UPDATE: This evening, the Jindal administration announced that it was suspending — through June 30 — its announced plan to cease funding of Medicaid hospice services. As the New Orleans Times-Picayune reports:
“…. on Wednesday, the administration reversed course. The program will be maintained for the rest of the state’s fiscal year, which ends June 30, with the use of “temporary bridge funding,” according to a news release from the Department of Health and Hospitals. The release referred to that money as grant funding but did not specify where it came from or how reallocating it to hospice care would affect other state programs.”
The longer-term fate of the Medicaid hospice program is uncertain.
How do conservatives propose to cut Medicare and Medicaid spending?
Gov. Bobby Jindal, oft-mentioned as a 2016 presidential contender, is going about it in a number of ways, including an executive order that will end Medicaid coverage of hospice services as of February 1. Each year, some 1,700 less affluent residents of Louisiana have benefited from those services.
“In a strongly worded statement released on Thursday, the Louisiana-Mississippi Hospice and Palliative Care Organization’s (LMHPCO) Board of Directors stated that it was “shocked and saddened” by Gov. Jindal’s recent decision to eliminate the Medicaid hospice benefit, effective February 1, 2013.
“While the board strongly disagrees with this decision, the board is even more confused by the administration’s assertion that this action will save the state $10.6 million in FY 2014,” the board stated.
“For 10 years, the Medicaid Hospice Benefit has provided terminally ill patients and their families in Louisiana with the confidence they need to forgo expensive end-of-life hospital admissions. According to the administration, Louisiana Medicaid spent $11,430,414.14 on hospice services for some 5,189 recipients in 2012 — an average of $2,202.81 per patient.
With or without hospice, these terminally ill patients will die. The average length of stay for hospice patients in Louisiana is 72 days, with 50 percent of our patients dying within 26 days of enrollment. Without hospice, as these terminal patients decline, they will typically be transported to the nearest hospital emergency room by ambulance, and will subsequently be moved into the hospital’s intensive care units — costing the state’s Medicaid system at least four times the cost of hospice care.”
Hospice, almost by definition, is not a life-saving intervention. It is a death-management intervention. As the Louisiana hospice officials note, this alleged “savings” will almost certainly result in higher costs to taxpayers, as people who are denied professional hospice care seek medical assistance in more expensive ways.
But beyond that bottom-line analysis, there’s a question of morality and decency. Like millions of Americans, I have witnessed first-hand the value of hospice both for the terminally ill patient and for his or her loved ones. The fact that Jindal is enacting this reduction as a way to help finance the elimination of state corporate and income taxes only compounds the tragic nature of the misjudgment.
– Jay Bookman