Posted on 12/31/2018 10:39:59 AM PST by E. Pluribus Unum
To determine whether a government program is successful, it's often necessary to look not only at how well it does what it's supposed to do, but what it's doing that it isn't supposed to. For example, killing people.
Take the hospital readmissions program built into Obamacare. The program derived from a simple observation that hospitals were treating lots of people who would then return for more treatment within the month. Unnecessary readmissions cost Medicare an estimated $17.5 billion a year. If hospitals were treating people effectively, the thinking went, those people shouldn't need to return so soon.
So the health law instituted a Medicare payment penalty for hospitals with too many readmissions for pneumonia, heart failure, and heart attack. Since 2012, Medicare has assessed about $2 billion in penalties on hospitals with too-high readmissions rates.
Hospital groups have argued that these payments are punitive and unfair, particularly to so-called safety net hospitals that serve the poorest, sickest patients. These patients tend to have higher readmissions rates, and the hospitals that treat them were more likely to be hit with payment reductions. (Earlier this year, the Trump administration changed the penalty structure for safety net hospitals.)
But the program has often been labeled a success because it accomplished its primary goal. Readmissions dropped between 2.3 and 3.6 percentage points for the conditions targeted. Readmissions associated with other maladies dropped by 1.4 percent. The authors of one 2016 study suggested that the lower readmission rates "point to how Medicare can improve the care that patients receive through innovative payment models." It offered proof, and hope, that with the right incentives, Medicare could save money and provide better care.
A new study appears to dash that hope, at least as far as readmissions are concerned.
(Excerpt) Read more at reason.com ...
A similar study needs to be conducted to determine how many people are refused care and eventually die, because of their incapability to pay the much higher and unaffordable deductibles under Obamacare.
This is the great LIE of the left...
NO ONE can be DENIED care from a Hospital... They MUST at the very least treat you to a stable state before they can discharge you, regardless of your ability to pay or insurance.
Now if you have a chronic illness this doesn’t really help you as you will be stabilized, put back on the street only to get sick again because you won’t be able to afford your meds or follow up treatment... But the idea you can be denied care (at least at a Hospital) is nonsense.
This was Zeke Emanuels model, let the sick die to reduce costs.
They can, however, get nursing homes and similar facilities to fail to call emergency services or transport patients to hospitals.
My mom was in assisted living and liked it there, but had several repeat hospitalizations, so they said she could not return there, and went to a nursing home where she died within 24 hours. No care plan had been implemented. Actions they took contributed to her death. And to add insult to injury some of her stuff was stolen.
I’d wish they had at least proposed a hypothesis for how the readmissions incentives could cause this outcome.
It seems to me that the incentive for the hospital would be to not release a patient too early because doing so would increase the likelihood of readmission.
I have had to deal with that when my mother was very ill. The hospital, which had discharged her earlier in the day did not want to re-admit even though she was in a great deal of pain. They told her that she should quit complained and go back home.
They ran into the wrath of Dad and readmitted her. They had missed a major abscess as it turned out.
They drained it and she was much better a few days later. If they had managed to send her back home it probably would have burst and killed her.
I work in Health Delivery and Insurance.. I am sorry to hear about your mother, but I do laugh when I hear people talk about competition improving health care.. because folks who spew that crapola, have no idea how the system works at the most basic level.
Reality is the US already has, what is effectively, single payer, but it tries to pretend it doesn’t.
80% of what you spend on health care in your entire life, on average will be spent in the last 2 years of your life..... And guess what health care you are on when you generally die? Medicare....
Health Systems don’t make money by offering better service or facilities or any of that crap you believe, they make more money by being better at figuring out the best way to code their reimbursements to Medicare....
And because Medicare pays the overwhelming amount of the money earned, basically whatever Medicare dictates is what the rest of the industry will now do, because a hospital or doctors office, will stop taking your insurance before they will do some process that costs them time and effort and is different for Medicare reimbursement.. So the entire industry is regulatory driven.. it is the THE single biggest driver of the industry... Anyone telling you that they will improve health care with competition is wholesale ignorant, of flat out blowing smoke up your arse.
Bump
To get the highest medicare reimbursement.. hospitals had to have hihh scores on.. was your pain managed during your inpatient visit? To get money from obamacare, they created drug addicts for a few years.
I think the question has been removed, and i wasn’t quoting it verbatim.
You’re mixing apples and oranges. Get rid of the regulatory stupidity and the market will work.
I can buy and use car insurance dozens of ways. Life, term life, dental, vision, etc.
WHY is health insurance so regulated?
I work in Health Delivery and Insurance.. I am sorry to hear about your mother, but I do laugh when I hear people talk about competition improving health care.. because folks who spew that crapola, have no idea how the system works at the most basic level.
Reality is the US already has, what is effectively, single payer, but it tries to pretend it doesn’t.
80% of what you spend on health care in your entire life, on average will be spent in the last 2 years of your life..... And guess what health care you are on when you generally die? Medicare....
Health Systems don’t make money by offering better service or facilities or any of that crap you believe, they make more money by being better at figuring out the best way to code their reimbursements to Medicare....
And because Medicare pays the overwhelming amount of the money earned, basically whatever Medicare dictates is what the rest of the industry will now do, because a hospital or doctors office, will stop taking your insurance before they will do some process that costs them time and effort and is different for Medicare reimbursement.. So the entire industry is regulatory driven.. it is the THE single biggest driver of the industry... Anyone telling you that they will improve health care with competition is wholesale ignorant, of flat out blowing smoke up your arse.
Well stated. Also until you get on Medicare and see the columns of Hospital or Doctor Cost , then Medicare approved and the vast difference that is accepted under that plan you can’t conceive how these types of plans in essence cause inefficiency or over padding of the end bill. e.g. extra socks, bandaids, overpriced meds like aspirin to make up part of the bigger ticket item costs.....
No wonder many private practice doctors won’t accept patients as its , as you point out a losing proposition for them to conduct business, treat patients and profit enough to stay in business.
Sure supplemental plans help but they come into effect after the Medicare rate is applied.....
To me before you graduate high school you should be asked these basic questions.
How long will you pay Social Security
Can you Social Security benefit ever be taxed or taken back
How long will you pay Medicare.
Will Medicare cover all your medical needs or will you need your own extra plan....
Those of you who are on these programs know the answers....
The rest remain ignorant of the life long proposition foisted on them, and the real $$$ loss you suffer on SS versus a private regulated plan that may be paying even a small interest rate over time
Ten or Twenty years from now Obama & his lackeys will still be crowing about what a success the Obamacare program was. They should all be sued out of existence.
bfl
I am not missing the point, you are blind to the realities.
No deregulation won’t fix the health insurance or health delivery industries. It won’t improve outcomes or lower costs.
You could scalpal some regulations around medical device certifications and liabilitiy laws, but even that won’t “bend the curve” in any meaningful way.
People that propose the market will fix health care are flat out fools... you know how the market fixes health care costs when it’s deregulated? By letting people die, because when your simply driven by market forces, when the cost to heal you exceeds the profit they can make from treating you, the market say let em die.
The folks who push this “market Uber alles” nonsense are no less moo bats than those who push government is the solution to all problems. Just the flip side of the same stupid coin.
Let me guess, your an insurance broker.
Boomers aging=more people dying.
People not eating right, diabetes, and generally being pigs =more people dying.
People not getting vaccinations = more people dying
Everyday stress and bullshit = more people dying.
There are a ton of reasons why people are dying.
The ultimate cause of death is life itself.
Without life, there would be no death.
I don’t know too many people who can pay the $6,000 deductible year after year.
“To me before you graduate high school you should be asked these basic questions.
How long will you pay Social Security”
The Millennials will never be able to figure out even the easiest Social Security calculations. Done by Design. For example, those that pay in the most will never get their money back, or those paying in the least get triple or quadruple what they paid in. It is extremely socialized.
My husband wanted to work until he maxed out his Social Security. Whatever that meant. Didn’t sound right to me so I was able to calculate that if he worked for 17 more years paying at the max rate, he would put in something like $135,000 in today’s dollars. His employer would put in the same. And if he’d lived to the average age of 83 he would get around $33,000 back more than if he didn’t work those 17 years. Definitely not worth it as a retirement investment! Just the incentive he needed to go Galt. The higher earners get screwed.
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