Falls? Infection following catheterization or surgery? While incidences can be minimized, they can't be eliminated completely. Some patients refuse to wait for help getting out of bed. This happened to a friend's dad just last week - he had a heart catheterization, did fine, got up to go to the bathroom without calling a nurse, fell, and broke his neck.

Poor glycemic control? Like nobody's family members ever bring them snacks in the hospital. Medicaid wants to blame the hospital for problems over which they may have no control, like what patients eat that's not included on their prescribed diet.

And some of the sequelae are just known risk factors of medical or surgical treatment. Minimize them, by all means. But don't penalize hospitals for something they can't possibly eliminate entirely.

The guy that broke his neck was probably waiting for a nurse for 30 minutes and couldn't wait any longer.

Hospitals cut nurses off shifts to save money, and they constantly run short handed. Also, a hospital would rather pay lawyers then put in equipment to kill germs, virus, and bacteria in the air handling systems. Its available, they just won't spend the money.

Hospitals have been cited for poor cleaning habits and there are public service commercials and TV shows that warn you to fuss at doctors, nurses, and hospital staff that don't wash before working on you.

When is the last time a nurse or your own doctor washed before examining you?

How do you know he waited 30 minutes? Proof? I also have a neighbor in her 90's who recently fell and broke her arm in the nursing home the same way. Her son told me he and his wife have told her numerous times she needs to press the call button, but she "doesn't want to bother anybody", and won't. The pressure alarm on her bed to alert staff when she got up kept waking her up at night, and she had it turned off.

My doctor always uses hand sanitizer before examining me or my son, which has been shown to be more effective than soap and water. She does it right in front of me.

Human skin is not sterile, and can't be made sterile. Period. There is ALWAYS a risk of infection after surgery. UTI's following catheterization are common, because there is no way to sterilize the urethra before catheterization. That's life.

I agree proper hygiene can minimize infections, but it cannot eliminate them totally. Unless a hospital can be shown to have poor sanitation, it is irresponsible to blame them for something unpreventable. Such practices may force hospitals to decline acceptance of Medicaid, due to the possibility that they may not be paid for caring for a post-op problem that is not their responsibility.

When do we start taking responsibility for our own lives. You have a problem with a doctor, nurse or hospital speak up. If you have a family member or a friend who has no safety awareness, sit with them. Quit blaming everything on somebody else and take responsibility. Nobody is forcing you to use a particular physician or hospital. Hospitals and nurses take the blame for many things which should have been managed at home. Maybe early intervention into an unhealthy lifestyle would have helped but no, it is easier to blame the hospital. If grandma falls at the hospital it is the hospitals fault, but when she falls at home you take no responsibility. Quit blaming the healthcare system and put the blame where it belongs, on us. We all want quality healthcare as long as it does not inconvienience us.

To quote from the article:

• Some physician groups have concerns about the new policy. "Simply not paying for complications or conditions, that, while extremely regrettable, are not entirely preventable, is a blunt approach that is not effective or wise for patients or the Medicare or Medicaid program," Dr. Michael Maves, CEO of the American Medical Association, said in written comments to CMS in March.

I would guess that means that the patient will be charged when Medicare refuses to pay the bill.

The article does not say whether or not the hospital can turn around and charge the patient. I hope there is some provision for this.

I think they are working with the logic that the doctor and/or hospital would then have to "eat" their mistake like a contractor would if they screwed up laying your carpet. Unfortunately that's not how it works when the party in question is that big - they get to pass it on to someone else or, take steps to avoid the exposure.

While mistakes and complications are regrettable, to blame the doctors and hospitals for everything is short sighted.  Hospitals are very complex organizations.  During any single patient visit, there are numerous interactions with numerous individuals leading to hundreds of points at which errors may occur.   Even if humans were 99% perfect in everything they do, this could still lead to one or two errors per visit per patient.  We only hope the errors are caught through redundant systems of checking and rechecking and following standard protocols.  Medicare and Medicaid already pay barely enough to support the hospital system, which is why most hospitals make little or no profit.  Not paying for the patient's care in these instances will force the hospitals to make further cuts which will further endanger, not just the medicare/medicaid patients, but all patients who visit the hospital. Also, Medicaid patients will have increased difficulty finding a doctor who will perform their surgery.

The democrats make jokes about republicans wanting to "throw granny off a cliff" with their plans for Medicare reform, but as Medicare and Medicaid attempt to reign in spending with short sighted budget cuts, by maintaining the current system, it is the  democrats who are throwing granny off a cliff.

I understand the dire need to cut Medicaid & Medicare spending to keep these programs available, but I don’t think refusal to pay hospital bills, or taking back health care dollars spent is a feasible option. As pointed out by the article ‘not all complications are entirely preventable’. Non compliant patients are a great example- it’s the hospitals’ fault the patient is noncompliant?

Is the new plan is to stick hospitals with charity care? This will cause private insurance rates to be negotiated higher to make up for the deficits, causing higher premiums and decreasing affordable healthcare access. Or, perhaps hospitals will have to close, causing fewer facilities to obtain health care from. This could cause farther travel to access healthcare; which is already a hardship for low income and elderly.

I think our society has placed healthcare as a commodity, not a service. Is it ethical to deny payment for services? Is it ethical to limit access to healthcare? Where will the future of health care be?

.