medicare and medical procedures

apparently medicare is no longer going to cover hospital procedures and treatments of complications and issues that develop while a patient is in the hospital that are considered “reasonably preventable”.  i was talking to ola about this, and between us, we think it’s a bad idea.  the new york times article about the issue focuses on the possible major pluses – it holds hospitals more accountable for better care, the charges that medicare doesn’t cover will not be something that the patient is going to be responsible for, etc.  consumer groups say that it’ll create more accountability and increase quality of care.

however.

this expense ends up being something that the hospital has to foot.  this is something that is going to have a very uneven impact on various hospitals.  for example, many private hospitals may/can start refusing to admit patients with medicare, or transferring them to other hospitals.  the hospitals that these patients will be transferred to, or go to in the first place, are hospitals like Harlem Hospital in Harlem, which is already totally overcrowded and underfunded.  This adds new patients (often chronic patients, because those are the patients MOST likely to be at high risk for things like bedsores and UTI’s due to catheters), and then when the inevitable occasional infection happens, made more common due to understaffing due to underfunding, it costs the hospital more money which leads to futher underfunding, and in the long run, maybe further understaffing. 

how is a policy that will encourage hospitals to “bounce” patients going to be good for the patient?

and it further fuels inequality, because those hospitals with the most ability to bounce patients are the private, well-funded ones, whereas the hospitals that cannot/will not refuse or transfer these patients are the ones that don’t have enough resources anyway.

i understand that there is a problem in many hospitals with these infections, bedsores, etc.  mistakes are made, sometimes people ARE careless.  however, this solution just seems like something that will further marginalize hospitals and patients that are struggling instead of trying to implement new quality-of-care guidelines that several hospitals have put into place.  these guidelines have significantly reduced infection rates at the hospitals where they have been implemented.  why not try that?

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3 Responses to “medicare and medical procedures”

  1. bad BAD BAAADD.
    What we really need to do is starting holding PEOPLE accountable for their own damn preventable illnesses, but oh no, this is America. We couldn’t possibly hold the individual responsible for their life. That’s the government’s problem, right?

    🙂

  2. hmmm…about this one i’m not sure i was clear. this thing is about infections etc that develop AFTER a patient is in the hospital…bedsores, catheter infections, etc. if somebody is admitted with a UTI, it’s not treated the same as if they develop one from their catheter, or develop an infection from their IV.

  3. I think a good question here is “What is reasonably preventable?” If you look at research, even with the best care these things (like UTI from a catheter and bedsores in a patient with limited mobility) do happen. Heck, even Christopher Reeve, with the best care that money can buy and inexhaustable resources, died of a pressure sore. I had not heard this latest Medicare mandate but it seems to me like another example of health policy being made by people not in the healthcare field.

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