Health care is so ridiculous. I see on a daily basis how ridiculous it really is. Millions and millions wasted every year on tests, treatments that are totally unnecessary. We are doing MRIs on 97 year olds. I mean really? What are we going to do if it is abnormal? Surgery? Yeah right...but hell, why not? The hospital makes a couple of thousand off that. The radiologist lines his/her pockets with money.
These tests are done for profit. In non profit hospitals. CT heart angios. Millions of unnecessary CTs. Angiograms. Back surgeries that rarely work. But hey the surgeons make a ton.
Doctors go to classes to learn how to code things in order to maximize profit. Healthcare is a money making machine for specialists and healthcare executives. They're making out like bandits bankrupting our healthcare system. They have learned how to manipulate the system for maximum profit.
Damn those medicare and medicaid patients and those with no insurance at all! Medicare keeps decreasing reimbursement! It demands we have good outcomes and is starting to not pay for bad outcomes! Who do they think they are trying to tell us almighty doctors what to do? Medicaid only pays so much. Those with no insurance, well where do I start?!!!
I find it interesting that the one system that is government run is the one demanding the most of healthcare systems: Medicare. It is linking payment to outcomes. It is refusing to pay for hospital acquired infections. It is setting standards for how certain conditions are treated and demanding the standards be met. How could they? How dare they practice EVIDENCE BASED MEDICINE?
Doctors view systems like Medicare as the ENEMY because they dare to require doctors to do what they should be doing. They say they are "losing control of their practice" blah blah blah. If you had done the right thing in the first place, you wouldn't be "losing control of your practice".
A government system, Medicare,
is proactively demanding better care. Its the only healthcare payor that is doing that. Hopefully Obamacare will do the same. It has already started to do that requiring wellness checks be paid for by insurance companies. Hopefully, these changes are only the beginning.
Now if we can only get doctors to stop whining about change.
I would like to offer a view from the other side. I was sent by my employer to one of those classes on coding "to optimize reimbursement." That reimbursement goes to the hospital. I don't see any extra. And I don't care, because that is not the reason I do what I do.
ReplyDeleteI DO have a problem with blanket refusal to pay for bad outcomes. Sometimes everybody does all the right things, and the outcome is bad anyway. Sometimes people do all the right things, and hospital acquired infections still occur, because sick people are at risk for getting sicker.
If, on my bad outcomes, you wanna look at my documentation and determine if I followed the standard of care, be my guest. If you find I did not follow the current standard of care, then don't pay me-I won't deserve it. But if everybody did everything right, and the complication still happened, and we all busted our asses to try to keep things from being worse, I have a problem with not reimbursing. Much of that reimbursement that Medicare is refusing is actually HOSPITAL reimbursement, which pays the nurses' salary.
I respect your opinion.
ReplyDeleteI had a hospital-acquired infection (pneumonia/pleurisy) which required considerable treatment in the ED and ICU. I never thought it was the hospital's fault, just a risk of an extended hospital stay in a weak condition. That was before I went on Medicare. As far as I know, it was fully covered (less deductible) like everything else. Why wouldn't it be?
ReplyDeleteNow that I am on Medicare, will a similar event not be covered? What's the rationale? How would that affect the treatment?
"the one system that is government run..."
ReplyDeleteNot quite.
You seem to have overlooked the VA.
That's been a government run healthcare system since long before Medicare.
Personally I would like to be able to rate my medicaid PATIENTS and let the rating determine the amount of out of pocket they pay. I would love to report some of these non-compliant with home meds, but super compliant with illegal substances, who like nothing better than to bitch at me and order another meal tray.
ReplyDeleteSpinal surgeries of any sort are awful. And from both a pt and nurse viewpoint, you are correct- they rarely have good outcomes. Not long-term anyway. In my case I regret ever having the 1st, I thought that pain was bad....ha.
ReplyDelete