Maybe it's worth a try...

John Ray notes that market forces are slowly being brought to bear on hospitals, which have heretofore been shielded from them.

Over time, hospitals will get more money if they follow guidelines, and lower fees if they neglect them. To add a further shove in the right direction, Medicare will post report cards on its Web site so the public can make comparisons.

People respond to incentives, and if the incentive structure is perverse, people respond in perverse ways.

Unlike most businesses, where those who offer better services or products receive the largest financial reward, health care institutions mainly get paid based on volume of services rather than whether patients get better. Under the perverse reimbursement scheme, avoidable complications that require readmission may actually be more lucrative to hospitals than getting it right the first time.

And indeed, one friend of mine was working in a related field – social work. Her rating depended on how many times she called a "case" back, and how many hours she spent with a "case". If she was prepared, had her act together, and did her research ahead of time, so that she processed her "case" in one short visit, she got a lower performance evaluation. I don't recall if she learned to waste time in an approved manner before being fired, though.

What would I have done?

Quit, on principle?

Call people in for a weekly "chit-chat" session, pour a cup of coffee, B.S. about kids, grandkids, whatnot, and maybe steer them toward job leads or more productive lifestyles outside of The System, but inside of Being A Friend?

Depends on how inventive I was feeling, I suppose.