Health Care Thoughts: Regulations Gone Wild

As Rusty presents his short ‘thoughts’ on the administrative end of the national healthcare reform process, I noticed some readers have taken the problems he notes as indicative that the whole process is flawed and destructive. I do believe that is a wrong tack to take and will not serve to learn more of what is happening in the process. The US public has only begun to take note of the growing necessity of deciding not only public spending but the huge costs to the current private system. Changes are happening in that area as well.

The steadily increasing complexity of insurance billing and particular contracts with groups is simply bypassed in macro discussions but has profound effects on delivery of services and costs. We glibly point to general ‘benefits’ sections of insurance as the ‘worth’ of plans and that justify the ‘premium’ schedules….not the real contracts on the other side of service delivery. Many general public discussions ignore the trends in the private sector. The overall costs of the system itself as the ‘cost curve’ bends downward without much general scrutiny will impact more than the handy medicaid and elderly targets in the political discourse..

Health Care Thoughts: Regulations Gone Wild

My favorite nurse has been attending in-services and doing some computer seminars on long-term care nursing. She is not happy.

She sat down the other evening and put together a list of 15 major regulatory driven changes in procedures and/or documentation. In reviewing the list, she determined that 2 or maybe 3 of the changes will improve the quality of care or the safety of residents.

So what about the rest?

She doubts that changing a 16 step process for administering sterile eye drops to an 18 step process will have much value. If she uses the 16 step process in the presence of a state or federal surveyor the facility would be cited for inadequate care, even though the care is perfect.

And the triplicate procedures for verifying narcotics are ever expanding into four and five step processes repeated multiple times each day (the DEA, having won the war on drugs, has been hounding nursing homes on paperwork).

Keep in mind a nursing home has much more extensive documentation rules that even an acute care hospital, with less staff.

When business and professional people complain about federal regulations, many academics and left leaning politicians pooh-pooh them as greedy whiners, but in the real world there are real impacts of regulations, not all positive.

Tom aka Rusty Rustbelt