Are Readmissions Always Bad?
Medicare will penalize hospitals for high readmissions rates, starting in 2013. But is this a good thing? Some say it is not.
Although most agree that preventable readmissions should be avoided for the patients’ sake, many disagree on what constitutes “preventable,” saying readmissions may not reflect quality and arguing reduced reimbursement actually might be unfair. In addition, there are other correlating factors, including socioeconomic class, support, and comorbidity that might influence readmission rates, according to the report. The report separates readmissions into different classes (planned, unplanned, related, or unrelated to initial admission). It notes that public policy should focus on unplanned readmissions related to the reason for initial admission for savings and care improvements. “Payment penalties intended to shrink readmission rates could exacerbate inequities and leave hospitals with fewer resources to make needed investments in improving patient care,” states the report. “Further, misaligned policies could direct hospitals to reduce readmissions that are appropriate for safe patient care and may actually save lives.”
Everyone agrees preventable re-admissions (or preventable admissions in the first place) is a good idea. I can imagine some perverse incentives, where hospitals try to avoid certain patients because they stand a good chance of being readmitted, thus losing money for the hospital.
I think you have to be careful with how you phrase the policy. But, then again, changing reimbursement so that hospitals get paid only for the procedure, not for the length of stay, isn’t a very good idea either.
REALITY!!
( http://my.firedoglake.com/iflizwerequeen/2011/05/16/how-about-a-little-truth-about-what-the-majority-want-for-health-care/ )
( Gov. Peter Shumlin: Real Healthcare reform — http://www.youtube.com/watch?v=8yFUbkVCsZ4 )
( Health Care Budget Deficit Calculator — http://www.cepr.net/calculators/hc/hc-calculator.html )
( Briefing: Dean Baker on Boosting the Economy by Saving Healthcare http://t.co/fmVz8nM )
START NOW!
As you all know. Had congress passed a single-payer or government-run robust Public Option CHOICE! available to everyone on day one, our economy and jobs would have taken off like a rocket. And still will. Single-payer would be best. But a government-run robust Public Option CHOICE! that can lead to a single-payer system is the least you can accept. It’s not about competing with for-profit healthcare and for-profit health insurance. It’s about replacing it with Universal Healthcare Assurance. Everyone knows this now.
The message from the midterm elections was clear. The American people want real healthcare reform. They want that individual mandate requiring them to buy private health insurance abolished. And they want a government-run robust public option CHOICE! available to everyone on day one. And they want it now.
They want Drug re-importation, and abolishment, or strong restrictions on patents for biologic and prescription drugs. And government controlled and negotiated drug and medical cost. They want back control of their healthcare system from the Medical Industrial Complex. And they want it NOW!
THE AMERICAN PEOPLE WILL NOT, AND MUST NOT, ALLOW AN INDIVIDUAL MANDATE TO STAND WITHOUT A STRONG GOVERNMENT-RUN PUBLIC OPTION CHOICE! AVAILABLE TO EVERYONE.
For-profit health insurance is extremely unethical, and morally repugnant. It’s as morally repugnant as slavery was. And few if any decent Americans are going to allow them-self to be compelled to support such an unethical and immoral crime against humanity.
This is a matter of National and Global security. There can be NO MORE EXCUSES.
Further, we want that corrupt, undemocratic filibuster abolished. Whats the point of an election if one corrupt member of congress can block the will of the people, and any legislation the majority wants. And do it in secret. Give me a break people.
Also, unemployment healthcare benefits are critically needed. But they should be provided through the Medicare program at cost, less the 65% government premium subsidy provided now to private for profit health insurance.
Congress should stop wasting hundreds of millions of dollars of taxpayer money on private for profit health insurance subsidies. Subsidies that cost the taxpayer 10x as much or more than Medicare does. Private for profit health insurance plans cost more. But provide dangerous and poorer quality patient care.
Republicans: GET RID OF THE INDIVIDUAL MANDATE.
Democrats: ADD A ROBUST GOVERNMENT-RUN PUBLIC OPTION TO HEALTHCARE REFORM.
This is what the American people are shouting at you. Both parties have just enough power now to do what the American people want. GET! IT! DONE! NOW!
If congress does not abolish the individual mandate. And establish a government-run public option CHOICE! before the end of 2011. EVERY! member of congress up for reelection in 2012 will face strong progressive pro public option, and anti-individual mandate replacement candidates.
Strong progressive pro “PUBLIC OPTION” CHOICE! and anti-individual mandate volunteer candidates should begin now. And start the process of replacing any and all members of congress that obstruct, or fail to add a government-run robust PUBLIC OPTION CHOICE! before the end of 2011.
We need two or three very strong progressive volunteer candidates for every member of congress that will be up for reelection in 2012. You should be fully prepared to politically EVISCERATE EVERY INCUMBENT that fails or obstructs “THE PUBLIC OPTION”. And you should be willing to step aside and support the strongest pro “PUBLIC OPTION” candidate if the need arises.
ASSUME CONGRESS WILL FAIL and SELLOUT again. So start preparing now to CUT THEIR POLITICAL THROATS. You can always step aside if they succeed. But only if they succeed. We didn’t have much time to prepare before these past midterm elections. So the American people had to use a political shotgun approach. But by 2012 you will have a scalpel.
Congress could have passed a robust government-run public option during it’s lame duck session. They knew what the American people wanted. They already had several bills on record. And the house had already passed a public option. Departing members could have left with a truly great accomplishment. And the rest of you could have solidified your job before the 2012 elections.
President Obama, you promised the American people a strong public option available to everyone. And the American people overwhelmingly supported you for it. Maybe it just wasn’t possible before. But it is now.
Knock heads. Threaten people. Or do whatever you have to. We will support you. But get us that robust public option CHOICE! available to everyone on day one before the end of 2011. Or We The People Of The United States will make the past midterm election look like a cake walk in 2012. And it will include you.
We still have a healthcare crisis in America. With hundreds of thousands dieing needlessly every year in America. And a for profit medical industrial complex that threatens the security and health of the entire world. They have already attacked the world with H1N1 killing thousands, and injuring millions. And more attacks are planned for profit, and to feed their greed.
Spread the word people.
Progressives, prepare the American peoples scalpels. It’s time to remove some politically diseased tissues.
God Bless You my fellow human beings. I’m proud to be one of you. You did good.
See you on the battle field.
Sincerely
jacksmith – WorkingClass 🙂
This is the other side of the story. Or, as Paul Harvey used the say, “the rest of the story.”
Here is yet another simplistic idea from Washington. If someone is discharged from the hospital, has a set back, and is readmitted three weeks later, is that really a problem? Would it have been more efficient or humane to confine that person in the hospital for those three week, rather than allowing him to be at home during that time? I don’t think so.
Then, where is the logic in confining 100% of all similar cases for three weeks out of fear that some small number might be readmitted?
The potential for perverse incentives here is very high.