Medicare Procedures Become More Technical

The overall population of the US knows that the current medical insurance system has significant problems. For upper-middle and upper class, the dangers do not seem so drastic, but for the lower income families, serious consideration is taken before consulting a hospital. This reason is because of all the hidden charges, certain insurance coverages, and being behind on payments. The current conflict is about a patient's status as either 'observational' or an 'inpatient'. What seems like just words to an everyday person, actually means millions of dollars in medicare payments if not specified.

Medicare officials are weighing changes to the admissions policy and sent letters to hospital associations in July soliciting suggestions. Among the options are requiring hospitals to notify patients that their stay is considered observation, setting a strict time limit for observation care and changing how the agency pays hospitals for such care, Blum says.

Now I am not saying that the US medicine is terrible and needs complete remodeling, but it is a harsh reality for patients that are discharged early on their road to recovery, simply because their plan doesn't cover the remaining time. Hospitals are forced to make do with what they are given.

The trend is emerging as hospitals cope with increasing constraints from Medicare, which is under pressure to control costs while serving more beneficiaries. In addition to more stringent criteria for inpatient admissions, hospitals face more pressure to end over-treatment, fraud and waste.

It is more and more evident that health insurance companies have one goal, make a profit. Hospitals can no longer make the right calls if Medicare is the ominous shadow watching through the glass. Although a tad dramatic, the sentiment is clear for all who find themselves in need of severe medical attention, and cannot receive it.