Obama Demonizing Doctors Again, And Showing The Strain
In this clip from Mr. Obama’s town hall meeting we see him clearly stating two very preposterous claims:
1. That doctors would, and may in fact choose to amputate the foot of a diabetic patient instead of better managing their diabetes by diet and exercise recommendations. (A similar argument to his ill-fated ENT Doctor-Tonsillectomy comparison from last month)
2. That surgeons who do such amputations earn in excess of $30,000 for performing the procedure.
The first claim we, and others made great effort to deal with last month and will not do so again here.
The second claim is just, well, ridiculous. Here is his exact quote:
On the Doctor’s front one of the things we could do is to reimburse Doctors who are providing preventative care and not just the surgeon that provides care after the person is sick.
“All I am saying is let’s take the example of Diabetes………Right now if a family care physician works with his patient to modify diet, etc they might get reimbursed a pittance, but if that same diabetic ends up getting his foot amputated that’s 30,000-50,000 the surgeon is reimbursed. Why not make sure we are also reimbursing the care that prevents the amputation?”
It is hard for us to make sense of what is happening here. Mr. Obama is not a political hack. Yet, his basic fact-checking apparatus is flawed or absent. The average reimbursement for this procedure in at least three major geographic areas in the U.S. is about $800 (American College Surgeons). Even if it were twice this, or 10x this, how does one get to $50,000?
As doctors, we at TBM are hard pressed to identify a single billabe CPT code for a procedure that reimburses that high. Even bilateral, sequential, double lung transplantation, the surgeons reimbursement is less than $50,000.
We are trying to step back here and offer some insight as to what would motivate a man as bright and thoughtful as Mr. Obama to make a statement such as this. He has little to gain– it is an obvious political play, yet everything to lose– his credibility declines non-linearly with even small gaffes. There is ample evidence that Mr. Obama is in a mild state of panic that this entire HCR “thing” is unraveling.
He is clearly getting sloppy, upping the ante with his old-style Chicago type politics and talking points that we see coming out of the White House. This $50,000 for an amputation thing is just so far out there we cannot really explain it.
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[...] stupid”, and as we have posted yesterday and over the past few weeks, Mr. Obama has been saying some pretty incredulous things bordering on buffoonery. So, we ask again– what is happening here? We are challenged to [...]
August 13, 2009
Sacramento – The California Medical Association issued the following statement today, attributable to CMA President Dev GnanaDev:
“CMA is deeply concerned about two examples of medical treatment recently used by President Obama to make his case for health reform.
“In the first example, he stated that surgeons make $30,000 to $50,000 to amputate a foot of a diabetic. This assertion is false. Medicare pays surgeons $589 to $767 for a foot amputation. Medi-Cal pays $420 for the same. Hospital and other associated costs may add up to the greater amount, but it is incorrect and misleading to suggest the surgeon’s costs are responsible for that figure.
“We share the President’s belief that we need to put greater resources towards primary and preventive care in order to keep people healthier and help address the nation’s rising health care costs. However, preventive care will never obviate the need for qualified physicians and surgeons to take corrective action to improve or save people’s lives.
“In the second example, the President suggested that physicians take out children’s tonsils to make more money. This implication is inaccurate and offensive.
“Doctors treat patients based on the health needs of the patient, not the financial incentives. When science suggests overutilization may be occurring, the medical profession has responded with improved guidelines to more fully inform physicians of the risks and benefits of any treatment or procedure.
“The California Medical Association is committed to reforming our health system to increase access to quality care and reduce rising health care costs. To achieve health reform, the American people must be able to trust our elected officials and the statements they make regarding health care.
“Patients trust their doctors. That trust is critical to an effective and successful doctor-patient relationship. We urge the President to stick to the facts and avoid the kind of misleading and inflammatory rhetoric that would erode that trust and derail our efforts to increase access to quality care and control rising health care costs.”
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