Hospitals Oppose Reform

Here we go. Hospitals, medical technicians and a medical imaging access coalition all oppose President Barack Obama's latest health care reform proposal to reduce Medicare and Medicaid spending. These organizations believe that the proposed cuts will impair access to medical care to many who need it.

The president suggested yesterday that $200 billion could be saved over the next ten years by trimming federal payments to hospitals. He justified this change by noting broader insurance coverage, so in other words, they'll make it up in volume. Many hospitals, especially those with large numbers of poor patients say these cuts will be unfair and will only hurt the poor, sick and elderly.

Although congress will sculpt the new laws, the president has influence. Obama has urged the congress to resist powerful lobbies trying to maintain their clout and profits. Like those greedy hospitals, medical technicians and imaging centers (X-rays, MRIs, CT scans), I presume. All in all, the president wants to cut $313 billion in both federal programs over the next decade.

All I can say is, "Wow!" Already being one of the worst reimbursing insurances in the country, Medicare under Obama's proposal would pay even less? Does anybody have any idea of what the consequences will be? Why don't we ask The Access to Medical Imaging Coalition, a trade group representing diagnostic imaging centers and their patients,

It would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures."

The group also said Obama's efficiency estimates were based on a flawed survey. You don't say...

What else? Some believe that providers--doctors, hospitals, imaging centers--will have to ration services due to the cuts. No kidding--what else do you think will happen? Do you think that doctors will pay for a patient's lab tests themselves? C'mon! If you have been reading this blog lately, then you know I've been saying it repeatedly--health care reform, as proposed by our current government, will do little to improve health care and a lot to diminish its quality. Unfortunate, since quality is the one thing American health care has got going for itself.

Health Care Changes On the Rise

You know how I feel about our current health care system--fabulous in many regards, but definitely in need of changes. One obvious change needs to be the enormous waste that goes on in the U.S. hospital system. Along with that needs to be better measures toward curbing medical mistakes, now one of the leading causes of death in this country.

But times, they are a changing: Recent reports disclose that Medicare, the nation's federal health insurer, will stop paying for medical errors and waste starting October 1, 2008. Whoa. Like what, exactly? Preventable hospital errors that will no longer be covered by Medicare are, among other things, catheter-caused urinary tract infections, injuries from falls, and objects left in the body after surgery. The rationale from Medicare is that not only will hitting hospitals in the wallet press them to tighten up on mistakes, but it will also lower costs, as the government estimates the cost of errors to be $10,000 to $100,000 per mistake, which usually gets tacked on to the patient's bill ($9.3 billion in excess charges per year). Doh! Next year, there will be three more errors added to the no-pay list--ventilator-caused pneumonia and drug-resistant staph infections head up the list--and Medicare believes that it will save the government $190 million over five years.

Well I guess I have mixed feelings about this latest news out of the federal government. Overall, I think it is a smart move. There is way too much nonchalance about standard medical procedures. For instance, the Medicare report disclosed that 25% of all hospitalized patients receive urinary catheters as standard procedure, despite the fact that many don't need them. Catheters trigger more than half a million urinary tract infections annually, the most common hospital-caused infection. Ouch! Even worse is that many catheters are left in longer than needed, causing infections. Last year, the University of Michigan conducted the first national study of catheter practices and found that almost 50% of hospitals don't keep track of which patients get one--now that's carelessness. Double ouch!

So, as I said, overall it's a good idea: Money talks; and when you threaten to withhold funds, it's amazing how fast things get fixed. But I am a bit ambivalent for two reasons. First, it might lead to hospitals and doctors hiding mistakes--not a comforting notion. And when the pressure is on, people and organizations have a way of rationalizing their decisions, even if those decisions lead to mistakes, and that might not be good for consumers. The other thing that worries me, especially as a health care provider, is that the insurance companies might use this move by Medicare to rationalize their own denial of claims. Medical insurers do as Medicare does, and they are notorious for using any weapon at their disposal to withhold payment of claims; because for them, it really is all about the money.

So I guess we'll have to wait and see. Nothing comes without problems: All good things come with complications, this situation being no different. But, all in all, we need to decrease the amount of medical mistakes taking the lives of Americans annually--it's just way too high. We have the greatest medical system in the world; it just doesn't make sense to lose so many people to medical mistakes; 82% of the deaths caused by medical mistakes are preventable, so why not nip them in the bud now? I guess that's what Medicare is trying to do. We'll have to see how it turns out, but I'm guessing it's the right move to make.