Concerning the Medicare re-admission penalty to hospitals, no hospital will refuse admission to a Medicare patient based on this penalty. It's purpose is to improve the care given to Medicare patients after they are discharged so that they are able to remain at home, improving care and saving $17.5 billion a year. Through 2020 Medicare costs will rise from $518 billion to $929 billion, 29 percent for hospital inpatient care; 20 percent of Medicare patients have been 30-day readmissions to the hospital with 38 percent of the approximately 5,800 hospitals in the U.S. having the highest rates. Starting Oct. 1 there will be a penalty assessed to these 2,200 hospitals. Studies showed that through simple discharge procedures such as proper follow-up care with their physician, visiting nurses, and better communication with discharged seniors, the rate of readmission dropped dramatically. Peace Health St. Joseph Hospital instituted a bundled discharge program in 2010 for their cardiovascular patients and reduced their already low readmission rate of 15.4 percent to 6.8 percent. This incentive for hospitals to help the patient remain stable after discharge is both good for the patient and good for the longevity of Medicare. The Republicans complain about the cost of the entitlement programs. Isn't it better to make Medicare more effective and efficient than replace it with a dubious voucher system benefiting primarily the insurance companies?