• The Check is in The Mail

    The Check is in The Mail

    By Dr. Kenneth Rothaus

    What are some of the greatest lies when it comes to health care?  A very famous one when the Affordable Care Act was first proposed was that we would all be able to keep our current doctors.  Another, if not as famous, possibly more devastating to our medical care is that a governmental bureaucrat or committee would not attempt to interfere with the medical decisions made by our doctors.

    In today’s WSJ, Scott Gottleib, MD reports on the “strained medical criteria” constructed by Medicare in order to deny patients with damaged aortic heart valves access to a less invasive corrective procedure than open heart surgery.  Currently many patients who would benefit from aortic valve replacement do not do so because of the risks of the procedure which include death. Recent studies document that more patients would not only benefit from the less invasive procedure, but would also be subject to lower risks of complications and death.

    Medicare has set up a system of approval for the less invasive procedure that makes it very difficult for the patient to get it scheduled.  Why would Medicare do that?  The answer is simple…..MONEY.  The fear is that more patients with damaged aortic valves would elect to undergo the less invasive procedure than are currently willing to consent to open replacement of the aortic valve.  Medicare would therefore end up paying for many more aortic valve replacements which would benefit the patients but cost the government more money.

    Dr. Gottleib concludes that medical decisions should be evidence-based and decisions should be left to the patients, their physicians and a competitive free market system.  We could not agree more! How about you?

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