To: i-node who wrote (536265 ) 12/13/2009 3:59:00 PM From: J_F_Shepard Read Replies (1) | Respond to of 1579675 Here's Obama's words: On the doctors front, one of the things we could do is to reimburse doctors who are providing preventive care and not just surgeon who provides care after somebody is sick. Nothing against surgeons. I want surgeons. I don't want to be getting a bunch of letters from surgeons now. I'm not dissing surgeons here. All I'm saying is, let's take the example of something like diabetes, a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now, if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they are 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 are also reimbursing the care that prevents the amputation? Right? That will save us money. And the point here is clear: Obama is saying that we'll save money by paying primary care physicians to prevent diabetes rather than amputate people's feet after it's too late. And that's simply undeniable. Not that cost savings is the only reason we should avoid foot amputations, but in the context of defending the costs of his health plan, this makes perfect sense. And he wasn't saying that surgeons get paid $50k for the amputation. That wouldn't make any sense, because he's trying to explain how expensive amputation is. And if Obama thought surgeons received $50k for amputation, then his full figure for amputation would have been much higher and he would have gone with the bigger number. And while I understand how his meaning may have been misconstrued, it's obvious from context what his intent was. Again, the point was the expense of amputations; not the fee collected by the surgeon. And in case you were wondering, this study claims "nontraumatic lower extremity amputation" cost between $40k-$75k in 2003; per the VA's numbers, which sometimes includes both feet. And so yeah, the numbers Obama quoted are in line with how much amputations cost, so I'd say that this is what he was referring to. (And yes, I wanted a better number here, but was having trouble finding one.) Conservatives Got it Wrongbiobrain.blogspot.com