A recent editorial comments on Medicare’s never-event policy.
There is no question that hospitals and doctors shouldn’t be paid for catastrophic mistakes, like wrong-site surgery. However, the editorial seems to support the widespread expansion of the initiative:
In the long run, as the list of conditions is expanded and more insurers follow Medicare’s lead, the savings could be substantial.
Medicare is already proposing partially preventable conditions to be added to the list, like hospital-acquired infections and delirium. No guidelines exist to prevent these complications 100 percent. Bob Wachter, among others, has discussed this in detail.
Blaming doctors for complications that cannot be totally prevented will only disincline them from treating high-risk patients, like the elderly and those with chronic diseases.
The Times’ editorial board should be careful what they wish for before trotting out their traditional anti-physician stance.
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- Will medical tourism drive domestic doctors out of business?
- Ripping the NY Times a new one
- President Bush, lauded by The New York Times? On health care?
{ 4 comments }
Welcome to my world, Kevin.
I like the idea of not paying for never events.
All valid remedies should be mutual. So if government has a never event, all taxpayers should be able to deduct its cost from their taxes.
Snow plow does not do our street. Space shuttle explodes. Overwhelming military fails to pacify a weak nation due to government lawyer interference with our warriors. Prison releases prisoner who commits a crime.
Deduct.
Or perhaps the never event called a balanced budget. Perhaps we should all stop paying taxes until they get it right. Oh wait, only half the population pays any federal income tax. Perhaps that 1/2 should stop paying.
So are you suggesting that when a patient acquires an infection that is significantly, if not 100 percent, preventable due to such factors as doctors not washing their hands, or hospitals not establishing or following protocols to limit infections, hospitals and doctors should still be paid in full? If you buy an airline ticket with a credit card and the plane crashes due to faulty maintenance, leaving you or a family member dead or injured, should you be required to pay for the ticket and any hospital or funeral expenses associated with the crash, simply because there is no maintenance protocol that can 100 percent prevent crashes? If not, please explain why medical care is different. Have airlines stopped serving passengers or “high risk” areas simply because they are not allowed to do this?
Considering the high number of deaths and injuries due to preventable medical errors every year and the medical profession’s cavalier indifference to the massive human suffering caused by these errors and failure to take adequate measures to control them, speaking the only language the medical profession seems to understand–$$$–is a good first step. Airline crashes are rare specifically because airlines cannot pass on the costs of their mistakes to their customers the way the medical profession can, so it has a far greater incentive to prevent error and does a damn good job of doing so. There’s also the fact that pilots tend to die along with their passengers when they slip up. Not many doctors get fired for preventable medical errors which number in the millions every year. And no, I don’t want to hear how making sure prescriptions are written properly and saving 11,000 American lives per year by doing so is somehow more difficult and complex than maintaining a 747. It isn’t.
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