At a hearing of the Senate Special Committee on Aging, Sen. Sheldon Whitehouse (D-R.I.) said he is introducing a bill that would allow for more pilot programs and Medicare waivers regarding hospice care. It would also allow hospice and curative care to be provided to a patient at the same time and would provide for home services before a patient is homebound.
Part of the problem with American hospice and palliative care is the cultural resistance to discussing end-of-life issues, but part of it is also Medicare's payment structure, he said.
Best-selling author and surgeon Dr. Atul Gawande, whose most recent book is titled Being Mortal, told the committee that the system of care for those with serious and chronic illness is “often inadequate and inhumane.”
Research has shown that in the last month of life, more than half of people experience moderate to severe pain and many also have depression. Those who receive palliative care suffer less, are more physically capable and can interact with others for longer. But they do not die sooner, and their costs are typically lower, Gawande said.
Another bill that has been introduced, the Palliative Care and Hospice Education and Training Act, would establish grants for more provider training and would expand palliative care research.
Last session's Care Planning Act is also being eyed as a possible legislative vehicle. It would have created a Medicare benefit called planning services for people with advanced illnesses.
At the hearing Thursday, Amy Berman, an executive at a foundation that works to improve care for older adults said Congress should improve training and research dollars for hospice and palliative care quickly.
“I would like to see legislation passed ... and I would like to be there to witness that signature,” said Berman, who is herself terminally ill with breast cancer.