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View Diary: "I have to get my hip replaced now, because ObamaCare is cutting that off for old folks" (367 comments)

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  •  Don't count on the hospital. There are now a (13+ / 0-)

    number of medical territories where the hospital has bought up the private practices, and like the one in my area apparently, now sets quotas or guidelines intended to encourage doctors to send patients into the hospitals for procedures, and these are very sensitive to governmental regulations of one kind or another. Last winter, my doctor had a list of tests I just had to take BEFORE june when I went on Medicare and which incidentally had to be paid for in cash, three grand worth. And, of course, the hospital has a small and very specific lists of the Medicare Advantage plans it will take, and is regularly warning that if the doc fix or other legislation does not pass, it will refuse to accept regular Medicare at all.

    •  Hospitals need to be accredited too... (1+ / 0-)
      Recommended by:
      mumtaznepal

      ... this doesn't sound kosher to me.  Is there a doctor in the house to say whether what happened to Christy is ethical?

      I haven't been here long enough to be considered a Kossack, does that mean that I'm just a sack?

      by Hey338Too on Wed Dec 12, 2012 at 01:59:07 PM PST

      [ Parent ]

      •  They are supposed to be. There's a board (5+ / 0-)

        called JCAHO that goes around every few years to 'inspect' the hospitals.  The hospital knows when they are coming and promptly 'fixes' anything that they 'know' to be in violation of the rules.  I used to work in a hospital IT dept.

        It's also not uncommon for particular items to be 'pushed' by hospital staff doctors (tests primarily) that is known to be covered by insurance, or are good revenue streams.

        The hospital that I had worked at set a new 'policy' to encourage flu and pneumonia vaccinations.... it was said to bring 'compliance' up, but you know damned well it was to help with the bottom line.

        •  Slightly off-topic, but JCAHO has really (5+ / 0-)

          changed the way they visit hospitals. The hospitals don't know when they are coming - they have a range of about 6 months, but JCAHO just shows up one day. It's impossible to hide bad practice for that long. In addition to the accreditation visits, they have unannounced visits randomly outside of the accreditation schedule.

          They also do "tracers" now, in which they can run off on any tangent, anywhere in the hospital, based on an irregularity they might see. In addition, they do patient interviews.

          Gone are the days of mostly chart review, quick staff interviews and alerting the hospitals to what they are looking for before they come in.

        •  Actually they are encouraged and scored (0+ / 0-)

          on getting their flu and pneumonia vac rates up. 30,000 people a year die from flu like disease in the US. That is about the number who die from gunshots.

          We can prevent or significantly reduce that number.

          I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

          by samddobermann on Thu Dec 13, 2012 at 06:03:42 AM PST

          [ Parent ]

          •  Let's put it this way - when I was told to make (0+ / 0-)

            the code changes, it sure as hell wasn't presented as 'best practice' or anything of the sort.  Then let's not get into the discussion of the liability arguments of not having an actual physician's order for administering the vaccine by a nurse either.  The 'order' was computer generated by the code I wrote into the pgm without any physician say.

            Yes, pneumonia and flu shots help many people.  There was more to the story than what I had originally put down.

        •  'Pushing' flu& pneumonia is a national guideline (1+ / 0-)
          Recommended by:
          Susan G in MN

          based on the best evidence.  It's the right thing to do, and the Joint Commission (formerly JCAHO) will look at those data when they review a hospital.  The hospital also spends a lot of money vaccinating health care personnel at no charge to protect the health of patients and keep personnel healthy and at work.

    •  I hope you didn't take all of them! (0+ / 0-)

      I would suggest you start looking for a different doctor. That is just ridiculous. What good would a 2 year old or even 6 month old test do for practically anything?

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Thu Dec 13, 2012 at 06:00:29 AM PST

      [ Parent ]

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