What's wrong with America's hospitals? The same patients keep going back there, and it isn't for the good food. US government-supported Medicare hospitals and Medicaid are performing poorly enough in preventing readmissions that Congress plans to penalise them for it. A 2009 study in the US found that a fifth of all Medicaid patients discharged from hospitals ended up back there within 30 days. Maybe one in 10 of these rehospitalisations are planned, said the study, in the New England Journal of Medicine. The rest of them are costing around $17.4bn per annum (£10.8bn), based on 2004 data. At a time when states like Arizona are so cash-strapped that they're selling off state buildings, that's money that governments can't afford to lose. One of the biggest causes of unplanned readmissions appears to be because patients are falling through the cracks of a fragmented healthcare system. Half of those that ended up enduring hospital meals again hadn't been back to see their physician in the interim, indicating a marked lack of follow-up care.