Medicare Patients Dying After Leaving Hospitals

According to the article “Medicare patients death shortly after leaving the ER raises questions about rural hospitals” by Casey Ross, published on the StatNews website on February 1, 2017, questions regarding staff and treatment of patients in rural hospital have been raised after a study brought to light the deaths of patients beneficiaries of Medicare after being discharged. According to the study, more than 10,000 Medicare patients, who do not have life-threatening conditions, die annually around 7 days after being discharged from hospitals.

The study has also risen questions regarding rural hospitals’ adequate resources and if the Government’s intent on lowering costs has had an impact on basic and essential care. It is no secret that under the Affordable Care Act hospitals have to treat patients efficiently while having to reduce admissions which are considered unnecessary. This in turn has resulted in the discharge of patients and exploring outpatient treatment as an option. According to Dr. Rade Vukmir, fellow of the American College of Emergency Physicians, has stated that Medicare and private insurers’ strategies regarding admissions and discharge have had an impact on decision-making.

According to the article the study shows that there is a higher rate of unpredicted deaths in low admission hospitals than in high admission hospitals. Dr. Zaid Obermeyer, an emergency medicine physician and professor at Harvard Medical School, states that “it doesn’t seem that the deaths are due to random chance. There is something different going on in those low-admission-rate hospitals.” Obermeyer also stated that there are several factors that may cause this problem, such as limited staffs, fewer transportation, problems with hospital protocols, and not necessarily can providers be attributed the cause.

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Tax Incentives For Doctors In Puerto Rico

According to the article “artículo “Avalan incentivos contributivo para médicos del país” by Rebecca Banuchi, published on the newspaper El Nuevo Día on February 8, 2017, Bill 5 was passed. Through this bill there will be a significate reduction on the taxes of doctors in Puerto Rico with the end game of reducing the number of doctors that are leaving the country and to increase the return of them to the country. According to the article, if the taxpayers identified as doctors in Puerto Rico accept the benefits of this bill, it is estimated that the treasury will have impact of $185 million dollars.

The bill proposes that the fixed tax rate for doctors be 4% and it would have a term of 15 years. The Secretary of the “Departamento de Hacienda”, Raúl Maldonado Gaudier, stated that it is costly for the government that doctors are leaving Puerto Rico, since they do not pay taxes. The President of the JSF, José Carrión III, stated that the government must certify the fiscal impact that recent legislation has. The President of the Healthcare Commission, Juan Oscar Morales, stated that the bill will not have problems with the entities that control the government’s finances.

The bill identifies as “qualified doctors” general doctors, specialized doctors, podiatrists, dentists, dental surgeons and specialized dentists. Also, the bill includes a list of guidelines to follow when evaluating doctors’ requests to benefit from the bill.

The bill has been criticized under the argument that it will take a toll on the public treasury, it does not attend other problems that cause doctors to leave such as problems with insurance companies, and it did not take into account the “Comisión de Hacienda’s” analysis regarding the fiscal impact that the bill will have.

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