Hospitals used to care for us until we got better — even if it took a couple of weeks. Then we went home. But almost 20 years ago, Congress passed a little-known law that changed all this by changing how hospitals get paid. Until the mid-'80s, hospitals were paid for every day we were there. But then the law changed, and hospitals began getting a flat fee based on our diagnosis. A heart attack had one price tag, a broken foot another. If we recovered quickly, the hospital kept the leftover dollars as profit. If we lingered, the hospital took a loss.

Like magic, hospital lengths of stay plummeted. Patients were discharged "sicker and quicker," often to nursing homes, which became centers of rehabilitation — a much less expensive setting than hospitals. Home-care agencies flourished.
—Liz Taylor, "Prepare for home care after '>b>sicker, quicker' hospital stay," The Seattle Times, July 24, 2002

Others worry that the government's new payment system for Medicare — under which hospitals are reimbursed a set amount for each case, according to the diagnosis, regardless of how long the patient is hospitalized — encourages hospitals to discharge patients "sicker and quicker."
—Dan Colburn, "Unionizing Doctors," The Washington Post, June 19, 1985