The hospice movement and palliative care programs have grown over the past quarter century at an astounding rate. Such programs now treat far more than just pain or cancer. Nevertheless, recognition of the critical need for improved cancer pain management was the genesis of modern palliative care. However, even today, many Americans lack ready access to such care. Recently, an increased focus on the need for more and better palliative care has led to important new publications, federal funding initiatives from palliative care research, and explicit recommendations from the National Cancer Policy Board on ways to lessen barriers to palliative care. Some of these potential solutions are discussed.