How Hospice Became a For-Profit Hustle

Ava Kofman writes for The New Yorker:

Forty years on, half of all Americans die in hospice care. Most of these deaths take place at home. When done right, the program allows people to experience as little pain as possible and to spend meaningful time with their loved ones. Nurses stop by to manage symptoms. Aides assist with bathing, medications, and housekeeping. Social workers help families over bureaucratic hurdles. Clergy offer what comfort they can, and bereavement counsellors provide support in the aftermath. This year, I spoke about hospice with more than a hundred and fifty patients, families, hospice employees, regulators, attorneys, fraud investigators, and end-of-life researchers, and all of them praised its vital mission. But many were concerned about how easy money and a lack of regulation had given rise to an industry rife with exploitation. In the decades since Saunders and her followers spread her radical concept across the country, hospice has evolved from a constellation of charities, mostly reliant on volunteers, into a twenty-two-billion-dollar juggernaut funded almost entirely by taxpayers.

A devastating read.

Bonjour Vietnam