Death panels (or living with dignity)

The US population is aging, as by 2030 the number of people in the US over the age of 85 is expected to double to 8.5 million. Furthermore, as the population ages, the number of people with chronic conditions will increase rapidly. These patients often not only suffer from low quality of life but also find it difficulty to navigate today’s fragmented health care system. Furthermore, the costs of treating these patients are exorbitant. As the sickest 10% of the US population accounts for 64% of the health care expenditures. These factors has increased the burden on Medicare and resulted in the exponential growth in Medicare enrollment and spending.

It has been shown in multiple studies that patients with serious illnesses require close communication and well-coordinated care with support provided for family caregivers. Palliative care providers most effectively deliver these types of services. Nevertheless, there are multiple misconceptions regarding palliative care. Firstly, there is a misconception that palliative care equals hospice care. This misconception has occurred because palliative care is mostly provided through hospice organizations. Further blurring the differences between hospice and palliative care has led to the notion that only patients nearing end of life are appropriate candidates for palliative care. It is important that patients understand that “palliative” does not mean impending death but is a philosophy of care that is meant to improve the quality of care of all patients suffering from chronic, incurable illness.

In the Affordable Care Act, there is a Medicare regulation detailing “voluntary advance care planning” that is to be included during patients’ annual checkups. The regulation is aimed at the elderly and may include advance directives to forego aggressive life-sustaining treatment. This new provision will allow Medicare to pay for voluntary counseling to help beneficiaries deal with complex decisions families face when a family member is approaching death. The law also states that hospice services must be covered, it establishes an insurance policy for future long-term disability care, and it offers funding to increase the long-term care workforce.

As the population in the United States ages, policies pertaining to improving the care and quality of life of seniors will come to the forefront. Palliative care programs have shown to improve these measures in chronically ill and patients with end stage diseases. Our public and private hospitals are severely lacking these services and we need to ensure that patients be educated regarding the advantages and benefits of palliative care.

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