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Letter of the Week - Nancy Supports Funding for Hospice Care

Every week, 2,000 - 3,000 Second District residents write to me about the issues pending before Congress, and I work hard to respond to each person as promptly and thoughtfully as possible.  On this "Letter of the Week" blog, I highlight constituent letters that are of general interest.  If you'd like to share your own views, please feel free to e-mail me at any time!

Dear Nancy,

As your constituent, I am writing to ask that you take action today to save hospice care in the United States. Hospice served more than 1.3 million Americans last year and continues to be a valued option for quality, compassionate end-of-life care.

Unfortunately, the Administration's FY 2009 budget proposes - through regulation - to cut hospice reimbursement under Medicare by eliminating the current budget neutrality factor in the hospice wage index. This proposal would cut Medicare hospice payments by $2.29 billion over five years and will be implemented administratively, thus bypassing Congressional approval.

Research shows that hospice is cost effective. An independent Duke University study in 2007 showed that patients receiving hospice care cost the Medicare program about $2,300 less than those that did not. It is difficult to understand why the government would deliberately jeopardize a program that is valuable to both its bottom line and its constituents.

Please contact Congressman Chris Van Hollen's office today to sign the letter to Ways & Means Committee leadership expressing support for the inclusion of a delay of a regulation that would cut rates to hospice. By including a moratorium on the hospice rate cuts in the anticipated Medicare package, we allow time to comprehensively study the Medicare hospice benefit before taking rash actions that would hinder access to hospice care throughout the nation.

I thank you in advance for your immediate attention to this urgent issue.

John from Atchison, KS.

Dear John,

Thank you for writing me about protecting hospice care. I thank you for your commitment to hospice, and I assure you I share it.

When I came to Washington last year, I looked forward to helping shape health policy for the better of the country. Health care is my background, and it is my passion. I am proud to come from Kansas. Compared to other states, we have a strong safety net; we have relatively low numbers of uninsured, and we have a tight network of providers in rural areas. I looked forward to sharing Kansas’ insights with representatives from all over the country and turning some of these good programs into something the nation could share. In this respect, this term has been a disappointment.

Instead of introducing new innovations, we've had to spend much of our time protecting already-proven programs. It is so hard to understand what (or whether) the Bush Administration is thinking when you see them attempt to dismantle programs like the state children's health insurance program (SCHIP) and gut the funding for services like hospice in Medicare. These are programs that make our society better and do it while saving money. It's scary to think what would have happened to these programs with a lap-dog Congress, and I say a prayer of thanks that we now have Congressional leaders who are willing to stand up to the administration.

The Administration is trying to cut hospice rates by $2.3 billion. It’s operating without a recommendation from the Medicare Payment Advisory Committee and without authority or instruction from Congress. And it’s doing it at a time when hospice providers are being squeezed by rising gas prices. It’s up to both Congress and the courts to block this action and preserve hospice payments. We will do our best, but this whole process is disappointing. It just shouldn’t be this hard to make good policy.

I have already signed two letters in support of preserving hospice payments. The first letter was sent to the White House. It was ignored. The second letter is going to the leaders of Congress, and I will continue to press them for action. The time is probably coming soon when we have to take a hard look at Medicare spending and make tough decisions. I recognize that. But there’s a smart way to do that, and the Administration’s approach is not it. I will always be willing to stand up and say that.

When the time comes to take a comprehensive look at our health care system, hospice providers will be asked to show their contribution to society. To do that, they will need better data than they have now. My office has offered to bring various provider groups together to facilitate the exchange of these data. We all need to do what we can to help preserve quality health care in Kansas .

Thank you again for writing me about hospice care. I hope to be able to write you again soon with good news. In the meantime, if there is anything else we can do, please let me know.

 Sincerely,
Rep. Boyda's signature
Nancy Boyda
Member of Congress