I was at Clincon yesterday, and one of the lectures was about trends in medicine. One of the topics was Obamacare. When Obamacare takes effect in eight months or so, some provisions will change the way that medicine is paid for in this country, and  not for the better.

The hospital will be paid a flat rate for a patient with a given problem, no matter how long the patient is in the hospital. For example, all patients who present to the hospital with congestive heart failure (CHF) will earn the hospital a set price, regardless of how many days that the patient stays in the hospital. This means that the hospital has an incentive to get you out of the hospital in a minimum amount of time, whether you are cured or not, and has the added incentive of diagnosing you with every ailment that they can think of, from halitosis to athlete’s foot.

To correct this problem, the geniuses in the government have devised a solution: If the patient must be admitted for the same condition within 6 months of discharge, the hospital gets nothing for the subsequent visits. So that CHF patient doesn’t follow his discharge instructions, and gets readmitted. The hospital eats it. It is only a matter of time before the hospitals are forced to find ways to keep frequent flyers away.

This is a real mess. I am not sure of everything that is coming, but I do know that it will create real problems in the health care field.

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