Editorial: A poor remedy

Wednesday, Aug. 22, 2007 | 7:08 a.m.

I n a policy shift announced this week, the Bush administration says Medicare no longer will pay for treating the secondary infections and injuries among hospital patients that are considered preventable errors under the new policy .

According to a story by The New York Times on Sunday, the rules to be published next week say Medicare will not pay hospitals for treating "conditions that could reasonably have been prevented," such as pressure ulcers, bedsores, injuries from falls and infections that result from prolonged use of catheters.

Bush administration officials say the rules could achieve significant annual savings in medical expenses and could save lives, because doctors and other medical personnel would be forced to strictly follow procedures to prevent secondary infections. The Centers for Disease Control and Prevention estimates that such infections contribute to 99,000 deaths annually.

Consumer groups and nurses hailed the decision as a way to cut down on preventable infections and injuries, the Times reports. But medical experts also said preventing such conditions isn't always possible. Even when all proper precautions are taken, older patients, who make up most of Medicare's patients, often suffer pressure ulcers or catheter infections when illnesses keep them bedridden for weeks or months .

And it remains unclear who will pay for treating these conditions when they do occur. The new rules say hospitals cannot charge patients for any costs related to "the hospital-acquired complication."

A spokeswoman for the insurance industry trade group America's Health Insurance Plans told the Times that private insurers are closely watching the new Medicare rules "with an eye to adopting similar policies."

Evidently, the assumption is that hospitals will absorb the costs - which typically means higher medical costs for everyone as facilities seek to recoup their financial losses. Policies that could improve the prevention of secondary infections and injuries among patients should be explored. But these rules don't go far enough in explaining who will pay. It is naive to think that hospitals are going to simply absorb the costs of treating these conditions without finding ways to pass those costs to all health care consumers.