Nancy Pelosi has been wrong so often that it should come as no surprise that she was wrong when she famously said in 2010 of the largely unread 2,800-page Affordable Care Act: “We have to pass the bill so that you can find out what is in it.” The bill did pass, albeit by the skin of its teeth, and Americans are still not quite up to speed on the many horrors that lurk within the pages of this legislative behemoth.
One such nightmare is the Hospital Readmissions Reduction Program (HRRP), which was designed by the government agency in charge of Medicare and Medicaid. According to the Mises Institute:
…[S]tudies showed that 20% of Medicare patients discharged from hospitals ended up returning within 30 days — often for preventable causes. The purpose of this new program was to incentivize hospitals to take proactive measures to treat such patients by penalizing them for high readmission rates.
As with so much of Obamacare, the goal of the program was to reduce the costs of care, not to ensure that patients received the medical care they needed. The policy wonks inside the Obama administration were never concerned with undoing the myriad governmental regulations that drove up the cost of care but only with making it cheaper — in both senses of the word.
Now a new study published in the Journal of the American Medical Association finds, shockingly, that the HRRP has contributed to 10,000 patient deaths. Its authors — cardiologists Rishi K. Wadhera, Karen E. Joynt Maddox, and Robert W. Yeh — write in the New York Times:
[A] deeper look at the Hospital Readmissions Reduction Program reveals a few troubling trends. First, since the policy has been in place, patients returning to a hospital are more likely to be cared for in emergency rooms and observation units. This has raised concern that some hospitals may be avoiding readmissions, even for patients who would benefit most from inpatient care.
Second, safety-net hospitals with limited resources have been disproportionately penalized by the program because they tend to care for more low-income patients who are at much higher risk of readmission. Financially penalizing these resource-poor hospitals may impede their ability to deliver good care.
Finally, and most concerning, there is growing evidence that while readmission rates are falling, death rates may be rising. … If we assume that the program was directly responsible for these increases in mortality and that prior trends would have continued unabated, the program may have resulted in 10,000 more deaths among patients with heart failure and pneumonia.
The Times article ends with a million-dollar question: “Why are policies that profoundly influence patient care not rigorously studied before widespread rollout?” Why indeed?
In February of this year another Obamacare feature, the Independent Payment Advisory Board (IPAB), was axed as part of a budget bill. This was the feature of the law that earned Sarah Palin ridicule from the Left for deeming it a “death panel.” Which is precisely what it was. Via the American Spectator:
IPAB was designed by the law’s authors as a rationing board composed of unelected bureaucrats vested with the power to “recommend” reductions in Medicare payments to doctors and hospitals. This would have inevitably reduced access to care for the elderly.
How discomfiting to find that the IPAB wasn’t the only death panel hiding out within this 2,800 pages.