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By Terry Berthelot, JD, MSW

Somewhere in our history, it became unacceptable to die. Elizabeth Kubler-Ross described in her seminal work, On Death and Dying, dying patients forced to endure fruitless procedures and then left in their dark hospital rooms, alone, to face the inevitable.  Each death was treated as a failure. Then in the 1970’s, the United States saw the birth of a new philosophy of care. This grassroots movement, known as hospice care, demanded quality of life for the dying and the medical, psychosocial, and spiritual support necessary to die at home. Medical insurance, however, did not pay for this kind of care.

This changed in 1983, when Medicare started covering hospice care. Since then almost all other insurance followed suit. Today, most dying Americans have access to hospice care, and physicians and other healthcare providers are increasingly knowledgeable about the hospice philosophy of care. In fact, nearly half of the Medicare beneficiaries who died in 2013 received hospice services. Thanks to Medicare’s leadership, dying in America is now viewed as part of the cycle of life, and patients and their families have access to appropriate care.

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