Let's disagree over things that are real, indeed!

In a recent town hall meeting in New Hampshire, President Obama decried his critics' "wild misrepresentations" of his proposed health care overhaul. He denounced their efforts to "scare and mislead" people and urged, "Where we do disagree, let's disagree over things that are real."

The President should take his own advice.



I don't know whether he is intentionally misrepresenting the facts or if he is really that poorly informed on the issue of physician reimbursement. Either way, it's frightening to see this from the man who has taken it as one of his major objectives to "reform" our health care system.

The amount a surgeon gets paid for performing an operation isn't a hard number to come up with. The President's advisers could find that out easily enough if they wanted to. Here, I'll help them: In 2009, Medicare allows $695.80 for performing a foot amputation.

That includes the physician's evaluation of the patient prior to the surgery, the operation itself, and all the care provided to that patient for the next 90 days in the hospital and in the office. Healthy people don't often need amputations. No, patients who need amputations tend to have a lot of medical problems. Things like diabetes, heart disease, high cholesterol, high blood pressure, a history of smoking, or sometimes all of the above. That means they're more likely to have complications after surgery like wound healing problems, heart attacks, strokes or other things that require a lot of time and care from their surgeon. All that care is included in the $695.80.

Furthermore, $695.80 may be what the surgeon gets reimbursed, but it's certainly not what he or she "takes home." Before anything is taken home, money comes out of that to pay for office space, staff, supplies, medical liability insurance, continuing medical education, and so on.

No one gets rich amputating feet.

I wouldn't imagine that the president makes up numbers like that off the cuff in the middle of a speech. Surely that was something he had prepared ahead of time to use when the moment was right. If anyone in the press bothered to call him on it, I'm sure he'd claim he "misspoke." Just like he did after he asserted in this same speech that the AARP endorsed this bill. They didn't. A slip of the tongue would be hard to believe in this case, given the fact that just a few weeks ago he asserted that surgeons cut out children's tonsils just to pad their pockets. No, he really intends to vilify physicians - particularly surgeons - in order to muster support for his health system overhaul. As if taking your child in for an operation isn't stressful enough, now you have the president telling you that surgery is probably unnecessary and your doctor is a greedy crook.

For the past two decades, Congress has been trying to control health care costs by trimming physician reimbursement. So much so, that many procedures done today reimburse less than they did 15 years ago. I don't mean when adjusted for inflation. I mean in actual dollars. Adjust for inflation, and they're worth even less.

If physicians, and particularly surgeons, were all the money-grubbing charlatans that the President would like you to think we are, there wouldn't be many left. There are a lot less stressful ways to make a lot more money than your doctor makes. (Take being a CEO of a health care-related company, for instance. Now, there's where some serious savings could be found! But I digress. . .)

The vast majority of physicians are compassionate people who do what they do because they love to help people. Which is a good thing. Or there might not be any left when the current administration gets done with their "reforms."