Obama's medical ignorance

In order to sell health care reform, President Obama has been assiduously trying to make the point that his favored reforms would only cut costs by giving incentives for better medical care. But he keeps getting into trouble by the examples that he uses. He seems to think that doctors are performing surgery willy nilly simply because they earn more for surgery than for preventative care. First he accused doctors of yanking out tonsils for simple sore throats. Then he said that doctors are amputating feet instead of providing good preventative care for diabetics. The American College of Surgeons is not pleased and issued this statement.

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

-- Yesterday during a town hall meeting, President Obama got his facts
completely wrong. He stated that a surgeon gets paid $50,000 for a leg
amputation when, in fact, Medicare pays a surgeon between $740 and
$1,140 for a leg amputation. This payment also includes the
evaluation of the patient on the day of the operation plus patient
follow-up care that is provided for 90 days after the operation.
Private insurers pay some variation of the Medicare reimbursement for
this service.

-- Three weeks ago, the President suggested that a surgeon's decision to
remove a child's tonsils is based on the desire to make a lot of
money. That remark was ill-informed and dangerous, and we were
dismayed by this characterization of the work surgeons do. Surgeons
make decisions about recommending operations based on what's right for
the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President's remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.

Ed Morrissey, who knows a lot about diabetic care from personal experience is amazed at the President's ignorance.

But here’s what the Really Smart Guy in the Oval Office apparently doesn’t understand about the medical system. Diabetics are treated by general practitioners and endocrinologists, neither of whom perform amputations. The AMA pointed out that Obama was off by a factor of 100 on the costs, but thus far no one has pointed out that the incentive structure he assumes doesn’t exist. Only after a GP and the endocrinologist, plus probably an orthopedist and a couple of other specialists, decide that the limb cannot be saved does the surgeon remove the limb. It has nothing to do with the compensation that the GP and the endocrinologist receives, or an imaginary windfall for an amputation that will have nothing to do with either a GP or an endocrinologist. I know this from long-time personal experience as the spouse of a Type 1 diabetic who lost her eyesight and kidneys to the disease, and who worried about amputations for years before her pancreas transplant.

Yup, this is the golden-tongued orator whose advice we should be following on restructuring the entire health care industry.

I think he needs to bring back the teleprompter.