Medicare won't pay for medical mistakes anymore

Accountability is a good thing, right? I'm all for it. So you'd think I'd be pleased by the fact that earlier this month, Medicare announced that it will stop paying hospitals for medical procedures to correct hospital errors. For example, if the surgeon mistakenly sews up his scalpel inside of you after your operation, the hospital's got to pay to take them out.

It's only common sense, right? So why am I so nervous? Read on.

Medicare is the government assistance program that provides healthcare coverage for the elderly and disabled. The overseers of this program have just announced a list of 10 "reasonably preventable" conditions that will not be covered, including post-operative infections from select procedures, bed sores, injuries resulting from falls, and incompatible blood transfusions.

The fact that Medicare - the nation's largest insurer - has made this proclamation has sent ripples throughout the healthcare industry. Major private insurer like Aetna, Cigna, and Blue Cross Blue Shield have followed suit, and some state hospital associations have agreed not to bill for these so-called "never events" (occurrences that are "never supposed to happen).

This is the first step toward the "pay-for-performance" trend in the government. The idea is to reward steps taken for prevention, managing chronic disease, and a reducing the number of unnecessary procedures.

"The whole trend is like a juggernaut, and it is not going to stop," says Dr. Donald M. Berwick, president of the Institute for Healthcare Improvement.

The refusal of Medicare or Medicaid to pay for these "never" events could be seen as a rare effort to finally impose some accountability on hospitals and a system that's been accepting of the adage that, as they say, "sh*t happens." And on that level I applaud this move.

According to one hospital president, "Historically there's been some acceptance that these things happen; we've come now to accept that they're avoidable. And that's a sea change."

But there's something about this that makes me uneasy.

Sure, this initial list by Medicare has just 10 things that aren't ever supposed to go wrong. But apparently another pay-for-performance measure by the program has experimented with rewarding physicians who follow protocols for congestive heart failure, coronary artery disease, and diabetes.

But this sounds suspiciously to me like government mandated medical treatments. Who, after all, is setting these "protocols?" And with new studies and research published every day, is it realistic to think that a government bureaucracy will be able to swiftly revise these protocols in order to keep them up with the latest research? Don't bet on it.

In another baby step towards turning the U.S. health care system into the overburdened and flawed Canadian healthcare system, the congressionally controlled Medicare Payment Advisory Commission recently recommended to reduce payments to hospitals with high readmission rates. Think about that for a minute… what about hospitals in areas with a high number of elderly patients, such as Arizona or Florida? Surely, the readmission rate for patients in these areas is likely to be very high - but for reasons that have nothing to do with the quality of care rendered by the hospital!

Once again, my fear is that politicians with socialist leanings are trying to twist the issue of patient safety into an excuse for more government control. You know how I'm always telling you to be fearful of anyone who wants to pass laws "for the public good?" Well, this seems to me to be a classic case of an excuse for more government control masquerading as something that's good for all of us.