Thursday, January 19, 2012

Processed Dying

The end of life process that makes up the ends of many of our lives, I find a little odd.  That an enormous number of us end our lives camped out in numerous large senior facilities of various service levels and quality just seems a little odd to me.
Peter Walman, Bloomberg, 6 December 2011 (hat tip: The Browser)

Janet Stubbs was grateful when the nursing home recommended hospice care for her aunt Midge. Although Stubbs knew her aunt wasn’t dying, the offer of free, Medicare-paid hospice visits from a nurse and chaplain, plus an extra weekly bath, was too good to pass up.

Stubbs didn’t know that her aunt, Doris Midge Appling, was admitted to Hospice Care of Kansas during the company’s “Summer Sizzle” promotion drive, which paid employees as much as $100 a head for referrals, according to the U.S. Department of Justice. Stubbs also said she had no clue that the nursing home doctor who referred her aunt for hospice moonlighted as medical director for the hospice company…

The rise of for-profit hospice care since 2000 has helped drive a 60 percent increase in the average time patients spend in hospice, to 86 days in 2009, according to Medpac. The average stay of the 10 percent of patients who remained in hospice the longest soared 71 percent to 240 days.

That means at least 110,000 patients weren’t facing imminent death when they were admitted -- although doctors said they were. To qualify for Medicare hospice coverage, patients must have a prognosis of six months or less to live, certified by two doctors.

Given the title of this blog, I thought I should at least make a note of the issue. I have to say though, the article does not make any note of ill treatment by the not-dying terminally ill. The scandal seems to be more one of finding the niche of care that the government pays the most for relative to costs. Since the hospice care was usually relatively short term, the cost accountants did not sweat the cost. Some of the hospice inhabitants were likely coming from hospitals (rather than nursing homes) that would have been truly expensive.

To my mind it is more illustrative of the human-industrial processing plant that makes up a significant portion of our economy. We have a processing procedure for our schooling, and at the end for twilight years. If you find yourself in prison, you will pretty much have scored the royal flush of human processing. All very Pink Floyd.

No comments: