Morris, you’ve done enough for my havoc-wreaking GOP

From Don McGinnis

After reading Dick Morris’s latest rant concerning President Obama’s use of fear to forward an agenda (column, “It’s Obama spreading panic,” Feb. 25), I am taken by the fact that he points out the current administration is using fear to orchestrate the biggest spending spree in human history.

It’s not that this is inaccurate. Indeed, it may be the truest thing Morris has ever said. However, lest we forget, the previous administration used exactly the same tactics to take us down the road to Baghdad with no less damaging a result.

As a lifelong Republican, who voted for every Bush who has run for president, I was forced to watch my party — that’s right, my party — being overtaken, right before my eyes, by the very people in whom I had placed my trust as they thrust us into a war that has proven to be destructive both economically (unless you make tanks, jets, helicopters or Hellfire missiles) and strategically, as we have burned more bridges than we have built in these past several years.

That we spent hundreds of billions of U.S. tax dollars and found but one drawing for an obsolete trigger mechanism, buried in somebody’s back yard no less, can hardly stand up to the moral “stress test” of true and legitimate justification for war. Nearly six years later Iraq is still standing on the edge of a cliff, just waiting for our departure to be pushed over.

I believe that, given the chance to perform a cost-benefit analysis of this entire drama, a true conservative would say that our worst fears cost us any chance at legitimacy. We have run our military ragged, lost sight of our stated enemy (you remember, the one that lives in caves in Afghanistan) and cost the GOP the White House and both houses of Congress.

Frankly, Dick, I think you have done enough for the GOP. I would stop shouting at the wind and try to find ways to support the new president’s agenda, no matter how much it hurts, because the last administration, the one from my party, wrecked everything, and we will all be paying for the rest of our lives.

Morganton, N.C.

Hospice costs flat,
not service-based

From Judi Lund Person, vice
president, Regulatory National
Hospice and Palliative Care

A recent letter that appeared on this page (“Hospice provider billed CMS equivalent of $11,896 an hour,” Feb. 25) captured my attention.

Hospice care is completely personal to the patient based on factors such as diagnosis, the point at which he or she enters care, family support, and desires of the patient and family. Patients and their families have a range of services available to them including nurses, social workers, home health aides, clergy and spiritual counselors, allied therapies and counselors, volunteer support, and, of course, a physician.

Hospice is reimbursed on a per diem basis, and has been since the benefit was first offered under Medicare in 1983. Hospice has never been reimbursed through a fee-for-service scheme. However, the Medicare Summary Notice might create confusion for families on how hospice programs are reimbursed.

The per diem is all-inclusive, meaning that all of the services — from nurses to clergy, all medical supplies and prescription drugs related to the patient’s qualifying diagnosis, and all durable medical equipment (hospital beds, walkers, bed-side commodes) — are included in that daily rate. That rate is adjusted geographically and currently averages $140 per day. With respect to end-of-life care, this is the only amount that Medicare pays the hospice program.

CMS recently changed the way hospices report their visits in an effort to better collect data on hospice services. Confusion about the differences between “charges” and “reimbursements” is perfectly understandable and the hospice community has raised this very issue with CMS numerous times. Patients and families have a right to know the cost of their healthcare and ask questions.

Finally, it is worth pointing out that research shows that, overall, hospice is extremely cost-effective. An independent Duke University study in 2007 found that patients receiving hospice care cost the Medicare program about $2,300 less than those that did not, amounting to an annual savings of more than $2 billion.

Most importantly, whatever care was provided should have been of the highest quality, tailored to the specific needs of the patient and family, and delivered with compassion. That is the only standard that is acceptable.

Alexandria, Va.