I can tell you precisely what will happen. Sicker patients will get less care and many will die as a result of that. It is having a high number of very ill patients (as the better critical care hospitals do) that leads to a higher readmission rate. The sick and dying will be shunted off to hospice or any other hospital that will take them.

ACA “incentives” are really criminal.

No, “we” don’t allow obscene amounts of money to be made off of sickness and ageing in america; the United States government allows it, or mandates it, as evidenced by Barack Obama’s protecting of the situation when he utterly caved on a public option and had Harry Reid kill the Dorgan amendment, among numerous other examples.

We need to “punish” hospitals, while the AHIP wet-dream bill protects and secures the insurance extortion racket?

Thanks Mr. Presididn’t, you’re such a master salesman. No wait, I take that back. Salesmen offer products you can choose to buy or not buy, it’s a mobster that gives you an offer you can’t refuse and then tells you how much better off you are. Capiche?

As a staff RN in a public hospital, I can tell you that this “reform” is like the “No Child Left Behind” “reforms.” The hospitals serving wealthy populations will be rewarded, and the hospitals serving the poor will be penalized.

This is because whether a patient has to be readmitted within 30 days is mostly out of the hands of the hospital. We can give the patient great care, great antibiotics and other medications, and thorough patient teaching about how to continue his recovery at home, but we can’t control what happens after the patient leaves the hospital.

Does the pneumonia patient, for example, follow our instructions to take the antibiotics until they are all gone, go to his follow-up appointment at the doctor’s office, eat a reasonably good diet, and get enough rest? Does he call the phone number we give him, to report immediately if he develops a fever or other symptoms that we have explained to him?

Or does he stop taking the antibiotics before they’re gone, skip his follow-up appointment because he doesn’t have transportation or insurance or has to be at work so he won’t lose his job? Maybe he’s homeless and doesn’t have a place to rest, and can’t eat well. And then he relapses, and has to come back to the hospital.

So hospitals serving the poor will now get their reimbursements cut. It’s not the private profit-making hospitals that are going to be hurt, it’s the community hospitals like mine, where we are already scrambling to provide a decent level of care with too few resources.

Obama dropped his support for single-payer, the only reasonable healthcare system, the second he was elected. And now he has his sights on destroying what is left of public health care in this country. And before Jon Walker replies that public hospitals like mine charge high rates, let me agree. Rates at every hospital in this country are high. That could have been fixed by a single payer system. Instead, private hospitals squeeze their patients in order to pay their investors, and public county hospitals like mine have to charge high rates in order to cover the costs we incur by treating so many patients who are unable to pay at all.

Just more flim-flam from Obama. Disappointing to see people like Jon Walker fall for it.

Sometimes I think people like Jon need to step back a little from the political echo chamber. Spend some time with people that work in the field, in this case healthcare, and quite simply follow the money, follow the money, follow the money!

Thanks, that was my suspicion as well when I read penalized for’ higher than expected readmission rates.’

Pretty much what I thought: this sounds like NCLB (which the current administration and the Ds in general think is GREAT policy). Thanks for your reply. It’s the needed counterpoint from the perspective of how actual care is affected rather than looking at this simply as policy.

Even the best of us need some help from time to time to figure out the world around us.

Thank you for this persepective.

Aside from the destructive effects of transferring money from poor hospitals to rich hospitals (which is all this will probably amount to), I have to wonder just how much the actual transferring will cost. What is the cost of the “evaluators”, their reports, the lawyers who generate the legal documents that enable the funds transfers, etc?

Wild guess, but I’m thinking that money could be better spent on, oh, say, patient care…