Why I hate Medicare

If I owned a hospital, I wouldn't take Medicare. They don't pay for shit, they have more red tape and bullshit guidelines than a used car salesman selling stolen adhesive products from the back of a minivan and hospitals lose money on EVERY Medicare admission. The statistic put out by the hospital that employs me released a figure that said every Medicare admission costs the hospital 400.00 PER DAY. Good thing we are a non profit community hospital because that shit is jacked.  That is not to say that I don't see the need for Medicare and programs like it, I do see the value- but if I owned a hospital, I'd, oh I don't know,  want to actually have across the board billing that gets me paid for what was done. I wouldn't have to jack up the prices of things like Tylenol so that 40  year old Jim Bob in 523 with Blue Cross has to pay extra so that 99 year old Matilda Sue in 520 doesn't bankrupt the friggin hospital.

Every year they pay for less and less and every year hospitals become more and more unsafe and the care becomes more and more substandard.

One way Medicare came up with to get the medical community up the ass with a cactus is to not pay for re admissions to the hospital within one month of a discharge.

Okay so let me get this straight.  Medicare pays a fraction of the actual cost for each admission, won't pay for ANY part of the stay if a patient contracts an infection of any kind (case in point.. patients on vents routinely develop pneumonia no matter how careful staff is about infection control.  Doesn't matter- if a Medicare pt. contracts pneumonia during a hospital stay, Medicare won't pay for it.) If  a patient contracts a UTI from a foley catheter being in place, their stay is free.  Okay so the good news is, less people are getting infections because money talks, and quality of care does go up when we know we will lose money if it doesn't improve.... what I DON'T like is that Drs are encouraged to push people out the door who might not really be 100% ready because those patients are costing us money and yet, those patients are getting re admitted and we are losing money anyway because those re admissions are free!!

What a complete and utter waste of time and resources. Want to know why people keep coming back?  How about the patient I got who was newly diagnosed diabetic and the doc wrote for her to start daily insulin injections... at 9am (that was the first I heard about her starting SQ injections- she was on metformin prior to her admission) and that I had to have all her discharge instructions done by 10:30 am so she can drive to the main hospital and pick up her glucometer and sample insulin pen. The dr didn't write for me to do any diabetic teaching (probably because he knew I didn't have enough time to do any).  Plus I had 5 other patients to discharge.  WHAT THE FUCK.  Patients should be self injecting, do meal planning, learn how to count carbs, understand when to check blood glucose levels, what A1C levels mean, etc etc. wayyy before they are discharged.  It's impossible to do my job the right way sometimes and that is extremely frustrating to me.  I can't blame that entirely on Medicare, but the whole revolving door mentality starts squarely with them.  You would think not paying for re admissions would curb premature discharges, but NOPE.

  

 

 And now for something completely different..

The phone rings and the lady of the house answers, "Hello".

"Mrs. Ward, please."

"Speaking."

"Mrs. Ward, this is Doctor Jones at the Medical Testing Laboratory. When your doctor sent your husband's biopsy to the lab yesterday, a biopsy from another Mr. Ward arrived as well, and we are now uncertain which one is your husband's. Frankly the results are either bad or terrible."

"What do you mean?" Mrs. Ward asks nervously.

"Well, one of the specimens tested positive for Alzheimer's and the other one tested positive for AIDS. We can't tell which is your husband's."

"That's dreadful! Can't you do the test again?" questioned Mrs. Ward.

"Normally we could, but Medicare will only pay for these expensive tests one time."

"Well, what am I supposed to do now?"

"The people at Medicare recommend that you drop your husband off somewhere in the middle of town. If he finds his way home, don't sleep with him."