Portfolio and Cover Memo

The Case for a Universally Covered Palliative Care

The dying process still remains a painful and stressing process in America despite the consistent commitments by the government on its fully financing of near death healthcare programs. This situation has been worsened by the rise of terminal illnesses such as cancer, HIV/AIDS and the last stages of illnesses such as diabetes and hypertension amid rising poverty levels in the country (Worster & Swartz, 2017). I raise this issue to you, the local community based on your central role in influencing local expenditures on health in our great state. There is urgent need by the government to fully cover palliative health services to all patients to relieve patients the pain and low dignity associated with the dying process.

A picture of a patient on palliative care at Emory University Hospital

Despite the verbal commitments by successful governments on funding palliative care, majority of patients still use their private health insurance schemes to fund this process. This case has therefore denied majority of the patients of these illnesses a descent and dignified death. Patients die before its time due to lack of holistic palliative care as they can barely afford quality care. They usually lack emotional, psychological, spiritual and adequate medical care accelerating their deaths due to high pain intensity, drug resistance conditions and other secondary symptoms associated with the terminal illnesses. The underinvestment on this program by the government has resulted in big ratios of patient to care facilities with the hospital administration indicating that there is an acute shortage of walking aids and a very low number of attending nurses.

The current situation, where every patient pays for their palliative care exposes the vulnerable populations such as the disabled population, those of low social-economic classes and those that have been marginalized for long in the country. Only those from well-to-do families have the ability to afford quality care in the last days of their lives. The recent reports released on the status of palliative care in Emory University Hospital Georgia, for example, shows a dangerous situation where dying has become so painful and undignified, with proper dying process too expensive for the public. The figure below illustrates the extent to which palliative care has been neglected by both the federal government and the state government of Georgia- a case of Emory University Hospital in 2019.

Level of Palliative Care	Cost of Palliative Care	No of Patients Covered
Full Quality Care	$ 2000	250
Partial Care	$ 750	1475
No Care	-	The rest of the Population

A table on palliative care status in Emory University Hospital, 2019

The statistics above, captured by the institution, illustrates a situation where above sixty percent of the terminal illness patient population is not able to afford quality palliative care. The category of attempted partial palliative care indicates that patients struggle to acquire these services. However the case paints a situation where a big chunk of the patients do not get the full comprehensive attention by the professionals. Even worse is the fact that many of the people die in hospital wards or in homes without being accorded care by qualified professionals and if this case is extrapolated to the entire state, the situation is ugly in Georgia and in America. Experts point that when offered properly, palliative care has the capacity to delay death and lessen the pain and other unpleasant symptoms caused by diseases.

Demographic reports indicate that over eighty percent of the population in America die past the age of sixty five years (Richman et al., 2015). This means that by the time many people are dying they have no employment and are fully reliant on social security funds. The patients are therefore confronted with the burden of paying for care at a time they are financially strained hence the low ability for patients to have a comprehensive cover for palliative care. Additionally, there is a big portion the public population who do not have the private insurance subscriptions to cater for their care. They are subjected to undignified deaths and hastened circumstantial termination of lives.

Moreover, the existing medical insurance plans have done little to cater for the nurses who offer their care to patients. A research conducted on the medical services workforce in late 2017 revealed that nurses who attend patients in palliative care are not under any allowance scheme from the government a situation that lowers their productivity at work (Knaul et al., 2018). It is therefore shameful and unfair the kind of care we accord a citizenry that has greatly served this nation and poor morality to subject others to painful deaths on the account of their poverty levels. It is against the American spirit of nationalisms and commitment to the welfare of its people.

References

Knaul, F. M., Farmer, P. E., Krakauer, E. L., De Lima, L., Bhadelia, A., Kwete, X. J., ... & Connor, S. R. (2018). Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. The Lancet, 391(10128), 1391-1454.

Richman, E., Ringel, A., Kreniske, J. S., & Safadi, W. (2015). Family as the primary caregiver: palliative care in the Golan Heights. Case Reports, 2015, bcr2014204965.

Worster, B., & Swartz, K. (2017). Telemedicine and palliative care: an increasing role in supportive oncology. Current oncology reports, 19(6), 37.