Recently my dad had to have a minor out-patient procedure done at a local hospital that is a major medical center. He was taken to a prep room to have some vitals taken, complete some paperwork, and wait until his turn came. The vitals included taking his blood pressure and putting on one of those fingertip things that monitors something. Heartbeat, oxygen? Who knows? Both the blood pressure cuff and the fingertip device were disposable, single use items.
He went for his procedure and I waited in the hall outside the prep room while another patient was ushered in for her turn at vitals, paperwork and waiting. The prep room only has a privacy curtain, so I could overhear nurse and patient. As the nurse applied the disposable blood pressure cuff and the fingertip device, the patient commented on the use of disposable items and the cost. The nurse replied, “Well, you can blame Medicare. They got tired of paying for infections that happen when patients are in the hospital.”
“Blame Medicare?” I thought. Both nurse and patient seemed to see the disposable items as an onerous cost forced upon health care providers to the detriment of patients and taxpayers. They could hardly have been more wrong, but it is fashionable today to blame government, especially federal government and especially “entitlement” programs like Medicare.
Infection control is a major expense in hospitals. Infection control is meant to reduce the risk of hospital acquired infections (HAI). That’s a benefit to the patient. And to reduce the cost to the hospital when they have to provide expensive care to HAI patients and settle lawsuits from poor patient outcomes, including death, that are caused by HAI.
The CDC reports that more than 700,000 patients get a HAI every year and that about 75,000 people die as a result. Reducing the two most common sources of HAI may save up to $150,000 per patient according to the American Journal of Infection Control. Patients lived from 10 to 15 years longer.
You can see why Medicare might want to resist paying for outcomes that were acquired in the hospital and that have a negative impact on patients. Medicare contracted to pay for gallbladder surgery, not an HAI. Everyone wants Medicare to be careful in spending taxpayer dollars and careful to safeguard citizens. So, Medicare is doing its job and doing it well when they refuse to pay for HIA. This has the added benefit of using a financial stick to encourage hospitals to literally clean up their act.
If you only go surface deep, those disposable items certainly have a higher financial cost than items that are used and reused. Those reusable items also have a cost in terms of HAI and patient safety. Maybe Medicare deserves a “thank you.” Maybe responsible government monitoring and guidelines and commitment to better health care and wise spending of taxpayer’s money deserve applause.
And as for those “entitlement” programs? They are misnamed. These are “earned benefits.” Social Security, Medicare, Medicaid. You paid for these benefits. You have earned the right to them and the right to have government ensure that you get maximum value for what you have earned… even when improved medical care is part of the outcome.
Submitted by Mike Pfeiffer, WCD Member
Sources:
“Infection control can reduce costs, improve outcomes.” Modern Healthcare, January 5, 2015. Click here
“Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications.” The Ochsner Journal. Spring, 2009. Click here
“Understanding HAI Burden, Demonstrating ROI Essential to Making a Business Case.” Infection Control Today. November 13, 2013. Click here