Medicare to Cease Paying for Hospital Screw Ups

Rarely does this journal agree with anything the Bush administration does in healthcare, but an exceptionally good decision creates an exceptional situation. Medicare is going to stop paying for conditions that could have been prevented by hospitals doing their jobs right. Starting in October 2008, any sponge left in a patient after an operation isn't going to be covered by Medicare.

According to the Wall Street Journal patient falls, pressure ulcers, urinary-tract infections, vascular-catheter-associated infections and mediastinitis (an infection following heart surgery) are chief on the list of things that Medicare won't fund. Jeff Nelligan, spokesman for the federal Centers for Medicare and Medicaid Services [CMS], which manages Medicare for the elderly and disabled, said, this "underscores the continued, steady CMS drive to become an active purchaser, not passive payer, of health care."

His observation is a keen one. A consumer who merely writes a check gets whatever the producer/providers can get away with. Paying attention can hold down costs. Private insurers, who make a profit every time they deny coverage, may well follow the CMS route. Medical mistakes may start costing people their jobs.

No one is perfect, of course, and mistakes are part of the deal when one is working with something so intricate as the human body. At the same time, bedsores are pretty preventable if the nursing staff is on its toes. When one considers that the Centers for Disease Control and Prevention estimate that 100,000 Americans die in hospitals from improper treatment or neglect, there's clearly room for some kind on consumer pressure.

Consumers of hospital care are, by definition, in no condition to go shopping for a better deal or more competent care. The only way that can come about is if a large entity like CMS stands up and says, "no more." The fact that the Bush administration is in charge makes this all the more satisfying.

© Copyright 2007 by The Kensington Review, Jeff Myhre, PhD, Editor. No part of this publication may be reproduced without written consent. Produced using Fedora Linux.

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