Pandora's Dismay: Eliminating Coverage-Related Barriers to Hospice Care

Dying Medicare recipients currently must accept the inevitability of impending death before Medicare will fund hospice services. Such a state of affairs is far from optimal, for hospice services provide both physical and psychological benefits long before patients have accepted their fates. This article explores the history and philosophy of hospice and highlights the anti-therapeutic gap between the time at which patients can benefit most from accessing hospice services and the time at which the Medicare statute and regulations first support access. It concludes by recommending that Congress blur or eliminate the currently existing false dichotomy between palliative and curative care that partially causes the gap and by calling for empirical research to help determine exactly how Congress should do so.