We are REALLY in trouble... This will be just like the MBAs and the insurance companies deciding what to reimburse but only WORSER...
Dr. Obama’s Tonsillectomy
Do Americans want a federal board deciding if their kids need surgery?
Those greedy doctors. “You come in and you’ve got a bad sore throat, or your child has a bad sore throat or has repeated sore throats,” President Obama explained at Wednesday’s press conference. “The doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out.’”
If that’s what he really thinks is wrong with U.S. health care—and with the medical profession—then ObamaCare is going to be even worse than we thought. The point Mr. Obama oversimplified is that the way the U.S. pays for medical services can encourage some physicians to prescribe unnecessary tests or treatments, especially in Medicare. But his implication is that doctors aren’t acting in the best interests of their patients in order, basically, to rob them.
Incentives matter, yet maybe the truth is that medicine is a highly complex science in which the evidence changes rapidly and constantly. That’s one reason tonsillectomies are so much rarer now than they were in the 1970s and 1980s—but still better for some patients over others. As the American Academy of Otolaryngology put it in a press release responding to Mr. Obama’s commentary, clinical guidelines suggest that “In many cases, tonsillectomy may be a more effective treatment, and less costly, than prolonged or repeated treatments for an infected throat.”
Mr. Obama seems to think that such judgments are easy. “If there’s a blue pill and a red pill and the blue pill is half the price of the red pill and works just as well,” he asked, “why not pay half price for the thing that’s going to make you well?” But usually the red and blue treatments are available—as well as the green, yellow, etc.—because of the variability of disease, human biology and patient preference. And the really hard cases, especially when government is paying for health care, are those for which there’s only a red pill and it happens to be very expensive.
Under the system Democrats are trying to ram through Congress, these case-by-case choices, currently made between patients and care-givers, will gradually be replaced by rigid government schemes. “Part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works—because that’s not how it’s working right now,” Mr. Obama said. We await the President’s evidence that the nation’s pediatricians are striking it rich with unnecessary tonsillectomies.
