Palliative Care as a National Priority

Diane Meier, Manish Srivastava, and Amanda Holbrook have a nice op-ed in the Cincinnati Enquirer describing Palliative Care as a national priority given the aging of the baby boomers.

The goal of palliative care is to help with symptom control, stress management, comfort and overall quality of life for patients who are dealing with a serious illness.

Who wouldn’t want that? I sure want it for myself and family. The last few years have been the best of times and the worst of times for the discussion of palliative care. In the worst of times category, a small provision of the ACA to expand the coverage of palliative care consultations in the Medicare program was termed death panels. There were and are no death panels. It is true that everyone will die. Go and read the definition above with this reality in mind. It is simply amazing that the most memorable line about the health reform debate is false and actually serves to harm persons in need by making it harder to expand access to palliative care.

In the best of times category, the controversy associated with these issues provoked some influential people to write about palliative care; Atul Gawande’s essay Letting Go published in August 2010 communicated beautifully the reality of both palliative care/hospice and the conditions that cause people to need it, and Eleanor Clift courageously shared the story of her husband’s death and how hospice helped her family through this difficult time.

And one of the most high profile peer reviewed studies of 2010 was a RCT of early palliative care in stage IV lung cancer that produced an important finding: increased life span, improved quality of life and reduced costs. This study has spurred new interest in funding palliative care research and there is a great deal of this work underway and in the pipeline. Completing quality research and communicating the results effectively must be a top priority if we are to develop a sustainable health care system.

The best antidote for lies is the truth, and the way to end bad speech is to crowd it out with good speech. The facts are on the side of palliative care and we have to get better at communicating them. However, the real question is whether our nation can handle the truth.

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