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Oct 2, 2008

Never Events

The Beginning of the End is Upon Us
10/01/08 - WhiteCoatRants

[edited] Today, the Centers for Medicare and Medicaid Services (CMS) officially begins saving money by refusing to pay for medical conditions that it believes should “never” happen.

[ For example, they say falls, urinary infections, and bedsores should never happen under sufficient care. ]

Medicare won’t pay to prevent these "never events" or for proper care and staffing in the hospitals. Medicare doesn’t want to pay, period. The whole never event idea was part of the Deficit Reduction Act.

The name of the game is cost-shifting, from public medical insurance onto you. The government has vastly underestimated the costs of this entitlement. They cut back on care and payments to hospitals. The hospitals need money from somewhere. You and I are left holding the bag.

Healthcare as we know it is about to change for the worse. When the costs engulf everyone, the Government will suggest universal healthcare/single payer [and care will be reduced without anyone getting sued].

WhiteCoat predicts:

1. You will be diagnosed and tested for more illnesses so that it is difficult to determine what care is provided for a never event.

2. You will often be transferred to another hospital, because CMS will pay for treatment if you present with a pre-existing never event. There will be more testing, complications, and higher costs.

3. Diagnosis will avoid never events, finding other conditions.

4. If you don’t personally pay for a 24 hour nurse, you will be responsible for the costs of treatment if a never event occurs.

It is worth reading the whole post.


More never event absurdity
10/24/08 - Buckeye Surgeon [Edited]

To review: "never events" are a new name for "avoidable" complications during hospitalization. Certainly, wrong site surgery ought not to happen. But, the list of never events includes urinary tract infections, surgical infections, falls, pressure sores, colitis, delirium, deep vein clots, and other events that often arise during critical illness.

Interestingly, you will not find a publishable work of science that describes how to reduce the risk of these events to zero, because it's impossible. For example, if you put a rubber tube into a bladder, no matter how sterile, some patients will get a urinary tract infection. It's a foreign body, for god sakes.

This an attempt to cut costs and distribute blame under the guise of "patient safety". But, it won't cut costs at all. Ironically, doctors will order more tests to prove that the patient had a pre-existing condition on admission to the hospital. The rise of community acquired MRSA (resistant staph infection) and other infections mandates this.

It is fallacious that "physicians are making money off their own errors". Give me a break. Let's say I note a wound infection after colon surgery. I open the incision a bit and drain the pus. I don't charge for it. The patient goes home with wound care instructions and gauze. Or let's say I diagnose a deep vein clot after surgery. I put the patient on blood thinners and monitor for 6 months. I don't charge for it. It all falls under the post operative global billing period anyway.

Respected publications like The NY Times and The National Review continue to spread Never Event nonsense. The public will come to accept this as conventional wisdom. Very frightening indeed.

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