Kofman described some of the techniques that major for-profit hospices’ “community educators” — i.e., marketers — would utilize on the people, often desperately poor, that they solicited. Shamelessly, they would approach households wearing scrubs, despite having no medical background, and would tout “amazing government benefits,” trying “not to mention death in [the] opening pitch, or even hospice if [they] could avoid it.
The absurdity, and the ethical breaches, do not end there. Wrote Kofman, “Some hospice firms bribe physicians to bring them new patients by offering all-expenses-paid trips to Las Vegas night clubs. … Other audacious for-profit players enlist family and friends to act as make-believe clients, lure addicts with the promise of free painkillers, dupe people into the program by claiming that it’s free home health care, or steal personal information to enroll ‘phantom patients.
Without diagnostic recertification, Medicare reimbursement also ends after six months. There’s an incentive to attract patients for a long stay — but another to be rid of them. This can result in patients being abruptly expelled, “losing diapers, pain medications, wheelchairs, nursing care, and a hospital-grade bed that a person might not otherwise be able to afford,” Kofman wrote.
We should be appalled that, on the final stretches of the road from life to death, we have allowed capital to set up one final toll.necessarily