New Medicare Payment Restrictions Announced

The $408 billion Medicare system currently provides coverage for about 43 million elderly and disabled in the US. Without it, many such people would have no other means of getting sickness care (don’t ever call it health care). As the expense for this program continues to soar upwards, new rules have announced that certain events will no longer be paid for by Medicare.
In hospitals, so called "never events" include objects left in a patient during surgery; blood incompatibility; air embolism; falls; mediastinitis, (an infection after heart surgery); urinary tract infections from using catheters; pressure ulcers, or bed sores; and vascular infections from using catheters. These events are among the injuries caused by medical care and are now considered the sole responsibility of the Hospital.
But there’s the rub. Just because Medicare says they’re not going to pay for these events, they lack the legal authority to say that the Hospitals are therefore responsible for paying.
The news here is simply that Medicare won’t pay anymore.
If you’re wealthy, highly educated and lawyered to the hilt, you’re not going to stand for the hospital sending a bill for something like this. You would hammer them to the wall. If you are wealthy, highly educated and lawyered to the hilt, you probably don’t need Medicare either.
If you’re an average person who is ill, recovering from illness and any one of these never events and the hospital slams a bill down on the table and demands payment or they’ll refuse further treatment, what’s likely to happen?
It’s no big secret that the number one cause of personal bankruptcy in the US is due to unpaid medical bills and I have little doubt that many of those bills are for undeserved expenses.
What would you do in such a situation? Even if you found a lawyer willing to take on the army of legal experts on staff at your local ER, would you expect quick resolution?
Medicare is already a burden on the tax payers. Some estimates suggest that half of the total budget pays for the administration of the system itself. If that’s true, the cost to John Q. Taxpayer is about $200 billion to run this system. How much more expense is being added to monitor these new rules to ensure that hospitals aren’t billing Medicare for their own mistakes? Is blocking the cost of extra antibiotics really worth more administrative overhead and rules enforcement personnel?
I’ve said it before and I’ll say it again. The current US medical system is messed up. Universal Health Care is a horrible solution. The AMA is a monopoly and they told Congress so in 1847. We The People should not be expected to pay for medical mistakes or for the administration of a bloated and ineffective system, however we are a country that does have compassion for others and no one should be left on the street begging for medical care. However, adding more levels of bureaucratic rules doesn’t really solve the true problem and is ultimately the wrong approach.

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