So businessmen seeking profits have made very bad business decisions and now want a bailout?

The elderly person is living at home but becomes unable to take care of themselves, even with maximum effort of the family and the limited assistance of some "Home health agency" care.

If the failure is some type of catastrophic event, stroke, hip fracture, the person goes to a hospital for treatment. After treatment the person is sent to a skilled nursing facility for recovery. Medicare is paying for part of this. The patient is responsible for the rest. (Advice: Get supplemental insurance.)

If the person is incapable of going home, the Medicare coverage runs out in about 30 days. At that point the patient pays 100%. Typically Medicaid becomes involved. This is a means tested program and a complete evaluation/investigation is made of the finances of the patient. The result is usually loss of almost all assets to the state for payment unless they have been properly protected within a certain time frame. (Advice: If you or your parents are 50 plus, consult an attorney who specializes in Medicaid, Nursing home care, etc.)

At some point the patient dies with no advance notice, or becomes too ill to be treated at the nursing home and is transferred back to the hospital. The patient either dies within the "treatment time" within the hospital, recovers and is sent back to the nursing home or is declared terminal and discharged to friends and relatives to die at "home" or is sent to a hospice.

A Doctor's opinion is required on the discharge irrespective of the destination.

If the patient's initial problem is not catastrophic, say senile dementia finally advancing to where the patient can not function, the patient may go straight to a nursing home, but this is fairly unusual as most Doctors will want some tests ran in a hospital to back up their recommendations.

But whether from a nursing home or hospital, a Doctor's opinion must be obtained before a patient can be sent to a hospice.

Medicare's actions highlighted in NYT article are required by law and have nothing to do anything else, despite all the BDS I see flowering on the thread. The Demos have control of Congress, all they have to do is pass a bill.

That they can not highlights their ineptness and lack of focus on the people's business in favor of attack politics designed to get them reelected.

In the end this is the real problem.

In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once curative efforts were abandoned.

But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer's disease and dementia. Those patients now form a majority of hospice consumers, and their average stays are far longer -- 86 days for Alzheimer's patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commission.