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patrickt
10-01-2012, 07:04 AM
"WASHINGTON (AP) -- If you or an elderly relative have been
hospitalized recently and noticed extra attention when the time came to be
discharged, there's more to it than good customer service. As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications."
http://hosted.ap.org/dynamic/stories/U/US_MEDICARE_PENALTIES?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2012-09-30-05-02-01

I'm not a doctor or healthcare professional and I've read no more of the Obamacare business than have our congressmen but as I read this I can see two ways for a hospital to guarantee no fines.

Some years ago an elderly friend of mine had a heart valve replacement and had no family in the U.S. I went and stayed with her until she was fully recovered. I met with her surgeons and recovery doctors and she came home relatively soon after surgery. I took her temperature every hour if she was awake over concerns with infection. I ferried her to appointments at the hopspital and doctors' offices. She did not have any complications but one obvious way to avoid the fine, should complications occur, is to simply not release the person from the hospital until the patient is fully recovered. That would, of course, increase costs significantly and could cause a shortage of hospital beds but that's not a problem for the government, is it?

Another solution is to not readmit the patient. If the patient dies there is apparently no penalty. So, the hospital simply denies there is any need to readmit the patient.

Please consider before you reject my thoughts as impossible that in Great Britain under the NHS, emergency rooms were penalized if they had more than a four-hour wait for patients in the emergency room so they simply locked the doors and didn't let people enter until they cleared the backlog. The NHS also had a court order to send patients to other countries for service if the NHS couldn't treat them before they were scheduled to die.

Peter1469
10-01-2012, 02:25 PM
That will encourage doctors to see more elderly patients.....

Beevee
10-01-2012, 02:55 PM
"WASHINGTON (AP) -- If you or an elderly relative have been
hospitalized recently and noticed extra attention when the time came to be
discharged, there's more to it than good customer service. As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications."
http://hosted.ap.org/dynamic/stories/U/US_MEDICARE_PENALTIES?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2012-09-30-05-02-01

I'm not a doctor or healthcare professional and I've read no more of the Obamacare business than have our congressmen but as I read this I can see two ways for a hospital to guarantee no fines.

Some years ago an elderly friend of mine had a heart valve replacement and had no family in the U.S. I went and stayed with her until she was fully recovered. I met with her surgeons and recovery doctors and she came home relatively soon after surgery. I took her temperature every hour if she was awake over concerns with infection. I ferried her to appointments at the hopspital and doctors' offices. She did not have any complications but one obvious way to avoid the fine, should complications occur, is to simply not release the person from the hospital until the patient is fully recovered. That would, of course, increase costs significantly and could cause a shortage of hospital beds but that's not a problem for the government, is it?

Another solution is to not readmit the patient. If the patient dies there is apparently no penalty. So, the hospital simply denies there is any need to readmit the patient.

Please consider before you reject my thoughts as impossible that in Great Britain under the NHS,emergency rooms were penalized if they had more than a four-hour wait for patients in the emergency room so they simply locked the doors and didn't let people enter until they cleared the backlog. The NHS also had a court order to send patients to other countries for service if the NHS couldn't treat them before they were scheduled to die.

One of them, some of them or all of them?

bladimz
10-01-2012, 04:02 PM
Well, i wish the hospital had kept my dad in recovery for a little longer than 2 days. In the hospital on a Monday, surgery on tuesday, released on wednesday and dead on friday (from complications).


Another solution is to not readmit the patient. If the patient dies there is apparently no penalty. So, the hospital simply denies there is any need to readmit the patient.The hospital might have a tough time with that one.

Trinnity
10-01-2012, 04:12 PM
It's an old story. The hospital is pressured as a matter of reality to get people out asap. Often they're not quite stable. So back they come. Govt does not understand that human beings can't be treated like machines. I don't know how else to phrase it. It's very complicated.

Calypso Jones
10-01-2012, 04:32 PM
Doctors have way better PR than insurance Companies. Insurance Companies do not make the rules. The doctors do. And then the doctors blame their unpopular decisions on insurance companies. More doctors know how to work the insurance system in THEIR favor and to hell with you Mr/Mrs. Patient.

coolwalker
10-01-2012, 04:51 PM
I just wish someone would straighten out the billing procedure for hospitals and operations. One of my daughters has had to have eye surgery now a couple of times and I get bills from virtually everywhere, with just amounts due. I have nothing itemized, I don't even know why I should have so many different bills. I has skin cancer a couple of years ago and had no less than 15 different places "look at" a small segment of my skin to say, yep, it's cancer. 15 mind you. I can see 2 or maybe even three, but 15!

patrickt
10-01-2012, 04:51 PM
One of them, some of them or all of them?

None of the articles I read mentioned and triage in the parking lot. But, my point was that when the government makes rules they don't consider the variety of ways employees can circumvent the spirit of the rules. If the government says that if the person gets readmitted within 30 days then the hospital is fined then the goal becomes to not readmit the patient.

Beevee
10-01-2012, 05:08 PM
None of the articles I read mentioned and triage in the parking lot. But, my point was that when the government makes rules they don't consider the variety of ways employees can circumvent the spirit of the rules. If the government says that if the person gets readmitted within 30 days then the hospital is fined then the goal becomes to not readmit the patient.

When the government doesn't make the rules, the country incurs massive debt by out of control businesses. You can't have it both ways.

Captain Obvious
10-01-2012, 05:12 PM
It's "pay for performance", been in the works for years. The fact that some media are tying this to Obamacare is a joke - it's been around for almost a decade conceptually.

Here's the conundrum though, these are inpatient cases and Medicare pays a flat reimbursement for inpatient stays. Simple pneumonia for example, say Medicare pays $5,000 for this DRG. The hospital gets $5,000 if that patient stays 2 days and they get the same amount if the patient stays 10 days. All things considered, there are "outlier" factors that kick in considering certain comorbidities, but on one hand hospitals are incented to get patients out fast and on the other hand they're punished for getting them out too fast (hence the "readmission" penalty).

Trinnity
10-01-2012, 05:20 PM
Thanks for the insight, Cap. That helps.

head of joaquin
10-01-2012, 05:39 PM
It's an old story. The hospital is pressured as a matter of reality to get people out asap. Often they're not quite stable. So back they come. Govt does not understand that human beings can't be treated like machines. I don't know how else to phrase it. It's very complicated.


The GOP model is simple: if you don't have money, you don't get medical care.

Meanwhile, sensible people realize we have to hold hospitals accountable for the money they get from the taxpayers. It's simple ironic, if not hypocritical, to hear the usual teaparty suspects whinging about it.

Peter1469
10-01-2012, 05:46 PM
The GOP model is simple: if you don't have money, you don't get medical care.

Meanwhile, sensible people realize we have to hold hospitals accountable for the money they get from the taxpayers. It's simple ironic, if not hypocritical, to hear the usual teaparty suspects whinging about it.


The GOP model is simple: if you don't have money, you don't get medical care.

tiger, that is what your mother would have called a lie. An untruth. Being a bad tiger.

And I would appreciate it if you didn't confuse the Tea Party(ies) with the GOP. We are taking over!

Captain Obvious
10-01-2012, 07:27 PM
The GOP model is simple: if you don't have money, you don't get medical care.

Meanwhile, sensible people realize we have to hold hospitals accountable for the money they get from the taxpayers. It's simple ironic, if not hypocritical, to hear the usual teaparty suspects whinging about it.

Baseless rhetoric.

What is not baseless rhetoric is liberal democrats paving the way for illegal immigrants to enter the country and take advantage of healthcare services through emergency rooms.

Fail

patrickt
10-01-2012, 07:36 PM
When the government doesn't make the rules, the country incurs massive debt by out of control businesses. You can't have it both ways.

That makes no sense. The country incurs massive debt when the government does make all the rules.

Beevee
10-01-2012, 09:11 PM
That makes no sense. The country incurs massive debt when the government does make all the rules.

What rules did it make that allowed Wall Street to run riot?

Peter1469
10-01-2012, 09:22 PM
What rules did it make that allowed Wall Street to run riot?
Wall Street wrote the rules....

Goldie Locks
10-01-2012, 09:45 PM
http://newsbusters.org/blogs/tom-blumer/2012/09/30/steven-rattner-we-need-death-panels-will-politifact-reverse-lie-year-tag

Steven Rattner: 'We Need Death Panels'; Will PolitiFact Reverse 'Lie of the Year' Tag on Palin?


The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Rattner has only admitted what anyone who has studied the situation already knows: ObamaCare will lead to rationing, which will lead to life-death decisions being made outside of patients' and their families' control. PolitiFact's Halon was and is wrong. Palin was and remains right. Halon and PolitiFact should own up to their error. It's an extremely safe bet that they won't. Leftists rarely do.

Calypso Jones
10-01-2012, 09:47 PM
I just wish someone would straighten out the billing procedure for hospitals and operations. One of my daughters has had to have eye surgery now a couple of times and I get bills from virtually everywhere, with just amounts due. I have nothing itemized, I don't even know why I should have so many different bills. I has skin cancer a couple of years ago and had no less than 15 different places "look at" a small segment of my skin to say, yep, it's cancer. 15 mind you. I can see 2 or maybe even three, but 15!

everybody wants a piece of the action. I worked for an insurance company. My baby's doctor was always cheating my insurance company and i got the distinct impression he thought i'd enjoy helping him. I told him that I PAID THE PREMIUM so that cheating my insurance company was cheating me.

Beevee
10-02-2012, 04:30 AM
Wall Street wrote the rules....

It's interesting to note that one Republican is quite happy for his country to have been flushed down the pan as opposed to not being flushed down the pan, had government control been in place.

bladimz
10-02-2012, 11:19 AM
Doctors have way better PR than insurance Companies. Insurance Companies do not make the rules. The doctors do. And then the doctors blame their unpopular decisions on insurance companies. More doctors know how to work the insurance system in THEIR favor and to hell with you Mr/Mrs. Patient.
Them what got's the money makes the rules.