Palliative care is emerging as one of the most important ways to provide care for people who are very ill and/?

I would say none of the above. Hospice is palliative (or "comfort") care, so they are not in competition. It is reimbursed by Medicare, and while yes, the person must have a prognosis of 6 months to live, I wouldn't say that is why there is limited availability. I would say the reason not many people choose to have palliative care is because they are afraid of death due to lack of experience with it. Plus, many people find it very difficult (because it is) to accept that their loved one is dying, and cannot resign themselves to just providing comfort care, rather than curative care to their loved one.