Show #408 Airing Sunday, 11/18/07
Medicare has actually been rewarding medical incompetence! That's right. Let's say you went to a hospital for a knee replacement, and as a "bonus" you came away with a serious infection due to the hospital's sloppy sanitary practices, Medicare footed the bill to treat the infection too! Well, this perverse system that rewards incompetence is about to change. Here to explain why is my very competent law partner, Laurie Steiner.
Question:Does Medicare really pay hospitals to fix their own mistakes?
Answer: That's right. If a doctor sews you up after surgery with a sponge left inside, the hospital gets paid for the initial surgery, and the hospital gets paid again for the surgery to retrieve the sponge.
If a patient develops bedsores because the hospital personnel fail to adequately care for the patient, Medicare pays the hospital to treat the bedsores.
If a patient falls in the hospital and breaks her hip due to the hospital's negligence, the hospital gets paid for the surgical repairs.
Under the current Medicare payment rules, hospitals get paid for extra costs caused by their own preventable errors.
Question:Is anything being done to change this?
Answer: Yes. Medicare has just announced that this is going to change. It will no longer pay extra for conditions that generally could have been avoided if the hospital had taken common sense precautions.
Question:So now will the patient have to pay instead?
Answer: No. The hospital will have to treat the problem and will have to absorb the costs. The hospital cannot turn around and charge the patient or private insurance, either.
Question:Who will benefit from this change?
Answer: We all do, for two reasons. First, it is expected that this change will cause hospitals to take better care to avoid mistakes, which will mean better health care for patients.
And second, the change will save Medicare (you and I) millions of dollars.
Question:Will this solve the problem of paying for incompetence?
Answer: Not entirely. While the hospital won't get paid for treating its mistakes, the rule change will not apply to the doctor who actually created the problem. So a doctor who left a sponge in during surgery can still get paid for the second surgery to take it out. Medicare will have to look at this problem in the future.
It seems pretty obvious that we should not be giving financial rewards for medical incompetence. I'm just glad that after 40 years Medicare has figured that out. My thanks to Laurie Steiner.
