As today’s Washington Post article reports on bioethics.net, the recent surge in gas prices is making the cost of providing home health care for those individuals who require services in the home even greater. While some companies are sensitive to this burden and are handing out gas cards to prevent home health care providers from dropping from the ranks, if gas prices continue to rise, it will only be a matter of time before home health care companies will have to find a way to cut costs–reducing the number of visits, putting the burden back on providers, or reducing costs in some other way that is certain to reduce the quality of care provided in the home. Just when you thought the economy and the oil barons couldn’t hurt us any more, it turns out they can hurt our health too….

So, what are the elderly, those living in rural areas, the homebound, or disabled to do in a world were gas costs in most places more than $4.00 per gallon? It wouldn’t appear that these individuals have much choice or any rights at all when companies like Northern Montana Home Health Care and Bear Paw Hospice, cited in the Washington Post article, have admitted that they are looking to discontinue service across remote parts of Montana where providing coverage would rack up serious gas mileage.

But what about the duty to treat the most vulnerable and sickest among us, even in these lean, petroleum-challenged times? Surely it is not adequate moral justification enough to claim, as the as the director of Bear Paw Hospice did that Medicare reimbursements don’t account for gas prices over $4.00.

Moreover, what about the companies’ duties to the workers they employ? Don’t they have a duty not to leave them, gas tanks empty on the side of the road half way between Billings and Butte? Handing out gas cards is the least that these companies can do when we know that the overhead in most healthcare organizations these days is around 13%.

If the Bush administration can’t find a way to cut gas prices, maybe health care organizations can find a way to cut some of the overhead and spend it on home health care providers’ having the fuel they need to provide quality care to those who most need it, even in the most remote places.

I’m sure anyone who has a elderly grandmother in Montana would agree and wouldn’t the price at the pump to determine her quality of care, her quality of life or her health outcomes.

Summer Johnson, PhD