Surgical Strike: Surgeons' Group Blasts Obama's $30K-$50K Foot/Leg Amputation Claim

August 13th, 2009 11:35 PM

The White House's perpetual campaign site, er, home page, currently has rotating messages at the top left. Two of them relate to health care (yellow underlines are mine):


The administration would be well-advised to hold back on the blather about "blatant falsehoods" and "misinformation" until their guy in charge stops disseminating them himself.

Take Obama's claim that the surgeon's fee for a single foot/leg amputation is $30,000 - $50,000 (please). 

Here, from the White House's transcript of the President's Tuesday appearance in Portsmouth, NH, is the beginning of what Obama had to say in comparing the costs involved in preventive care against diabetes to the cost of one of its potential consequences:

So we are going to be taking steps, as part of reform, to deal with expanding primary care physicians and our nursing corps. On the doctors' front, one of the things we can do is to reimburse doctors who are providing preventive care and not just the surgeon who provides care after somebody is sick. (Applause.) 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. (Laughter.)

He probably wasn't going to get many letters at that point, but in his next statement, he guaranteed a groundswell of well-deserved outrage (bold is mine):

All I'm saying is let's take the example of something like diabetes, one of --- 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'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. (Applause.)

And they said that George W. Bush was out of touch.

Yesterday, The American College of Surgeons struck back -- hard (HT the Corner), and reminded the public that this isn't the first time in recent weeks that the President has misrepresented and/or smeared these professionals (bolds are mine):

CHICAGO—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.

If a Republican or conservative had committed such an obvious gaffe, it would be front-page news. But then, so would "inhalator," "57 states," "Arkansas is closer to Kentucky than Illinois," and any number of other howlers that the establishment media has ignored out of this guy for about two years.

The surgeons should therefore no be surprised if there is media near-silence on the latest error. In fact, they should expect it. Heck, on the high end of what Medicare pays, it's "only" overstates the cost of an amputation by a factor of 26 to 44.

Cross-posted at