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Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review May 4, 2005 / 25 Nissan, 5765

Medicare causing cancer-stricken Mom more pain

By Jan L. Warner & Jan Collins


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http://www.JewishWorldReview.com | Q: My 86-year-old mother was diagnosed with terminal lung cancer early this year. She decided not to receive treatment other than pain control because she had been on dialysis for six years due to end-stage kidney disease and was totally worn out.

Her cancer doctor told us he expected that she would live three to four months, referred her to hospice, and sent her home. We then got word from hospice that they could not take Mom unless she agreed to stop dialysis. If she stops dialysis, her kidney doctor says she will be dead in 10 days. We have tried to contact the Medicare people, but can't get a straight answer. So Mom is continuing dialysis to stay alive, but is not getting hospice pain management for her cancer. Can you tell me what to do? This is ridiculous.

A: "Hospice" is a type of care geared toward making the dying process as comfortable and pain-free as possible, using what is called "palliative," or comfort, care. Hospice can't provide "curative" care — that is, procedures and care that promote recovery. To be eligible to receive hospice, a physician must certify that the individual is terminally ill with six months or less to live, and the individual must sign an election form stating that he or she understands that the care to be provided will be for comfort, not for cure, and opts out of the curative provisions of the Medicare program.

Once a person qualifies for hospice, Medicare will provide coverage for "reasonable and necessary" services to provide comfort care and to manage the effects of terminal illness and related conditions.

Therefore, your mother and your family — and any individual with a modicum of sense — could reasonably expect that your mother would be provided pain management for her cancer and dialysis for her kidney disease until she died. Right? Wrong!

There is neither rhyme nor reason when it comes to dealing with the bureaucracy known as Medicare. Dialysis is the procedure by which waste and excess fluids are removed from the bodies of individuals with end-stage renal disease, and is clearly not a cure for kidney disease, but it is a way to keep such an individual alive. Crazy as it may sound, however, dialysis is not covered under the hospice umbrella of care, even though dialysis is not considered "curative."

Why? Hospice providers receive a "per diem," or daily rate per person, to supply care to terminally ill Medicare beneficiaries. From this daily rate, the hospice must provide all care, and the bottom line is that the daily rate paid by Medicare is insufficient to pay for dialysis.

Therefore, even though your mother is otherwise eligible to receive Medicare coverage for hospice, she — and others with terminal illness who receive life-sustaining, but not curative treatments — will not receive the benefit because of the structure of the Medicare payment scheme.

Who to call? For starters, you may want to contact The Centers for Medicare & Medicaid Services (www.cms.hhs.gov), but that will probably be a waste of time.

We suggest that you call, write, and e-mail your congressmen and senators, and get your friends and neighbors to do the same. Tell your elected representatives how the bureaucracy is playing ping-pong with your mother's life and welfare. Why should your mother be required to live out the rest of her life in pain in order not to die an agonizing death by stopping her dialysis? Given the fact that your Congress and president stepped up regarding the feeding tube issue of Florida resident Terri Schiavo, surely they are interested in the helping tens of thousands of Americans like your mother who are being trampled by the system they helped create.

Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.

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