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Tribune Editorial: When spending less is better medicine

(Leah Hogsten | The Salt Lake Tribune) Jordan Valley Medical Center and four other hospitals previously run by IASIS Healthcare have a new owner, Medical Properties Trust out of Birmingham, Ala. and a new operator, Steward Health Care of Boston, Mass. A Steward official said all 3,300 IASIS employees along the Wasatch Front will retain their jobs.

The Gordian knot of health care in the United States (other First World nations solved this problem generations ago) is the reasonable fear that the only way to reduce the crippling cost of medicine is to deliver less of it.

Thus did the lie that Sarah Palin told about what was to become the Affordable Care Act — that the value of Grandma’s life would be weighed by Obamacare Death Panels — gain a lot of traction in the popular imagination.

But the truth of the ACA is reflected in news, related by The Tribune’s Luke Ramseth the other day, that five Utah hospitals are among those issued financial penalties for too often letting their standard of care slip below acceptable levels.

The penalties mean offending facilities receive 1 percent less in the payments they would otherwise expect from Medicare and Medicaid, the federal programs that pay for health care for, respectively, the aged and the poor. That may not sound like a lot, but even 1 percent of the federal account receivables can add up to millions of dollars for a large hospital.

The penalties are assessed when hospitals are found to have been doing an insufficient job of preventing medical problems that should be, well, preventable. Specifically, the feds are on the lookout for infections that patients didn’t bring with them to the hospital but picked up while they were there. Those can be nasty, painful, expensive and, in the worst cases, fatal.

The point is to avoid placing hospital administrators in a spot where their bottom line is improved by shorting their patients on quality care. To put hospital managers on notice that doing a sloppy job will cost them money, not save it. So they are saved from a situation where their humanity — which is probably why they got into the health care business in the first place — is placed in conflict with their fiduciary responsibilities.

The two become one and the same.

The five Utah facilities on the latest penalty list are LDS Hospital in Salt Lake City, Alta View Hospital in Sandy, Jordan Valley Medical Center in West Jordan, Castleview Hospital in Price and Mountain West Medical Center in Tooele.

The good news: That’s significantly fewer than the 16 Utah hospitals that were slapped as recently as three years ago. Assuming the inspectors haven’t gotten careless, it is reasonable to conclude that the program is helping hospitals get better, not only by threatening fines but also by pointing out problems that those too close to the situation might miss.

Better care for less money. It isn’t easy, but there are ways to do it.

Anyone who wants to replace the ACA with anything else must not allow that core mission to be forgotten.