Social justice and advanced cancer patients: An analysis of key policies

Abstract

•Purpose: This policy analysis examines key aspects of two policies fundamental to work with terminal cancer patients: the Medicare Hospice Benefit and Medicare policy in palliative care. End-of-life care, affected by these policies, should address physical, emotional, and spiritual suffering for all vulnerable groups. •Methods: Using Gilbert and Terrell’s framework, social allocations, social provisions, service delivery, and financing are examined to better understand each policy’s effects on equality, equity, and adequacy for terminally ill cancer patients. •Results: In practice, each has substantially socially unjust effects for cancer patients. Disproportionate advantages result for those who are white, have family caregiving support systems, those with higher socioeconomic status, and individuals with stable insurance coverage. •Conclusion: The Medicare Hospice Benefit and Medicare coverage for palliative care need to be better understood by policy practitioners and all practitioners in health care settings. Advocacy can contribute to improved equity in end-of-life cancer care.