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Greg Dobbs Column

We’re lucky to live, and die, in Evergreen

Reprinted from the January 7, 2015 Canyon Courier

Greg Dobbs HeadshotSometimes we don’t know how lucky we are. Even when we are dying.

The Washington Post the past couple of months has run a series called “The Business of Dying.” The title alone is a shocker; do we really want “business” and “dying” to appear in the same sentence? Probably not. But the day after Christmas, readers found out why they do, in the title of the seventh story in the series: “Dying and profits: The evolution of hospice.”

I don’t know about you but that sure scares me. I’m all for profits… I wish I’d made a few more myself over the years… but when I’m dying? Do I really want someone making profits even then?

No I don’t, and since roughly half of all Americans these days eventually get hospice care,neither do you. But after analyzing hundreds of thousands of records about the treatment of hospice patients across the U.S., The Post concluded that too many hospices focus as much or more on the condition of the bottom line as they do on the condition of the patient.

However, the study draws a very clear distinction: this is true with for-profit hospices to a much greater degree than with those that are not-for-profit. Which makes this the right place to put my own cards on the table. For many years now, I have been on the board of Mount Evans Home Health Care & Hospice (which, as old-timers here in Evergreen will remember, once was just known as Mount Evans Hospice). As chairman of the fund-raising committee, sometimes I am painfully aware that Mount Evans is a not-for-profit. That’s why we fundraise as feverishly as we do: to keep the bottom line out of the red so that we can continue to give the best care possible to anyone and everyone in most of a four-county region (Jeffco, Clear Creek, Gilpin, and Park), regardless of insurance or ability to pay.

Sad to say though, to quote The Post, with “the influx of for-profit companies into the hospice field…patient care suffered along the way.” Examples? The typical for-profit hospice “spends less on nursing per patient; is less likely to have sent a nurse to a patient’s home in the last days of life; and is less likely to provide more intense levels ofcare for patients undergoing a crisis in their symptoms.”

That’s why the combination in a single sentence of “dying” and “profits” scares me. Hospice across America has become a $17-billion industry. When you read the names of the investment firms that now control a good piece of it, you see the owners of companies like Dunkin’ Donuts, Hertz Rent-A-Car, Bauer Hockey Equipment, Trico Windshield Wipers, and United Defense. Nothing wrong with any of them, but do we really want our care during our dying days to be overseen with the same kinds of financial goals they set for Dunkin’ Donuts? Uh-uh, especially if some of those delicious glazed donuts helped get us there.

Late last year, Mount Evans was named one of the Top 100 agencies in the nation. I think the Washington Post series explains why, because it raises this question: Are the goals of a for-profit company and a dying patient easily aligned? To be fair and not paint everything with a broad brush, evidently sometimes they are. But The Post— and earlier studies by a health policy professor at Yale— suggestthat all too often, they aren’t. Which is yet another reason why we’re lucky to live— and even to die— in Evergreen.