActionMan

      Don’s spam with ads

      • JGC

        Ha! That is not an ad to promote their services, quite the contrary. That is a way to contact them with questions/complaints about the way they are generating profits off the taxpayer, possibly through Medicare fraud.

        Here is the parent company, Chemed

        http://www.chemed.com

        where you can look at their Investor FAQ link. It’s true: Chemed is the umbrella company for both Vitas and Roto-Rooter – how bizarre! Is Roto-Rooter going to be going into the funeral embalming services following the expiration of the client in their Vitas hospice facilities?

        • hennorama

          JGC — the connection is clear: businesses in which one has limited choice regarding the necessities of life and death, and which can involve a good deal of “reaming.”

          There of course are many plumbers and hospice care providers who do a great job, and provide their services in a completely professional and ethical manner. Unfortunately, we rarely hear about them.

          • pete18

            “Limited choice” is a reality in business, government and all of life. The idea that hard choices and limits don’t come up in government programs or work policy laws
            is a fantasy.

          • hennorama

            pete18 — thank you for your response.

            Of course, my comment said nothing about “The idea that hard choices and limits don’t come up in government programs or work policy laws …,” but don’t let that minor detail stop you, OK?

  • Brigid L.

    My mother died of pancreatic cancer in 2012. When it came time for home hospice, we asked a friend who had lost her mother the prior year for a recommendation. The hospice care was great. Since then we have recommended this hospice to two families who also had positive experiences. Anyone who is considering hospice should turn to people they know for recommendations. Because we were able to afford it, we supplemented care with a home health care agency to provide us with a break so we could get sleep at night. For those who are uncomfortable or unable to provide home care for a dying loved one, inpatient hospice may be an option. I know families who had positive experiences with this as well.

  • Roger Johanson

    There is more complexity to this. Years ago, my sister, an ordained pastor, took a position as a director of a non-profit hospice care center in the south. She valued the important work of the center. Soon however, while remaining non-profit, a for-profit company took over management of the center. The changed character of the center made it uncomfortable for my sister to continue working there. We would be well served if we kept the profit motive out of this remarkably valuable enterprise. Our own father had a peaceful death in a hospice center across the country. All humans deserve the dignity and compassion that not-for-profit hospice delivers.

  • bbmm18

    Doctors never talk to patients and families earlier when they are healthy or earlier in disease stage. Folks are often blinsided when asked to choose this option upon discharge from hospital. By the time we learn to deal well w this we are all done. Will be easier for future generations. We had a wonderful 5 day exp w my father at a FL hospice facility once decision was made. For Mom they never tell anyone how otherwise healthy dementia patients progress mostly to not eating much. She was offloaded from one after 6 months. Lived her last 7 months w another that assured us they would keep her on. When a friend worried abt how to deal w a parent in failing health I told her to prepare for the H question and they were not totally blindsided a few days later when it came up. I ws a primary cgiver and took it one day at a time while working from home.

  • hennorama

    End-of-life care for loved ones is another reason to have, as yesterday’s show discussed, ‘Family-Friendly’ Work Policies.

  • bbmm18

    It may have not been clear in my previous post that even locally the care was excellent and aids and nurses and social workers were very good, some exceptional.

  • anamaria23

    I hope you reported your experience to your physician and administration of the hospice as well as perhaps your congressperson, naming names. I have never, ever heard of addiction being an issue in hospice care. I have had three family members in hospice care recently and they each were kept free of pain and other discomforts.

  • JGC

    It would be interesting to know if your folks were at for-profit or non-profit hospices. But it sounds like it was such a bad experience, you just want to put the whole business behind you.

  • nycam

    The doctor on the air recently made broad generalizations which gloss over the distinction betw. for-profit and remaining non-profit groups.
    Privatization doesn’t work if it is without oversight, as this helps to prove.

  • 1Brett1

    Hospice care should be administered by a non-profit entity. There is too much open to corruption in a for-profit setting.

  • HonestDebate1

    ***Off Topic***

    After initially being downgraded from 0.1% to -1%, the Q1 GDP has just been revised downward to -2.9%. This is awful, please do a show that goes a bit deeper than blaming the weather.

    • tbphkm33

      Guess “HonestDebate1″ has forgotten the harsh winter experienced by most of the country. Oh well, better to score political points.

      • twenty_niner

        BS

        The winter of ’78-79 was worse and there were 8 quarters of economic growth right through the winter.

        1978-Q1 2.15 Trillion (GDP)
        1978-Q2 2.28
        1978-Q3 2.34
        1978-Q4 2.42
        1979-Q1 2.46
        1979-Q2 2.53
        1979-Q3 2.60
        1979-Q4 2.66

        http://www.forecast-chart.com/chart-gdp-rate.html

        The current economy is central-banking hologram with the slightest nudge causing the illusion to fall apart. The Pollyanna routine is getting old at this point. The US has had harsh winters throughout its history. I don’t think I’ve ever heard or read of a 3% decline being blamed on snow.

    • Ray in VT

      Please tell us what the crack team of economists ’round the stables attributes it to.

      Interestingly, despite the continual cries of “this is awful”, employment grew throughout the quarter, the broad base of economic indicators point in a positive direction and by all accounts GDP growth has rebounded in the current quarter. Calm down. The sky is not falling.

      • HonestDebate1

        “This downturn in the percent change in real GDP primarily reflected a downturn in exports, a larger decrease in private inventory investment, a deceleration in PCE, and downturns in nonresidential fixed investment and in state and local government spending that were partly offset by an upturn in federal government spending.”

        http://content.govdelivery.com/attachments/USESAEI/2014/06/25/file_attachments/302348/Gross%2BDomestic%2BProduct%2B%2BFirst%2BQuarter%2B2014%2B%2528Third%2BEstimate%2529.pdf

        • Ray in VT

          Yes, and I bet that none of those things, such as “real nonresidential fixed investment”, such as building construction, isn’t something that got impacted by the weather, or “real personal consumption expenditures”, like auto sales, were also not impacted.

      • hennorama

        Ray in VT — but, but, but …the entity [Debates?NotHe] is like a child, unable to wait for an appropriate time to bring up this topic. Therefore, you can’t blame it for the nonsense it writes.

        As it indicated below, it doesn’t listen to the show until much later (“I don’t get the show until 7PM so I have still not heard it.”), so you can’t blame it for just bringing up completely unrelated stuff, as a child might do.

        Its thoughts are obviously so important to it that it must express them immediately.

        To it, the sky is falling, always.

    • HonestDebate1

      Sorry Mr. Moderator, I will refrain from making more replies. Hopefully you will provide a forum where my comments will be on topic. I’ll wait until Friday as I’m sure tomorrow’s show will be on the IRS debacle.

      • Ray in VT

        I think that they’re covering the latest “bombshells” regarding Benghazi.

        • jefe68

          One of the guests is going to be Jessica Rabbit. Speaking of bombshells…

          • Ray in VT

            But she’s bad. Oh wait, she’s just drawn that way.

          • 1Brett1

            You do realize that someone is making you write your comment this way, that you are being completely controlled? We all are being controlled. The forum is being directed by one man!

        • 1Brett1

          Ray, I am off topic; I could wait until another day to be off topic, and I apologize for being off topic, but I am off topic because my goals in posting are of a higher quality/of greater importance than others, so it’s okay. The moderators, I’m sure, are fine with this because I admit that I am off topic; also, they will certainly see this comment and create a show to accommodate what I want to talk about, further justifying my need to be off topic…

          [Moderators, please be advised that any topic pertaining to Benghazi, the IRS, or anything to do with Obama's atrocities/his combination of diabolical destruction of 'Merica/his incompetence would be fine, just pick one. Thank you!]

          Oh, and just so you know, Ray, you, I, hennorama, jefe, nj, and various other librulz’ commentary on this forum are being controlled/manipulated/and otherwise directed by one individual who regularly posts on here…who knew? I’d call him Gregg, but doing so would mean I am displaying utter defeat. Victory is lost!

          • Ray in VT

            That sums it up pretty well I think.

  • tbphkm33

    Is not the hospice industry a manifestation of larger endemic problems with the U.S. “capitalist” economy. In 2014, the United States is not so much an open capitalist economy, but a rigged “capitalist” economy based on cronyism and corruption. Ironic that Ronald Reagan and others scored political points in the 1980s by berating Latin American countries as being “papa doc” economies. Thirty years later, that is what the United States has been transformed into.

    The hospice industry is just a good example of what passes as “capitalism” today in the United States. If you cannot rig the industry to keep competition out, then make sure you at least have a corrupt way to fleece private individuals for everything they have and then also the public coffers.

    Crony capitalism is like a pervasive cancer infecting the entire U.S. economy. Why would you think that there would not be individuals trying to line their pockets in the business of dying. The funeral industry should be really upset, by the time the family shows up at their door, there is little money left over for a funeral.

    • twenty_niner

      “Crony capitalism”

      The current administration that you support, pardon the insult if you don’t, has sanctioned the largest crony-capitalist cabal – that between the Fed (and other central banks) and Wall Street – in human history.

      • tbphkm33

        Hmm, and which President oversaw not only the buildup to the 2008 crash, but then bailed out the banks… hint, it happened all before Obama was sworn into office.

        • twenty_niner

          Agreed. He sucked too.

  • pm05

    Hospice “companies” ! Astounding! Hospice was supposed to be compassionate end of life care. NOT a business! Never! There are many many nonprofit Hospices. These for profit companies should be driven out of business…. Just unbelievable that these companies are profiting from our dying!

  • Fred Bellet

    My wife lingered for over 3 1/2 weeks in hospice care in 2009. During that time she would get 15 or so visitors at a time, almost daily. This went on for nearly 3 weeks. Each person that visited her were among the many to line up at meal times for a free meals, coffee, soda, etc. It must cost hospice a bundle in the hospitality department.

    • brettearle

      Pardon my potential naivete, but you would likely not have divulged this ugly nugget if you weren’t significantly enough over the loss and didn’t consider the story instructive to the public.

      But, frankly, I am looking for some clarification:

      Are you suggesting that those who visited your wife, looked for reasons to Free-Load, apart from caring enough to visit your wife, in the first place?

      • Fred Bellet

        I was just trying to make the point that the hospice was shelling out quite a bit of money to feed everyone that was there to visit their loved ones. I wondered the cost… No one was freeloading… You are pardoned…

  • GracieZG

    The hospice business model is seriously challenged. My friend who had ovarian cancer was transferred to a long-term hospice facility because she had a bad reaction to morphine and asked for a different pain killer. They told her they could put her on another drug, but she would have to transfer to a long-term facility, because the facility she was in was for short-term patients. That is when we realized what the business model was. If she stayed on morphine, she would be dead within two weeks. If she wanted the other drug, she had to transfer to a lower-care, lower-end facility, because her death would take much longer. It was strictly a business decision, based on a business model. Research “snowing,” which is when a medical person takes a person out with morphine. I’ve now watched three relatives and two friends die while under hospice care. The hospice people themselves are absolute angels. Remarkable people. However, the business model is quite real. Morphine = quick death. I had a friend in the last year whose wife went under hospice care. I explained to him that the drug she is given will determine the length of her life. I just wanted to make sure that they understood the business model, and made the decision consciously, rather than just be “snowed.” It is a very cynical business model. But it is the reality. I actually read a book called “Nurse” that discussed “snowing.” It is a real thing, and now it is institutionalized.

  • TheDailyBuzzherd

    Death, Inc.

    Crematoriums. For-Profit Hospice, Long-Term Care, Rehab, Group Homes, Hospitals. Perpetual Healthcare. Big Pharma. Calculated Risk. Yale, Connecticut. Bill-Collecting Bounty Hunters. The Charge Master. Funeral Parlour Chains. Caskets by Costco®. Group Discounts. Rent-a-Stiff. Corpse Capitalism.

    We have arrived, people.

    • HonestDebate1

      Don’t forget the death tax. Government has to get theirs. I just wish I knew what they do to deserve it the way those you list do.

      • Ray in VT

        When did the government start taxing death? I am aware of the tax upon inheritance, which is paid by the person receiving the money, which would seem to be a sort of income for the person getting it.

        • tbphkm33

          No, no, if its incoming revenue in excess of $250,000 the Republican’s do not see that as income – it should receive a preferential zero or next to zero tax rate. After all, you can’t tax the rich – what are you thinking, they are “job creators.”

  • Barney Fife

    Interesting that VITAS was being run by Florida Senate President Don Gaetz, the second richest person in Florida politics. Interesting that Governor Rick Scott, the first richest man in Florida politics ran Columbia HCA at the time of THEIR fraud. Do you see the link there? GOP politicians who are denying the expansion of medical care via Obama care.

    • tbphkm33

      Blasphemy!!! No Republican has ever been involved in corruption to line the pockets of themselves and their cronies.

    • harverdphd

      No wonder you can’t be trusted with a bullet. You’d shoot yourself in the foot.

  • Susan Noethen

    I currently work in the regulatory side of hospice, three of my family members received hospice care and I was a hospice RN in the 1990s.

    My family members all received good care, and

  • pense

    Unfortunately, I’ve had 3 encounters with hospice, including one presently, two in MI and one in another state. The first experience was awful and more painful than I could ever express. The doctor and hospice left my loved one in the care of a person who was addicted to morphine, and left my relative home alone, essentially. The only thing they wanted to know is how much morphine he required. If he moaned, they said, “he’s in pain! !!” Once the hospice trajectory congress into play, the hospice people are so aggressive although the bulk of the responsibility is on the family. The words “are you in pain? ” is their constant. Even when the person is not in pain, their mantra is more morphine. When my mom was in palliative care in the hospital, every time I’d turn my head, they would pump het up with the dilaudid. One moment, she’d be laughing and talking, and the next she was a comatose zombie who couldn’t utter a word. She got better when the doctor who said he was even butting heads with them requested that he be allowed to place a sign above her head, “no meds unless requested”. When she came home and later had to be entered into hospice, that experience was much better. If you can’t expect nurses top do this alone, how in the world do you expect Lay people to do it alone? ?? Currently, another relative is in hospice after having to go into the hospital for dehydration. Prior to her hospital visit, she was on course for treatment, but once she got on the hospice train, there was no getting off.( If a person is old, they want the hospital bed. You’re going to fire. Bye bye, go to hospice. Go home with your drugs and go into a morphine coma into the next dimension.) Later the other specialist decided that she could undergo treatment, but before doing so, he had to confer with the hospice doctor. After they conferred, it was agreed that she would only receive one treatment and the hospice doctor, who to my knowledge, has never even seen her, was sure to call me to let me know that the one treatment would be considered “palliative”and that she would remain in hospice for the treatment. I thought, “oh, they’ve figured out a way to both get paid. ” They brought oxygen, morphine, and all types of equipment to the home, letting family act as medical staff, essentially, with a quick run through of how to use the material. They should pay the families. Bereavement? Ha! I never saw any.

  • Godzilla the Intellectual

    Speak for yourself. Death doesn’t come for everyone.

    • jefe68

      Gee… do tell oh undead one…

      • Godzilla the Intellectual

        It’s all a bit technical but let’s just say our future is secure.

  • Lawrence

    You should have reported the charges to Medicare. You still can.

  • 1Brett1

    Your tone doesn’t seem to encourage conversation…

  • brettearle

    You should report your experiences to the Medical Overseers who regulate Hospice.

    Additionally, you should write an OpEd piece for your local, or regional, Newspaper.

    An important way to reconcile the respect and dignity that this Hospice did not afford you is by alerting the Public of your offensive experiences.

    This will help to significantly discourage similar incidents, in the future.

  • brettearle

    it may be–despite what one might think–that, at the end of life, health care professionals, of all kinds, are frightened of Liability.

  • brettearle

    I can’t attest to the relationship between hastening an inevitable death in a Hospice environment and the administration of Morphine..

    But if you are operating under the assumption that
    there aren’t times when there’s a Wink-Wink, Nod-Nod going on in the Medical Environment–where patients are sometimes dying sooner, than they might have ordinarily died [even if it only means minutes, hours, or days]–then i would argue that you have your head in the sand.

  • http://raortman.com/ Ronald A. Ortman

    We have filed a lawsuit against 1) Vitas Hospice Services, LLC, for medical malpractice; and 2) Karen Brydon, RN, for violations of the Texas Deceptive Trade Practices – Consumer Protection Act (DTPA). The case is currently being litigated in the 37th District Court in San Antonio, Texas. Cause No.: 2014-CI-04978.

    http://adams-vs-vitas.com

  • mumtothree

    For-profit nursing homes love it when their residents go on hospice. Many if not most long-term nursing home residents are on Medicaid, with a fixed (low) reimbursement rate. So when the doctor says a patient is terminal, the family is told that hospice care will be provided. For the most part, this consists of (1) extra medication and (2) extra time from staff. At times this is “instead of” time, i.e., if not for a hospice determination, the staff would have spent that amount of time caring for the patient anyway. It is billed to Medicare (not Medicaid) in 15-minute increments. You can see why they do it. Their argument is they are losing money on every Medicaid bed so they need to juice it up with hospice paid by Medicare.

  • Claire Bear

    I live in the county where Ben’s article was based and my heart goes out to this family. I also work within the health care arena. I get to see first hand the dirty and corrupt behaviors of VITAS hospice. Sadly the local public has not been warned against this agency as the local paper does not run any stories about this hospice probably due to the large amount of ad space they purchase. Working within a south county hospital their patients come in uncared for and with many complaints of unmet needs/neglect.
    Physicians will refer a patient to our own hospice who will evaluate and explain that the person does not meet criteria and then they will call VITAS who will run right out and admit the person. I guess the rules do not apply to them. If we call Adult Protective Services about a hard to place person we will be told “call VITAS they will take anyone.” They do not have to be terminally ill. The local fire rescue department states that their marketing representatives will come by and ask them to give their cards to frequent fallers so they can offer them services. Since when does falling constitute a need for hospice? We have Physician who state they are offered “stipends” to attend elegant dinners sponsored by VITAS to solicit referrals. This company does not play by the rules, they come into our hospital and roam the floors, looking into patient rooms and attempting to peek at charts. I truly wish the government would do their jobs and investigate them. We have other local hospices who operate with integrity but Vitas is not one of them. I applaud your article Ben. Just remember there are some great hospices and we want to honor the work of those nurses, social workers, CNA’s, ministers, etc…. One big box bad company should not ruin it for the little guys trying to do the right thing.

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