There have been no postings to this site in several months. My excuse is that local and national matters of interest have reached such a state of lunacy that I haven't known where to begin. This week, however, marks the high point of lunacy with the assumed passage of health care "reform," more accurately to be considered the death knell for sensible health care in America. Most disturbing is the fact that the bill is disliked and even feared by a majority of US citizens. Nothing short of dictatorship will assuage the craving of our president for power.
Since the 2300-page text of the Health Care bill was made public just this morning, March 20, I downloaded it for a quick look-see. I have chosen a few details to explore on this blog for the edification of any readers who may show up, but mostly for my own satisfaction in having stated my opinion once again. As one small example (pages 289 to 307 of the text), I looked at:
REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS.
What I found is frightening, and is only a tiny piece of the pie. Do you happen to know who the current Secretary of HHS is? Neither do I, but I promise to look it up. This Secretary, whoever she (or he) might be, will have full power to pay or starve hospitals and physicians upon her whim. I quote in small part:
"ADJUSTMENT TO HOSPITAL PAYMENTS FOR EXCESS READMISSIONS.-
(1) IN GENERAL. - With respect to payment for discharges from a .. hospital .. on or after October 1, 2011, .. to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital .. by an amount equal to etc. etc. blah blah blah."
Do you begin to see my point? More quotes:
"MONITORING INAPPROPRIATE CHANGES IN ADMISSIONS PRACTICES. -
The Secretary shall monitor the activities of .. hospitals to determine .. steps to avoid patients at risk in order to reduce the likelihood of increasing readmissions... If the Secretary determines that such a hospital has taken such a step .. the Secretary may impose an appropriate sanction." To summarize, the Secretary of HHS will monitor hospital admissions to see if they are admitting the same patient more often than she thinks is appropriate, and will punish hospitals for trying to avoid such situations. Neat.
Another one:
"PHYSICIANS.- (1) STUDY. The Secretary .. shall conduct a study to determine how the readmissions policy .. could be applied to physicians. (2) CONSIDERATIONS.- (A) creating a new code .. and payment amount .. under the fee schedule .. of the Social Security Act (in a budget neutral manner) for services by .. a physician who sees an individual within the first week after discharge from a hospital ..; (B) developing measures of rates of readmission for individuals treated by physicians; (C) applying a payment reduction for physicians who treat the patient during the initial admission that results in a readmission; and (D) methods for .. payment reductions to the physician ..."
Am I really reading this? If your doctor treats you in the hospital and you are later readmitted, the Secretary can apply payment reductions to the doctor?
These are just a few of the readmission provisions in the huge bill. And budget neutrality is a consideration? If so, why does the bill appropriate $25,000,000 each year just to implement these 19 pages of the bill, out of 2300? I can't wait to see what is in the other 2281 pages.
Thank you for reading all of this!
1 comments:
They have been doing this for years, just so one has noticed. The sooner they get you out the door the better. One way hospitals make money is that if you are discharged at a certain time and someone is admitted shortly there after to that same bed they can charge both a full day for that one bed. Just another reason the hospitals don't want you there too long. The number increasing number of people returning to the hospital is ridulculous, for what they were just treated for and secondary infection related to such.
Janette
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