Flexible spending accounts (FSA's) are employer-sponsored benefits that allows you to pay for eligible medical expenses on a pre-tax basis.  If you have set up one of these accounts with your employer and haven't used up the money you've set aside, now is a good time to start spending those dollars.  Most plans don't allow you to carry over money each year so you might need to get creative on how you can spend the money before you lose it.

An FSA will cover items that can be very useful to palliative care patients and their caregivers.  It allows for reimbursement for things you might be spending on regularly, such as:

• Adult diapers and other incontinent supplies
• Wound care dressings and first aid supplies
• Latex gloves
• Medical equipment (walkers, shower chairs, wheelchairs, etc.)
• Fees for hospital services, qualified long-term care services, accident and health, and qualified long-term care insurance premiums, nursing services, laboratory fees, prescription medicines and drugs, and insulin.

If you are a palliative care patient or the caregiver of one, chances are your spending money on at least one of these items.  Why not spend pre-tax dollars to get them?  Use up your hard earned money sitting in your FSA and remember to sign up for an FSA next year.

November is nationally recognized as Hospice and Palliative Care Month.  This is an excellent time to do whatever you can to raise awareness of hospice and palliative care and to support local and national programs providing or supporting palliative care.

What is National Hospice and Palliative Care Month?

How Will You or Your Organization Honor National Hospice and Palliative Care Month?

What is Palliative Care?

What is Hospice Care?

A recent report by Human Rights Watch found an alarming number of Indian cancer and HIV patients are left to suffer without adequate, if any, pain control. The 108 page report, released on October 28, 2009 found that "many major cancer hospitals in India do not provide patients with morphine, despite the fact that more than 70 percent of their patients are incurable and likely to require pain treatment and palliative care." According to Diederik Lohman, senior health and human rights researcher at Human Rights Watch:

"India's health care system abandons so many patients to severe pain. They are left to suffer; many told us that their pain was so bad they would prefer to die."

The report identified three key factors responsible for this underuse of affordable and effective pain control:

1. Restrictive drug regulations in India: Many Indian states have excessively strict narcotics regulations that make it very difficult for hospitals and pharmacies to get morphine. In 1998, the central government recommended that states adopt modified regulations, but more than half of India's states have not done so.
2. The failure to train doctors: Most medical students and young doctors receive no training on pain treatment and palliative care because the government does not include such instruction in relevant curricula. As a result, most doctors in India simply do not know how to assess or treat severe pain.
3. Poor integration of palliative care into health services: National cancer and AIDS control programs do not contain meaningful palliative care components, thus depriving such care of public funds and relegating it to second-tier status.

Interestingly, India is one of the largest producers of Opium, the key ingredient for Morphine.  Yet, the majority of the crop is exported while millions of Indian people suffer unnecessarily without adequate pain control.

Read the full Human Rights Watch report, "Unbearable Pain:  India's Obligation to Ensure Palliative Care"

What is Palliative Care?

Finding Palliative Care

Pain Management in Palliative Care

Medical marijuana advocates, users, and suppliers recently received some good news.  President Obama has implemented a new policy advising federal prosecutors to stop targeting people involved in the sale and use of medical marijuana in compliance with state law.  Fourteen states have legalized the medicinal use of marijuana, although the laws vary widely between them.  While this new Obama policy is good news for legally diligent citizens, many are still worried about complying with the web of state laws, which can be quite confusing.

Most medical marijuana proponents are excited by this decidedly different take on marijuana use which is in stark contrast to the Bush Administration's view.  They are optimistic that this brings us one step closer to nationwide legalization of medicinal marijuana.  And indeed, it's looking more and more like legalization is in the future.  Fortune Magazine ran tantalizing cover story in September about the legalization of marijuana.  I was surprised to find out that Obama had introduced this marijuana policy all they way back in February of this year.  Interestingly, although this was a huge step forward in the legalization process, this move by the President received little to no publicity.  The article is a great read and admittedly thought provoking.

I happen to live in California, the pioneer of medical marijuana laws.  Hospice patients in my area don't have a hard time getting approved for medical marijuana (okay, if we're being honest here, anyone with enough cash and some form of medical condition, real or made up, won't have a difficult time either).  The use of medicinal marijuana is rapidly increasing in the palliative care community and we are already seeing positive outcomes - reduced nausea, increased appetite, improved pain control, etc.

You might have some questions about medical marijuana and whether it's right for you or your loved one.  Here's some information to get you started:

Medical Marijuana:  Frequently Asked Questions