This chapter sketches out the brief rich history of modern “hospice” and “hospices”, concentrating on developments in the United States and the United Kingdom, and highlights the spread of influence and the adaptation of ideas in other cultures and jurisdictions. Hospice is both a service and a set of ideals; a way of doing and a way of thinking. Financial considerations remain central to thinking about the provision of hospice and palliative care in the United States. Skilled nurses, social workers, chaplains, and volunteers provide the kind of holistic care that is increasingly valued by older people. The paradox for the health care system is that the patient must be dying in order to get it. Medicare pays hospice a fixed daily rate. Hospice has a key role to play in current debates about care at the end of life.