October 5, 2011
Dear Editor,
In the article on the government’s “reward and punishment” system under the Affordable Care Act, the writer expresses a strong concern on the “worst hospitals” being at risk of financial failure because of the policy in the reform law that punishes hospitals that do not improve their patients’ health overall. However, although there are fears that the policy will push out hospitals that usually serve a very sick and poor population and therefore “increase health disparities for minorities,” this is a pessimistic view of the impacts of this policy. Hospitals that serve low-income, minority communities face unhealthier patients, but at the same time they also probably have low quality of care because of poor management or regulations that are usually as a result of minimal incentives. The government is taking a tactful market approach that gives it some power that it lacked before to incentivize hospitals to try to improve their care. However, the policy should clarify “improvement.” But feeling pressured to improve, hospitals can become more active in implementing new management tools and care approaches that they otherwise did not adopt because of the absence of any financial incentive. The “worst hospitals,” actually have more room to improve.
Sincerely,
Karla Vasquez
In the article on the government’s “reward and punishment” system under the Affordable Care Act, the writer expresses a strong concern on the “worst hospitals” being at risk of financial failure because of the policy in the reform law that punishes hospitals that do not improve their patients’ health overall. However, although there are fears that the policy will push out hospitals that usually serve a very sick and poor population and therefore “increase health disparities for minorities,” this is a pessimistic view of the impacts of this policy. Hospitals that serve low-income, minority communities face unhealthier patients, but at the same time they also probably have low quality of care because of poor management or regulations that are usually as a result of minimal incentives. The government is taking a tactful market approach that gives it some power that it lacked before to incentivize hospitals to try to improve their care. However, the policy should clarify “improvement.” But feeling pressured to improve, hospitals can become more active in implementing new management tools and care approaches that they otherwise did not adopt because of the absence of any financial incentive. The “worst hospitals,” actually have more room to improve.
Sincerely,
Karla Vasquez
Karla,
ReplyDeleteYou write that hospitals serving underserved communities "probably have low quality of care because of poor management or regulations." Where are you getting this? Do you have evidence to support your claim?
Now, I can't complain about providing incentives for hospitals to do better. Rewards for improvement can be good. But penalizing the "worst" hospitals, which tend to serve patients whose health statuses are poor to begin with, cannot be justified. This is exactly what PPACA intends to do, and will only take valuable resources away from low-income and minority populations.
Although I do agree that the "worst" hospitals have room to improve--in fact, all hospitals do--penalizing them is a backward approach.
Zeyu (Taku) Xu