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Wednesday, August 1, 2007 If we know anything about modern medicine, it is this: A tug-of-war is going on between the needs of patients and how much those needs cost, especially as new technologies help us live longer. You can see this tug-of-war at play in the debate over the payments hospitals should receive for rehabilitating patients after they've had a knee replaced, endured a spinal injury or suffered a stroke. Medical procedures make it infinitely easier to get those kinds of treatments. They also cost big bucks, which is why Medicare's bean-counters have put a limit on how many rehabilitation ailments the agency will cover for seniors. Fortunately, there's a way to balance these financial realities with patients' needs. First, Medicare should temporarily ease up on its squeeze. It requires that 75 percent of a hospital's rehab patients suffer from one of 13 approved ailments. If your ailment falls outside that list, you may not get treatment because the hospital may not get paid. Two bills in Congress address that problem by changing the formula. H.R. 1459 and S. 543 lower that percentage to 60. By enacting these laws, Congress could give rehab hospitals more flexibility in the type of patients they treat. Second, the agency that runs Medicare should study the ailments that really need coverage. The examination would take a few years because of medicine's rapid advances, but it would allow Medicare to develop a more realistic list of ailments. Once that study's complete, money for rehab work should start going to patients instead of facilities. There's no reason patients should worry about whether a certain facility has enough room for them. We hope Texas Sens. Kay Bailey Hutchison and John Cornyn, as well as the North Texas congressional delegation, help Washington find the right balance. Patients, hospitals, and taxpayers have a vested interest in the solution.
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