Bad News! These rules will also kill old folks. But don’t take that from me, ask a doctor, like Milton Wolf
This is the vicious cycle of big government: Institute top-down, central planning to solve problems, real or imagined. Blame its failures on the greed of others. Institute more top-down, central planning to address those problems, real or imagined. Repeat.
Here’s the government’s latest assault on patients: Medicare fines over hospitals’ readmitted patients.
As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to save taxpayers money.
Sounds great. What could possibly go wrong?
As one central planner put it:
If General Motors and Toyota issue warranties for their vehicles, hospitals should have some similar obligation when a patient gets a new knee or a stent to relieve a blocked artery, Santa contends. “People go to the hospital to get their problem solved, not to have to come back,” he said.
Weak analogy. Would you hold GM or Toyota responsible if someone drove their new car off the lot and then crashed it because they were driving recklessly? Oh, but patients always follow their doctors’ advice, you say? Uh huh.
But setting aside the obvious structural flaw of this plan that punishes hospitals for outcomes that are beyond their control, consider the incentives it creates. The government is now incentivizing hospitals to deny care.
No two patients are the same. Some are just sicker than others. Some will need more hospitalizations no matter how excellent their care is. Under this new plan, hospitals are incentivized to avoid the sickest patients because they’ll have a higher likelihood of bouncing back and triggering the fines. You better hope your mom isn’t one of them.
And if your mom does get sick again after a recent hospitalization, the government has just created a powerful incentive for the hospital to deny her readmission. Good luck with that.
Scary stuff to ponder, both my parents are on Medicare, the last thing they need, or that I need for that matter, is to have that extra worry when they get sick. More at Forbes
The Obama administration’s latest target for health care cost control is Medicare hospital re-admissions. Nearly 20% of Medicare patients discharged from a hospital require re-hospitalization within 30 days, costing the government $17 billion per year. The federal government regards many of these re-admissions as “avoidable” wasteful spending. Under ObamaCare, the government has begun imposing financial penalties on hospitals deemed to be readmitting too many Medicare patients within 30 days for pneumonia, heart failure, or myocardial infarct (heart attack). The presumption is that the hospitals didn’t provide proper care initially or didn’t assure appropriate post-hospital care.
Last month, the federal government announced the first round of penalties. To many experts’ surprise, the list included some of the nation’s top hospitals including Massachusetts General Hospital (ranked #1 in the latest US News report), Barnes-Jewish Hospital in St. Louis, and University of Michigan Hospital. Over 2200 hospitals across the country were penalized.
In response, hospitals will undoubtedly seek to improve any truly substandard patient care. But many hospitals may also be tempted to game the system to improve their readmission statistics.
There’s already worrisome precedent for such gaming. A recent article in Health Affairs reported a sharp rise in hospitals transferring sick ER patients to short-term “observation” beds (for up to 72 hours sometimes), which don’t count as true hospital admissions. This rise coincided with Medicare payment rules aimed at reducing hospital admissions. Hospital admissions fell, but patients received lower levels of care and likely incurred greater out-of-pocket expenses.
The ObamaCare rules will also pressure doctors to delay re-admissions. Dr. Shabbir Hossain described caring for a woman as an outpatient whose congestive heart failure recurred shortly after hospital discharge. Despite his best efforts, her condition deteriorated daily. He admitted breathing “a sigh of relief” when he got her safely past the 30-day “clock,” which meant the local hospital would be more willing to re-admit her.
Much more at the link, and it will scare you. Odd, Liberals have often decried the role that cost plays in health care, they loathe “greedy” insurance companies that consider cost, yet, ObamaCare has made that worse than ever, and in universal health care, which many Libs long for, there IS no option other than government care. I guess it is OK with the Left if the government pulls the plug on you to save money.