August 13, 2009

A FACTOR OF THIRTY

Pres Obama said this during a health care speech:

If a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.

Apparently Medicare only reimburses around $1000 for an amputation, not $30,000.

I want to take something Krauthammer said tonight on Special Report and run with it a little.  He said:

Well, when the president is off, in talking about the fee for an amputation, by a factor of at least thirty, he's got trouble and it makes people worry about all his other so-called facts.  Remember, he's been selling here a free lunch; he says the way I'm going to solve the problem is prevention.  We're gonna put a lot of money in prevention and it's gonna save a lot of money overall.

Krauthammer then goes on to discuss a CBO letter quoting studies that said that preventative medicine actually costs more in the long run, since you're screening far more people who won't end up with whatever disease you're looking for.  The CBO says that all those pittances added up for everyone to get screened for diabetes end up costing more than the couple of feet you have to amputate.

But I want to run in a different direction.  Krauthammer got me going.  The president keeps saying that we're going to save money through preventative medicine.  But he thinks he's comparing "a pittance" to $30,000.  So yeah, that makes it sound like we'll save a ton of money if we can get doctors to prevent having to amputate feet.  Think of how many people we could get in for a simple preventative appointment with their doctor for $30,000!  But if it really costs between $500 and $1000 for an amputation, then that's far fewer preventative appointments for the cost of one amputation.

My question is, Does Pres Obama even know that?  I mean, where did he get this $30,000 figure, which he presents so authoritatively?  And does he know how much smaller the figure really is?

Is he being deceptive or just ignorant?

If he's deceptive, that's despicable.  But I think he's just ignorant.  I think he really believes that, at a reimbursement cost of "a pittance," he can help many more Americans by preventing amputations or tonsilectomies or whatever else he thinks greedy doctors are doing just to make extra money.

But that means he actually thinks that doctors see someone with diabetes and think, "Man, if I just bide my time and fatty here loses his foot, then I can buy a new jet ski!"

I just find it worrisome that Pres Obama thinks we're going to save all this money with his new health care plan because he's overestimating how much we currently spend by a factor of thirty!

Posted by: Sarah at 07:06 PM | Comments (9) | Add Comment
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1 I think he's a mixture of deceptive and ignorant.  He knows he's not checking facts himself, but when someone brings it up to him, he claims ignorance.

When my counselor told me she was all for national health care, I wanted to ask her if she would be happy to be paid what TriCare pays her ALL the time.  I get the explanation of benefits sheets.  I know that she gets from TriCare 2/3 what she bills, give or take.  My chiropractor doesn't even take TriCare, but he voted for Obama and is still very happy about it.  I know that TriCare is only just now expanding their chiropractor services, but I know they don't take it very seriously.  Where's his practice going to go when there are no insurance companies to cover him?  He will lose his higher-maintenance customers, because they might not wish to afford more than two visits a month (at $40/visit).

Should this bill go through, I wonder if any health professionals who think Obama is all that will change their tune when the excrement hits the oscillating air-circulation device.

Posted by: Deltasierra at August 13, 2009 09:31 PM (unCAk)

2 The man can't rattle off the accomplishments of Billie Jean King without botching it...no doubt some staffer's head adorns a pike outside in the Rose Garden. You can't expect the same sort of fact gatherers to get something correct that would require actual math.

Posted by: deskmerc at August 14, 2009 12:24 AM (pYOXQ)

3

Not everyone who receives the 'pittance' for preventative care would have needed an amputation. Even at his grossly inflated cost per amputation, the expanded roles of people on preventative care (remember that its 'free' so everyone will want it) given to those that don't need it will balloon the costs well over his deceptive number.

Figure that balanced against what an actual amputation costs and it becomes, like Krauthammer said, off by a factor of 30, or more.

Sigh, we are all doomed.

PS, I personally think he is being deliberate in his deception. It has always worked for him in the past, the media regurgitates his figures on a daily basis with nary a skeptical eye turned their way.

Posted by: John at August 14, 2009 12:57 AM (T0dFH)

4 A salesman who once worked for me was fond of the phrase "in sales as in medicine, prescription without diagnosis is malpractice."

Obama has a pocket full of policy prescriptions which he's been carrying around for a long time. He is much more interested in getting the patient to take those prescriptions than he is in diagnosing the patient's actual situation.

Posted by: david foster at August 14, 2009 06:34 AM (uWlpq)

5 I think we've seen evidence before that Obama's not good with numbers. 

Posted by: David Boxenhorn at August 14, 2009 08:03 AM (bjGKR)

6 Oh, this claim just about made my head explode, except that it was shaking too quickly in disbelief... "did he ACTUALLY say that?!?! Oh my word... demonizing doctors, accusing them of patient neglect and/or malpractice... he's either a liar or a moron." That kind of put me over the "hemming and hawing" stage, and now I believe that he's lying out of a little ignorance and a lot of quasi-conscious malice. Quite the trait, for a CIC trying to ram through legislation...

Posted by: Krista at August 14, 2009 12:41 PM (sUTgZ)

7 Not that he'd be taking them to the doctor, but his daughters must have never had an ear infection or tonsillitis for that matter.  If he thinks ENT specialists are yanking out tonsils left and right to try and afford a new yacht, he's even denser than I'd imagined.

There is literally a magic number that you must reach before your pediatrician will even REFER you to an ENT person and then, the ENT person will 'monitor' your child over a certain number of weeks/months.  I believe my youngest had no less than 19 trips to the doctor with strep throat and double ear infections (her ears do not drain properly & won't until she grows and her face widens) before we could even have someone talk to us about tubes.  It wasn't until a particularly awful bout of strep that left her tonsils enlarged, touching and causing sleep apnea (her record b/w breaths during sleep?  17 seconds) before we could discuss removing her tonsils and adenoids.

It has nothing to do with health care.  It has to do with the mentality of 'we know better what is best for you.'  And, once this administration ushers in health care for all (no matter how craptastic), they will FOREVER be able to say, "Sure...vote for the other guy, but they will take away your health care."

I also cannot stand the lecturing on etiquette and manners.  Puh-leeze.

Posted by: Guard Wife at August 14, 2009 12:54 PM (qk9Ip)

8 Worse, is the fact that he's saying things in terms of savings.

Even if an amputation did cost $30,000, we don't really save anything, because the costs for the gummint to insure everyone will far outstrip potential "savings" by spending less on preventive medicine.

It's like this:  You have ten bucks.  You go to the store, and want to buy a widget.  One widget is $5, one better widget is $6, one cheap widget is $2, and there's even a widget marked down from $20 to $9.

No matter which widget you buy, you don't "save" anything.  You spend.  The only choice you have is what amount you spend.  And NO, buying the $20 mark down doesn't mean you "saved" $11.  YOU STILL WALK HOME WITH ONLY $1.


Posted by: Chuck at August 15, 2009 09:46 AM (bMH2g)

9

Science fiction writer Heinlein,Asimov? once wrote 'TINSTAAFL',

there is no such thing as a free lunch.  As for OHB's "facts"- Winston Churchill was asked how he'd gotten 6 mos. of research for info before his speech. Ans. I made them up, but it'll take 6 mos. for them to prove it. We'll have other crises to distract them.

Posted by: Ray Ott at August 29, 2009 12:36 PM (g6d1f)

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