Proselytizing Articles

There was a time, long, long ago (in a galaxy far, far away) when going to the hospital meant going home with a gift basket. These days all u get are those weird pinkish/redish basins and a stinking urinal. It would appear, however that hospitals have substituted a new-age basket for your pleasure. Only, instead of getting an open-ass gown and a pair of grabby bottom socks you get a whole lot of infections with weird names. . .

In a study published in Archives earlier this year the authors tried to quantify the excess harm and cost caused by hospital acquired infections (specifically pneumonia and sepsis). Similar to the estimates made by the Institute of Medicine in 1999 (98,000 preventable deaths per year in hospitals), the results were quite stunning. Their results when extrapolated to the general population estimated that there was an excess 48,000 deaths and an additional $8.1 billion spent, as result of hospital acquired pneumonia and sepsis in 2006. And that’s when the proselytizing begins. Insurance companies are already penalizing hospitals for hospital acquired infections, and as a result many hospitals are taking steps to try to reduce them. However the authors state that the incentives are all wrong, hospitals ought to be paid more for the infections, not less. I can hardly understand why, perhaps because killing people is expensive?  Not to mention the methodological flaws of this study. Instead of using discharge records, they went to a database of discharge diagnoses, which are essentially the final bill of diagnoses that a hospital uses to bill insurance companies. Most physicians understand that pneumonia is a very subjective diagnosis that has no definitive hospital admission criteria other than a physician stating that there’s ‘something’ on a chest radiograph. Thus it is a very easy diagnosis to not only to get someone into the hospital, but also to get everyone paid for it. In addition, once the patient is discharged the chart goes to the hospital billing department, where it is up to the biller and his or her extensive high-school education and on-the-job training to figure out what the patient was in the hospital for. This person’s job is to look for a diagnosis, ANY diagnosis that the hospital can use to send a bill to the patient’s insurance for. If the word “pneumonia” is written anywhere in the chart, you can bet that sucker’s gonna get on the final list of diagnoses and be generating some cash.

I see articles like this one as one of the signs of The Great Medical Collapse. What’s this? Well it does not take a genius to see that medical spending is out of control and will not be sustained at current levels without some crazy increase in taxes (that will never happen). That means that payments to medical providers and benefits to patients is going to decrease. With less money around I think we are going to see more medical societies, specialties, device makers fighting for a larger slice of what will eventually be a much smaller pie. And thus more predictions of increasing death, decapitation and general disembowelment for poor innocent citizens unless more money is directed at certain areas skillfully determined by your friendly neighborhood national pharmaceutical giant.

I can already see the news story . . . ‘today senator Doolittle heard from the mother of Mary O, a blonde, blue eyed, hot, but still approachable, new mother of twins, and wife of a marine sergeant serving abroad, who went to the hospital for a simple pimple popping procedure, but then acquired an MRSA infection and died gruesomely. “It highlights the plight of millions of the 48,000 people who die every year from unnecessary infections in the hospital” said the senator. “To put this into perspective it’s like 120 jumbo jets falling from the sky every day, or 48,000 full size SUVs’ crashing. Or for Indian-Americans, like 9600 auto-rickshaws crashing”. Senator Doolittle signed a 40 billion dollar bill to increase funding to the area of post-pimple popping infections and their treatments to give the medical field the tools they need to fight these infections properly.’

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