Surely Capt. John Yossarian would get that old familiar Catch 22 feeling from the state and federal demands that hospitals become more efficient and innovative on the one hand, but, on the other hand, government rules and regulations stand in the way of doing just that.
The Healthcare Association of New York State is once again calling on the state to make what a recent report calls common-sense regulatory improvements in the interest of greater efficiencies and better care demanded by health care reform.
HANYS is focusing on inconsistent and contradictory rules from the state and federal governments. For example, it only makes sense that state and federal requirements for patient observation services for Medicaid and for Medicare be the same.
But they are not.
''Inflexible rules covering patient observation services are different for Medicaid, Medicare, and private insurers, creating uncertainty about how the varying rules apply,'' the report notes.
Among other recommendations in its new report, ''Still Tangled Up in Rules,'' HANYS also urges the state to bring its regulations in line with the national standard to allow hospitals to have mentoring and training programs in emergency departments instead of the state requirement that registered nurses have a year of clinical experience before working in the ED.
''Conforming to the proven approach of a mentoring and training program within an emergency department would provide the experience needed to ensure good nursing care, but is prohibited by current New York State regulations,'' the report notes.
Equally as important, HANYS recommends the state establish a multi-agency workgroup to identify regulations among state and federal oversight agencies that are inconsistent or duplicative and then work to standardize those rules.
Common sense would dictate that changes to enable hospitals to operate more efficiently need to go hand in hand with state efforts to control its own spending by cutting payments to health care providers.
In the book by the same title, Yossarian finally figures out there is no Catch 22 rule, but because everyone believes it, it is as if Catch 22 really exists.
Surely we can do better than that, even in hidebound New York state.