-By Dan Scott
If you take President Obama’s example at face value concerning unnecessary tonsillectomies here are six points to consider why he basically made the case against his so called Healthcare Reform Plan (ObamaCare):
1) He accused doctors of unnecessary medical procedures. His example was a pediatrician profiting from tonsillectomies. Since when does a pediatrician perform surgeries? They don’t, a (pediatric) surgeon does. A pediatrician does not get any kickback or money from the surgeon for the referral. His example shows either a profound ignorance of the division of labor within health care or a deliberate deception. In fact under his example, the pediatrician would make MORE money from seeing the child repeatedly over a period of months by collecting the copay at each visit under a PPO arrangement. In an HMO where the doctor makes most of his money on a flat rate per patient per month regardless of the number of times the person sees the doctor. Under an HMO, the pediatrician would make money by making the tonsillectomy referral since seeing an individual LESS would mean having more patients on the roster thus collecting more money in the aggregate. However, most HMOs would ding the pediatrician for having a higher rate of referrals thus restricting their medical practice to stop such abuse.
2) All medical procedures on a child or adult are done with the prior CONSENT of the guardian or patient. If you are going to question the integrity of doctors, you will also have to question the motives of guardians and patients for acting proactively.
3) Many tonsillectomies are done as a PREVENTIVE measure when a person chronically gets tonsillitis three or more times despite modern drug therapy, so is this procedure unnecessary when not done under an emergency basis? Since when is being proactive, not prevention? This then begs the question, for all the talk of prevention by Obama; doesn’t his very example belie prevention? Look at Canada and Britain, when you delay a treatment or claim because the problem is deemed not serious enough to merit a medical procedure at the moment, are you not saying prevention (being proactive) is MORE expensive than the reactive emergency medicine? Obama by this very example using tonsillectomies exposed the cost savings fallacy of the Healthcare Reform Plan just as the CBO did by crunching the numbers. There can be no cost savings if proactive medical procedures are viewed as unnecessary extra medical procedures.
4) Optional procedures (value added) done under Medicare such as EKGs and EEGs maybe done not to pad the bill but to compensate for the less than cost reimbursement rate by Medicare. But then how many fewer EKGs performed would still constitute quality health care? Isn’t Obama’s premise that more preventative health care means less sickness? If bills are being padded with optional unnecessary procedures it is due to a failure of government policy called cost shifting. There comes a point when the medical care provider must find a way to pay the bills to keep the lights on if they can’t cost shift by over charging someone else. But that’s precisely what’s done under a GOVERNMENT run system, not a private run system. Remember, private insurance reimburses at rates to keep the medical care provider in business, the government does NOT! Until government stops cost shifting, medical care providers have to make up the difference or get out of the health care field, this means there can be NO cost saving from any proposed so called reform. This also means fewer doctors seeing more patients and not continued quality health care.
5) Under Obama’s example, a pediatrician is said to be making money on referring someone for a tonsillectomy. Extra procedures are done as a result of defensive medicine to AVOID a lawsuit, but there is no tort reform in this bill! If you want to save money on extra preventative procedures due to defensive medicine, then you have to reform the legal system, period. You can’t do one without the other. Therefore again, there can be no cost savings without tort reform.
6) If Obama has this much difficulty in thinking a tonsillectomy is unnecessary, then how can any bureaucrat making rules be any better? And what recourse would anyone have in such as system? With the health insurance company, you can sue them for being overly restrictive, the government you cannot.
President Obama either through his own poor understanding of basic common medical procedures or just plain deception in selling a pig in a poke, has made the best case there is against the type of reforms he is advocating. Whether he intended to or not, he clearly made the case that prevention and extra procedures are two sides of the same coin since any argument made against an extra procedure would be the same one against a preventive procedure since how do you prove a negative? How can you say that extra procedure didn’t prevent a future sickness if your premise is reactive medicine costs more than preventative medicine? Preventative medicine can do many things but one thing it can not do is forestall the inevitable, that’s why no matter what you do the bulk of anyone’s total medical expenses will be just prior to their death. After all isn’t the point of most medical care treating a disease, which if left untreated would probably lead to the person’s death? But then maybe that’s why OMB Director Orszag wants to change the premise by now claiming the reform of health care has nothing to do with cost savings…
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Dan Scott calls himself a “Member of the Global Capitalist Cabal preaching Capitalism and personal responsibility as the economic solution to world poverty.” He is also a member of the 14th Amendment Society — victimhood is a liberal code word for denying the civil rights of others. He is also a proud member of the Global Warming Denier Cabal, insisting that facts not agendas determine the truth.
Dan can be seen on the web at http://www.geocities.com/fightbigotry2002/ as well as http://www.geocities.com/dscott8186/saidwebpage.htm, And can be reached for comments at dscott8186@yahoo.com.
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