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Hospitals at home

Federal Health Minister Greg Hunt has outlined his plan for a major shake-up of rules governing private health insurance which would include a “hospital in the home” option, writes Helen Pitt at The Age.

The American health system always gets a bad rap in Australia. Many times there are good reasons for this: exorbitant hospital costs, treating only the insured, the lack of universal health care for all Americans – until they turn 65 and are entitled to free Medicare.

But the in-home approach in the US, working in tandem with insurers, works well from my experience, especially at the pointy end of life in the delivery of palliative care.

Britain was the birthplace of the modern hospice movement thanks to Dame Cicely Saunders, who spent more than 50 years trying to humanise the dying experience for patients whether they were in a hospice, a hospital or at home.

In the US, psychiatrist Elizabeth Kübler-Ross adapted her ideas and helped to found the American home hospice care movement. Both the US Medicare system – for those over 65 and under a certain income – and private health insurers cover at-home hospice care to patients who have less than six months to live.

Hospice care also includes help for patients’ families to keep them at home. Cynics would say this it to cut health costs, but it also makes the dying process less clinical.

According to the National Hospice and Palliative Care Organisation’s latest figures, 66.4 per cent of dying Americans received at-home care and 26.1 per cent went to an in-patient facility. In the late 1970s, the US government began to view hospice care as a humane option for the terminally ill, and it is time Australia did too.


A hospital at home would help us all. It certainly helped my dying husband (The Age)


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