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At a prime-time news conference, July 22, President Obama said: “Health-care legislation is a strong key to economic recovery. If we do not control these costs, we will not be able to control our deficit. The time is right for health-care overhaul. The stars are aligned."
You may have noted recently numerous articles about how various procedures have not been proven to be necessary. Laparoscopic joint surgery is ineffective, closing patent ductus arterial defects resulted in increased number of strokes, the PSA tests is of no value in diagnosing prostate cancer, and back surgery is no better then physical therapy. Clinical trials under intense scrutiny are worthless. The list goes on and on. The aim is to cut medical costs by limiting the amount of medical care you will get, thus saving huge dollars for the new health reform package.
OUTPATIENT SURGERY
Outpatient surgery accounts for more than 65% of all surgeries, this is up about 20% from 20 years ago. There are approximately 35,000 outpatient centers in the U.S, that perform surgical procedures. This represents about 17% of all patient procedures.
Outpatient surgery eliminates the need for a hospital stay, is generally considered safe, especially when performed at accredited hospital outpatient departments or ambulatory surgery centers.
Because of minimal invasive surgical techniques, and advances in anesthesia, outpatient surgery offers lower costs, more convenient scheduling, and faster recovery and healing times then does hospital inpatient procedures. Ironically, the hospitals today receive more money for your surgical procedure done as an outpatient, than if you were admitted.
About 45% of these procedures are done in hospital outpatient departments and an additional 38% are done in more than 5000 surgical centers that are certified by Medicare and Medicaid.
To become accredited, strict standards for equipment, operating room safety, personal personnel training, and surgical credentials are needed. If there are no required regulations, doctors may perform surgery under his medical license, despite not having any formal licensing or accreditation requirements for the procedure (e.g. tummy tucks by dermatologists). .
To become voluntarily accredited by one of three agencies that perform inspections can be costly, often exceeding several thousand dollars. To become accredited for every minor procedure limits the procedures being done.
To qualify for a mandatory surgery center, the facility can't do any other business operations or share their waiting room space for non-surgical patients. This means the doctor can’t see you postoperatively in the facility. Again, limiting procedures.
Medicare is pushing for defined plans on how to transfer patients to a hospital if it becomes necessary, the kind of training office staff have, the kind of cardiac life support, and whether the nurse a nest assists are working without the supervision of an anesthesiologist in the doctor's offices. To remove a mole, the doctor would need a huge staff. This also eliminates the volume of procedures, and raise the cost of doing procedures.
Medicare rulings now require surgery centers to report information on quality and safety measures like hospitals do. These new Medicare guidelines are recently in effect.
The accreditation Board for ambulatory surgery found 23 deaths among 1.1 million procedures. Most of them were from tummy tucks and facelift surgery. There certainly occur more than 23 deaths for every million procedures in a hospital.
Of these 23 deaths, the leading cause of death was pulmonary embolism in which a blood clot forms in the lung, heart attacks after surgery, breathing problems related to anesthesia, and abuse of pain medication given after surgery.
COMMENTARY
With these strict new Medicare guidelines, many centers will be put out of business, since the amount of outpatient surgery will be reduced tremendously. This may be a good cost-saving measure. By eliminating a site for surgery can be done, less procedures will be performed and Medicare will pay less money for them.
By performing surgery in a hospital situations, the number of procedures can be well regulated. There'll be an increased weight in these procedures being performed. It is another step in limiting your ability to have outpatient surgery.
Outpatient surgery is very safe for healthy patients and accredited facilitie, and are run by competent professionals. It is also up to the patient to fully disclose any conditions that might put him at risk during surgery and to make sure his medical records have been reviewed before the surgery. Doctors are smart enough not to perform outpatient surgery on compromised or chronically ill patients.
23 deaths among 1.1 million procedures are far less than would occur in a hospital setting. Read between the lines, and see that all medical treatments and procedures are being scrutinized and are listed as not necessary or inefficient, unless absolutely proven according to Medicare's standards.
What do you think? Your comments are always appreciated. Visit www.drneedles.com for more discussion of medical controversial topics.
Sources: American accreditation of ambulatory surgery facilities/ Joint commission/ Accreditation Association for health care/
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