Re: Hospitals Face Pressure to Avert Readmissions
Dear Sir: Because the individual has significant control over his own health, treatment for ill health is not suitable for insurance. Insurance is suitable only for those classes of events that are beyond our own control. Such insurance usually contains clauses in the contract that deny payment in the event that the individual himself was the cause of the insured event. For example, life insurance does not pay if one takes one’s own life. Fire insurance does not pay if one burns down one’s own insured property. But, no one can control where or when a tornado will strike, so damage from a tornado is an insurable event.
Medicare’s preposterous rules that hold healthcare providers responsible for the demand for service by individuals fails on many levels but mainly it fails to recognize that individuals have great control over their own health. To compound this intellectual error, Medicare deigns to saddle the healthcare provider with this responsibility, when healthcare providers are consulted only AFTER one becomes ill. The provider has no control over the events that led up to the loss of health or the severity of the problem before being consulted, has no control over the frequency with which the patient will return for further treatments, and has almost no control over whether or not the patient adheres to the provider’s recommended treatment regimen. This is especially difficult when lifestyle issues are involved, such as eating and smoking habits or drug and alcohol consumption.
Furthermore, I find it ironic that government demands to pay for a vital service and then tries to find ways to deny that service to the public or force some other entity to pay. Patrick Barron
