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Social Justice and Advanced Cancer Patients: an Analysis of Key Policies

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Suzanne Marmo
Suzanne Marmo
Suzanne Marmo
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Shannon R. Lane at Yeshiva University
Shannon R. Lane
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Abstract

PurposeThis 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.ResultsIn 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.
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ORIGINAL PAPER
Social Justice and Advanced Cancer Patients:
an Analysis of Key Policies
Suzanne Marmo
1
&Shannon R. Lane
2
#Springer Nature Switzerland AG 2020
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’seffects
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.
Keywords Oncology.Social justice .End-of-life care .Palliative care .Medicare .Health
policy
https://doi.org/10.1007/s42972-020-00003-0
Dedicated to Paul Kapralos.
*Suzanne Marmo
marmo–romans@sacredheart.edu
Shannon R. Lane
shannon.lane@yu.edu
1
School of Social Work, Sacred Heart University, 3135 Easton Turnpike, Fairfield, CT 06825, USA
2
Wurzweiler School of Social Work, Yeshiva University, New York, NY, USA
Journal of Policy Practice and Research (2020) 1:37–54
Published online: 13 2020
May
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... To promote social justice in end-of-life care, all populations need to experience equity in palliative care and identified barriers experienced by specific populations should be the focus of social action, advocacy, and practice innovation for palliative care social workers. Marginalized populations have poorer outcomes such as higher mortality and higher likelihood of hospitalization during the dying process, along with being less likely to die at home and less likely to be referred to palliative care (Hughes & Vernon, 2019;Kramer et al., 2005;Marmo & Lane, 2020). ...
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