Restore Medicaid hospice benefit

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In response to the economic challenges we face, South Carolina's Department of Health and Human Services has eliminated the Medicaid hospice benefit effective the end of February. This decision will directly affect poor, terminally ill patients in the state. Without the hospice benefit, the state's poor will be forced to return to the "old methods" of dying -- at home without professional care; in a nursing home without the additional support of hospice-trained staff; or in a hospital's intensive care unit.

Hospice is a cost-effective, personal delivery of caring health care and with the actions of DHEC, the most vulnerable among us are being denied the basic dignity and choices all people should have. When given a choice, most people prefer to live their last days at home, with the comfort of family and friends surrounding them. Without hospice, most will seek treatment in hospital emergency rooms and will further strain an already stretched delivery system of health care.

The issue goes beyond simple human compassion to one of basic fiscal responsibility. Based on the findings in a study by The Milliman Group, a New York health care consulting and actuarial firm, cutting hospice increases cost per terminally ill patient -- because the needs of the terminally ill aren't eliminated, but are simply shifted to the more expensive ways of delivering the same services.

Every dying person and their family should be able to access professional help from physicians, nurses, social workers, chaplains, trained aides and volunteers, as well as the needed prescriptions, medical equipment and supplies that hospice provides. Hospice care is an extraordinarily efficient way to provide this very specialized and expensive care.

Hospice isn't part of a budgetary problem; we are one of the solutions. I urge all South Carolina residents to contact their elected officials. We cannot allow our most vulnerable citizens to be left by the wayside at a time when they need care the most.

Thomas Smith

Augusta

(The writer is administrator of Heartland Hospice of Augusta, and operations manager of Heartland Hospice of the Midlands in Aiken, S.C.)

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HotFoot
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HotFoot 02/07/09 - 07:41 am
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Compassion? What do you

Compassion? What do you expect from all those nice Christians in SC gubmint? But the LTE makes excellent points (he should know) about cost-effectiveness, as well. It's both fiscally irresponsible and insensitive in the extreme to deny the poor of SC to die in comfort and with dignity.

patriciathomas
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patriciathomas 02/07/09 - 07:58 am
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Compassion is nice. Without

Compassion is nice. Without taxpayer money, people can't have compassion? When a terminally ill patient's family can't afford sufficient compassion, the taxpayer should foot the bill? This LTE is nice and makes a lot of good points from the writers perspective. A few points seemed to be glossed over, though. Does the "old method" of dying make you more or less dead than the new method? If the terminally ill don't receive either hospice care or emergency room care, will they still die? We all want the most compassionate care for our terminally ill loved ones, but why is it the responsibility of the taxpayer to provide it?

HotFoot
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HotFoot 02/07/09 - 08:28 am
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As the LTE pointed out, these

As the LTE pointed out, these people will then seek treatment--outrageously expensive treatment--in hospital emergency rooms. What would you do, PT, if a family member without medical insurance was at death's door and you had no way to assess if he or she could be saved? What if that family member--your mother, say--was in extreme pain? You'd just say, gee, it's her fault she doesn't have insurance, I guess I'll just have to let her die? No, you'd take her to get medical care wherever you could find it, probably the ER. (Well, most people would. I can't really assume that about you, but then you'll say that you'd never be in that position. Arrogant per usual.) Hospice care is low-cost by comparison. Invoking the fact that the person won't be LESS DEAD is simply callous. Treatment can have other valid purposes than extending life.

patriciathomas
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patriciathomas 02/07/09 - 08:35 am
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midwest, I don't wait until

midwest, I don't wait until the last second to confront these situations. That approach leads to the panic decision making you seem to embrace. What I would do, and did do, is operate within my personal parameters. I would not, and did not, be a burden on the taxpayer. How about you? Do you feel the taxpayer is responsible for providing your compassion?

HotFoot
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HotFoot 02/07/09 - 01:31 pm
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Never used any government

Never used any government service I didn't pay for, PT, aside from taking heavily subsidized Amtrak. Didn't even file for unemployment when my employer reorganized a bunch of us out of our jobs--just started working freelance and immediately made too much money on my own to qualify. We've taken care of two parents through multi-year, costly illnesses and deaths, and yes, our families paid for it, not the government. BUT WE WERE LUCKY. WE WERE FORTUNATE. Not everyone is, PT. Anyone who's been alive as long as you apparently have should know that we can't control everything that happens to us. Not even you, O wise one. So take your "personal parameters" and SHOVE THEM.

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