February 6, 2023

The Theme of the Month is “Life and Death”

In Sunday’s sermon, February 5, I encouraged people to break down the barriers that prevent us from talking about dying and death. I proposed that the strong cultural and religious fears come from our personal fears about dying and prevents healthy private and public conversations, and in the void, some serious problems exist. One big impact is we have not asked ourselves serious questions about end-of-life decisions, or if we have, we have not shared them. This means families do not have enough information to know what we want when end of life decisions must be made. This can be devastatingly hard when grief overwhelms our capacity to make crucial decisions.

Another impact is recent changes in the for-profit healthcare system. When I made this comment yesterday, I spoke too fast and did not provide enough detail about my concerns. So, please let me clarify to help ease confusion and concerns. I fully support hospice care services. I had both my parents in hospice and have worked with hospice providers over my many years of ministry. I have always had very good experiences. When done well, hospice care is a solace for families and patients as patients ease into their death.

My concern comes from an article in the New Yorker, published on November 28, 2022, on their website, and on December 5, 2022, in hard copy. The article is echoed by the experience of a few of my colleagues who work as hospice chaplains. The article dives into changes over the past 10 years of the increase in large for-profit corporations buying hospices and taking advantage of lax processes for Medicare patient reimbursement.

Medicare does not have the capacity to provide oversight into reimbursement, and the Department of Justice, despite the desire to prosecute corruption, rarely takes on cases because they cannot win in court. In cases that end in settlement, some people get money, but everyone keeps their jobs, including the for-profit hospice companies who keep fraudulently billing Medicare. Unfortunately, there is little research on how extensive is the problem, but it’s large enough to have the attention of the New Yorker, the DOJ, and a few legislators.

My message to you today is if you or a family member are in need of medical support for end-of-life care, hospice is a wonderful and important option. However, do careful research before choosing the hospice company.

My apology for any confusion about my support for hospice as an important part of end-of-life care. I do hope that none of you have to look for hospice in the near future.

With love, Rev. Kate

Care and Connections

With deep sorrow, we share the news of the death of Naomi Crane on February 1. A Celebration of Life will be held later in the spring. Condolence cards can be sent to 6923 Rosewood St., Pittsburgh, PA 15208.

If you have joys or sorrows you would like to share with the community, please send them to me, kwalker@first-unitarian-pgh.org