Obama.Care’s penalties on hospital re-admissions will kill off the sick and elderly

You clearly have no idea what you're talking about.

Firstly, this isn't on a patient by patient basis. The CMS compares a hospital's readmission rates for Medicare patients, admitted with heart attack, heart failure and pneumonia, against the national average. If the rates are found to be excessive, this can lead to a maximum reduction of 1% of the base Medicare reimbursements for the following year. There is no "death panel" making life and death decisions about which patients can or cannot be re-hospitalized.

Secondly, the longer that a patient is in a hospital, the more chance that person will get something like pneumonia, MRSA, sepsis, pressure ulcers (bed sores), etc — people shouldn't be in the hospital longer than they need to be and many readmissions could be avoided.

The program actually fosters better care and to provide further incentive, there's a second program called Value Based Purchasing that rewards hospitals monetarily, based on quality metrics, from a pool created by withholding 2% of Medicare reimbursements.

It's more of a nudge than anything. In fact, the hospitals could just say screw it and continue trying to bilk the tax payers with unnecessary readmissions and just forfeit the 1%.

a reply to: theantediluvian

But I would consider the fact that maybe a few hospitals with those bell ringing records might have more Medicare patient populations ?

Sounds like an excuse to further the death panel agenda.

How can they compare a hospital's statistics with somebody's life just because they are close to a care facility that may have a high concentration of patients with specific medical conditions that have a higher than normal rate of re-occurrences in a short time frame?

a reply to: theantediluvian

Triple-Amputee Iraq Veteran's Struggle with VA Bureaucracy Heads into 8th Month

He told us that "about a year ago" he received paperwork from the Department of Veterans Affairs (VA) informing him that he "was being overpaid." He said the VA claimed they had "overpaid [him] something like $4,000."

Kolfage said his initial reaction was, "What the heck is this?" He called the VA and told them he was never overpaid and he that was trying to understand what was going on.

The phone call was followed by more paperwork and forms that he had to fill out before, Kolfage says, the VA told him what was going on: "They said that because [he] was remarried and had not informed them that [he] was divorced before getting remarried, they ended up overpaying 'X' amount of dollars." The letter explaining the situation came approximately eight months ago—September 12, 2013.

-
I know this is a VA incident ( and not an ACA incident ) ...

HOWEVER

If the "Federal-Government-Beuracracy" can be THIS NIT-PICKY with a ... Triple-Amputee-Veteran ???

WELL

Go Ahead ... PLAY the GUESSING-GAME !?!?!?
.

a reply to: dukeofjive696969

I'm anxiously awaiting this weeks anti-Hillary thread. Xuenchen doesn't normally make them, but they're here on a weekly basis.

As for the OP, you weren't upset when hospitals and private insurance companies did it, but when the government's insurance (medicare) started doing it...only then were you upset. Government = bad, private industry = good!!!

Dang it all. Who wrote this ACA bill anyway? I went to the relevant section of the actual text (page 347-350) and can't make heads or tails of the screwy thing. Now I have a good IQ, a masters degree, strength in reading comprehension and spatial relations - but this made my eyes cross. From what I can suss out, the hospital will be paid less money based on some weird calculation for "high risk medicare" patients who are readmitted less than 30 days from the time they are initially released. So, yeah, I can see a hospital wanting to put off treating a bypass patient for a post surgery infection until day 31.

ACA Text

As for death panels? Yep, I laughed too until I read Dr. Ezekiel Emanuel's (that would be Rahm's brother) paper on distribution of health resources in an environment of scarcity. Dr. Emanuel "helped design" (his quote) the ACA. His paper comes downs to a system called "Complete Lives System". Now, admittedly, this paper looked at how to dole out healthcare when assets are scarce - but not too much of a stretch to see that's going to happen.

The Complete Lives System (CLS) gives priority to adolescents and young adults (ages approx. 10-45). The thinking is that, up until 10 years of age, society really hasn't put a lot of resources into a human being. After age 45 or so, the return on investment of that person decreases. Probable health issues outweigh any benefit of treating a 55 year old over a 30 year old. CLS also adjusts for quality of life (Quality Adjusted Life Years QALY) stating that a person who is 30 and blind doesn't have the quality of life of someone 30 and sighted. Then there's the one that bothered me, since I have an incredible smart 15 year old with autism. Disability Adjusted Life Years (DALY) where you adjust the life years for the potential productivity and usefulness to society.

We're not there yet, but as medical resources become scarce and funding dries up (since we're pretty much bankrupt as a country) it wouldn't be surprising to see this triage scenario - starting with the older, more expensive, folks.

Principles for allocation of scarce medical interventions

originally posted by: links234
a reply to: dukeofjive696969

I'm anxiously awaiting this weeks anti-Hillary thread. Xuenchen doesn't normally make them, but they're here on a weekly basis.

As for the OP, you weren't upset when hospitals and private insurance companies did it, but when the government's insurance (medicare) started doing it...only then were you upset. Government = bad, private industry = good!!!

Mr. Clever as usual. This topic is about Medicare.

Where was I "never" upset with the system prior to PPACA?

Did Medicare do this before ?

If it's in the new 0bama-law, it must be a new concept.

originally posted by: xuenchen
a reply to: theantediluvian

But I would consider the fact that maybe a few hospitals with those bell ringing records might have more Medicare patient populations ?

Sounds like an excuse to further the death panel agenda.

How can they compare a hospital's statistics with somebody's life just because they are close to a care facility that may have a high concentration of patients with specific medical conditions that have a higher than normal rate of re-occurrences in a short time frame?

"How can they compare a hospital's statistics with somebody's life"

There is no action on a PATIENT BY PATIENT BASIS.

The readmission rate for ALL MEDICARE PATIENTS, for three illnesses, are compared against the national averages. What part are you having trouble with? There is no assessment of individuals or comparison of individuals.

Let me illustrate this to you with an example. If a hospital admits 10,000 patients a year for heart attack and 20% of them are readmitted within 30 days after release and the national average is 15%, then that hospital could lose 1% (1 penny of every dollar) of Medicare reimbursement payments for the next year. That means that if they billed $250,000,000 the following year for the next 10,000 patients, they might only receive $247,500,000 from Medicare.

So you honestly have no idea what you're talking about and you have the nerve to "lol" while you're spreading disinformation about a "death panel agenda."

a reply to: xuenchen

What was that again, xuenchen? Obama I don't care will take care of the poor and needy and sick, right? oh, my bad I forgot that nowhere it said that the sick will be treated.

Yes, once again Obama I don't care prove that it was nothing but a bailout to the insurance companies at the expenses of the working class.

So let screw the poor, needy and sick, they are nothing but burden on the system and insurance profits.

The irony.

a reply to: Mountainmeg

That's cool but Dr. Ezekiel Emanuel didn't write the PPACA. From what I understand, it originated with a whitepaper from Max Baucus that was actually drafted by Liz Fowler.

Fowler's career in Washington stretches back more than a decade, when she first left a private sector hospital group in Minnesota in 2000 to join the Health Care Financing Administration, a federal agency now known as the Centers for Medicare & Medicaid Services (CMS).

By the following year, Fowler had landed at the powerful Senate Finance Committee, working on health care issues for Montana Democrat Max Baucus. Lobbying records show that Fowler stayed until 2006, when she departed for a two-year stint at health insurance company WellPoint, only to return to the Senate in 2008, again working on health policy for Baucus.

When it comes to health care, and health lobbyists, Baucus isn't just any senator. Since 1998, he has collected more than $5.1 million in campaign contributions from the insurance, pharmaceutical and nursing industries, making him one of the health care sector's most heavily backed lawmakers.

source

She went on to become an adviser for the President and then in 2012 she returned to the private sector to work for Johnson & Johnson. Xeunchen in his urgency to induce mass hysteria would have you believe that the PPACA is all about a "death panel agenda" and destroying insurance companies because of.. umm... communism? Who can even keep up? That kind of misinformation doesn't further the cause of the people, that just makes detractors look like clowns.

In actuality, I'd say that the PPACA has a lot more to do with getting as many people covered by PRIVATE HEALTH INSURANCE as possible, filling their risk pools with younger healthier people. The PPACA never seemed like an ideal solution to me — it's more like a compromise to get more people insurance while increasing the profits of insurance companies.

a reply to: theantediluvian

You still haven't submitted any justifications for this Medicare outrage.

Obviously you are in full support of such things, but can you show us the "advantages" ?

The penalty for hospital readmission within 30 days CAN be a good thing. The 76 year old owner of the business that employs me was admitted for heart surgery at the end of April. Rather than discharge him in the customary 48 hours after this surgery, the hospital kept him an additional day just to make sure he was clotting and healing properly, to avoid a re-admission.

BTW... the same rationing issues experienced by the Veteran Administration is coming to Private Medical Care too. For better or worse, when you see the V.A., you're seeing the future of private medicine. It's by design. The 23,000 page Affordable Care Act goes WAY beyond what we're seeing today. Only 60% of this 23,000 page law has been converted into actual rules/procedures thus far!
-cwm

a reply to: theantediluvian

Xeunchen in his urgency to induce mass hysteria would have you believe that the PPACA is all about a "death panel agenda" and destroying insurance companies because of.. umm... communism?

Well I'm not the first to send "mass hysteria".

It seems a certain person (not that you are a fan or anything) actually got some specific language pulled from the Senate PPACA before it passed.

Good thing somebody read the damn thing and spoke up or we would have doctors giving legal advice without a license !!

"Death panel" is a political term that originated during the 2009 debate about federal health care legislation to cover the uninsured in the United States used to describe the system's Independent Payment Advisory Board (IPAB). The term was coined in August 2009 by Sarah Palin, the former Governor of Alaska, when she charged that the then-proposed Patient Protection and Affordable Care Act would create a "death panel" of bureaucrats who would decide whether Americans—such as her elderly parents or children with Down syndrome—were "worthy of medical care". Palin's claim has been referred to as the "death panel myth",. Palin specified that she was referring to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options.

Palin's claim was criticized in editorials by mainstream news media, fact-checkers, academics, physicians, Democrats, and some Republicans. Prominent Republicans such as Newt Gingrich and conservative talk radio hosts Glenn Beck, Rush Limbaugh and Michelle Malkin backed Palin's statement. One poll showed that after it spread, about 85% of Americans were familiar with the charge and of those who were familiar with it, about 30% thought it was true. Due to public concern, the provision to pay physicians for providing voluntary counseling was removed from the Senate bill and was not included in the law that was enacted, the 2010 Patient Protection and Affordable Care Act. In a 2011 statement, the American Society of Clinical Oncology bemoaned the politicization of the issue and said that the proposal should be revisited.


Death Panel

The Independent Payment Advisory Board (IPAB) [another Death Panel] I think has been stalled by no-funding (Thank Gawd !!)

I think the PPACA is in file cabinets in the back compartment....

a reply to: xuenchen

i just thought that it would be a good idea to put the name of the panels.
one is.

Independent Payment Advisory Board ( IPAB )

this from the wiki,

The Independent Payment Advisory Board, or IPAB, is a fifteen-member United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which has the explicit task of achieving specified savings in Medicare without affecting coverage or quality.

this is the one that really says it all to me.
Patient-Centered Outcomes Research Institute ( PCORI )

from the wiki

The body is charged with examining the "relative health outcomes, clinical effectiveness, and appropriateness" of different medical treatments by evaluating existing studies and conducting its own. Its 19-member board is to include patients, physicians, nurses, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts. It will not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment. Medicare may take the Institute’s research into account when deciding what procedures it will cover, so long as the new research is not the sole justification and the agency allows for public input

we should be aware that these two groups are the ones who will be deciding what care is given. no matter what all the pretty words in the description of their jobs, they are set in pace for the one payer system that is coming down the road.

they plainly say that they will cut cost and evaluate treatment options, how much more plainer can that be.

a reply to: hounddoghowlie

Yup !!

The Death Panels are real.

They are very careful about the wording and emphasis.

Lots of legal mumbo-jumbo and plenty of "calculations" that would make Einstein dizzy.

The idea of not treating old folks is already in play. My 87 year-old relative who is a WWII veteran was told by his VA doc that his problems couldn't be solved because it would cost too much and he was "too old" to be treated for the neck issues he is experiencing. The VA wouldn't even do testing to see what was causing his pain because in his doc's words, "You would need surgery and they're not going to pay for surgery on someone as old as you are." This despite the fact that he is otherwise healthy, lives alone and cares for himself and his cat completely.
His private physician told him the same thing when he went to him with his complaint. His reason for not testing and treating him was much the same, "You have had bypass surgery and you're 87 years old so you're not a candidate for any type of surgery because you might not wake up from it." He went on to say that Medicare wouldn't pay for procedures that would probably kill him.
The old man told both docs, "It's not dying I'm worried about, it's having to live with this pain and other problems. If I don't wake up, at least I wouldn't be in pain anymore."
They are more than happy to supply him with prescriptions for pain pills which he won't take because he says they make him forgetful, dizzy or groggy all the time.
When I heard his story ...I was so angry and so hurt for him that I wanted to just smack someone up side the head. I don't care who instituted this policy---they are evil. It is an evil society that does not respect and treasure the elders of the society.

a reply to: xuenchen
My friend, their going to put, The Death Panel Clause back in?

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Obamas Death Panels

a reply to: windword

but it won't help those with chronic illness or diseases that can't be cured but only need treated when flareups or other related problems occur. even if the goal of that section of the aca was to fix the problem you bring up it really won't, the hospitals will use it to lower costs and reduce already strained worker load by refusing admission.
hell i'm on medicare/medicaid because i have such an illness but i'm restricted in how many e.r visits i can make as it is(i think it was 3 or 4 times a year or maybe a few more) and they have refuse to pay for an ambulance for years so i have a huge debt i can never pay.

i can tell you with what i've seen that hospitals, other medical related organizations/facilities and their employees only do a minimum of effort as is required to provide care for patients and that they will jump on every opportunity to save cost, time and effort even if others suffer for it.
too many medical professionals are jaded and apathetic towards patients/customers that i doubt any part of a law like the aca will fix the real problems, i mean the whole goal of this law is to save money and increase how many are under a "cost effective" plan, it is not meant to help people or improve quality of care or relieve the lack of nurses, supplies, equipment and beds for patients/customers, nor will it make any of it cheaper.

i'm sorry to say this but the aca will make everything even more costly, lower quality of care further and set us on the path of uncontrolled privatization subsidized by the government through massive taxes on the people.
it's already showing the signs of this but i guess people never learned from the past failures with government sponsored privatization of industries and utilities in this country or how costs have jumped and quality has dropped by huge margins over the past few decades, we are falling behind in every sector at home as it is, this will be just another damaging failure for this country.

a reply to: Mountainmeg

Dang it all. Who wrote this ACA bill anyway?

The Fox was allowed to write the security protocols for the Hen House...

Big Pharma bought every politician in both parties to ensure the eventual enslavement of whats left of the middle-class...