The Corner

The one and only.

The New England Journal of Medicine Criticizes Obamacare


The New England Journal of Medicine recently published an illuminating article on one of the failings of Obamacare:

As part of the Affordable Care Act (ACA), Congress directed the Centers for Medicare and Medicaid Services (CMS) to penalize hospitals with “worse than expected” 30-day readmission rates. This part of the law has stimulated hospitals, professional societies, and independent organizations to invest substantial resources in finding and implementing solutions for the “readmissions problem.”

The authors explain that there are three reasons why this focus is a bad idea:

First, the metric itself is problematic: only a small proportion of readmissions at 30 days after initial discharge are probably preventable, and much of what drives hospital readmission rates are patient- and community-level factors that are well outside the hospital’s control. Furthermore, it is unclear whether readmissions always reflect poor quality: high readmission rates can be the result of low mortality rates or good access to hospital care. Second, although improving discharge planning and care coordination is a laudable goal, there are better, more targeted policies that are more likely to be effective in achieving it. Finally, because hospitals are expending so much energy on reducing readmissions, they have probably forgone quality-improvement efforts related to more urgent issues, such as patient safety.

If ever there has been a perfect example of government interference for “the public good” causing more suffering, this is it. The bureaucrats empowered under Obamacare have decided that this is the arbitrary standard that hospitals must follow, despite that the fact that is has no bearing on whether a hospital is successfully caring for its patients. Instead, this policy will lead to lower standards of care. Chalk this up as another reason why Obamacare must be repealed.