Medicare: "Government can act with no evidence"

More problems with Medicare’s medical error P4P policy:

I am now more convinced than ever that policy is driven by money, politics and power, but I would have hoped someone would at least pay lip service to the science.

And in the NY Times, a letter with some real-world implications of the policy:

So, I admit Mrs. Jones, an elderly patient of mine, to the hospital because she has pneumonia. Because of the stress of the infection, she becomes delirious, which puts her at high risk of falling.

In the interest of safety, I restrain and sedate her, which necessitates an indwelling urinary catheter.

One week later, despite meticulous nursing care, Mrs. Jones develops a urinary tract infection and a minor pressure sore on her back because of her debilitated, immobilized state.

My hospital administrator then suggests that I remove the restraints and the catheter and reduce the doses of her sedatives so that the conditions don’t get worse and our hospital doesn’t lose money.

Two days later, Mrs. Jones falls out of bed and breaks her hip.

How, exactly, has the new Medicare policy improved Mrs. Jones’s safety?