Hospitals Refuse to Readmit Sick Patients — They Die — The Next Headline

With the VA scandal still in the throws of discovery it is clear that the federal government incentivized the fraud that led to 100’s of veteran deaths.  Bonuses were paid to federal employees if it looked like the VA was doing its job and taking care of patients.  This lead to massive fraud.  No one actually verified that the patients were taken care of.  

In non-VA hospitals:

“The U.S. has begun levying fines against hospitals that have too many patients readmitted within a month, and rewarding hospitals that do well on a benchmark of clinical outcomes and patient surveys. ”  (http://www.bloomberg.com/news/2014-06-26/hospitals-soon-see-donuts-to-cigarette-charges-for-health.html)

In other words, regular hospitals are being paid if they can prevent patients from being re-admitted.  My guess, based on human nature, is that some patients have already died because hospitals have refused to admit them.  This is no different than the VA scandal where people are rewarded for not providing appropriate care.  

Just think of it this way.  A recently released heart patient develops an arrhythmia.  It’s been 29 days since he was last discharged.  In order not to pay out extra in fines, the hospital tells the patient he needs to wait three days before he comes in.  He dies in the meantime.  How many times will this scenario be repeated. Once again government intervention results in untimely deaths.  Yet the hospital and its administrators have a better bottom line.  

It is time to get the government out of health care.  The government’s interest is not patient health but cost control and if patients die on the way, so be it.  The VA situation has proven this to be the case.  The stage is set for many, many more avoidable deaths.

Our Veterans Deserve Better — Here is the Fix

There are lists of over 1000 veterans waiting for their first appointment at bunches of VA hospitals.  How that happens baffles me.  The fix is simple, Hire 10 doctors seeing 3 patients an hour for 8 hours a day.  (Any doctor in private practice will tell you that they often see 8 to 10 patients an hour, so 3 is peanuts.)  Each doctor would see 24 patients a day so that is 240 patients per day for the 10 doctors.  In a week they have seen 1200 patients and in two weeks the backlog is gone.  Keep the 10 doctors and support staff to take care of the follow up and in two months you have either treated and released, admitted, tested, or set up ongoing therapy for 2400 patients all who were initially seen and evaluated within two weeks.

In order to enroll, document and plan for the influx you will no doubt need to hire 5 nurses, and 5 front desk folks, schedule labs, hospital admissions, equipment purchases,  plan for in-house lab tests and outsourced lab tests, plan for reviews of those tests and arrange for treatment protocols with follow up.  Any competent medical office manager could do this blindfolded while having a stroke.

The fact that this was not done in all these facilities is a total mystery.  It’s simple resource allocation.  Competent people do it in every business and healthcare organization in the country every day.