Monday, August 24, 2009

"Here, Bite Down On This Stick" -- ObamaCare Skimps on Anesthesia

Every medical student learns an old adage: You can skimp on some medicine, but you can't skimp on obstetrics or anesthesiology. An elderly surgeon explained it to me this way, "In surgery, people die in days and weeks—a doctor has time to fix a mistake. But in obstetrics and anesthesiology, they die in minutes and seconds."

Twenty years ago, I became an anesthesiologist. Since then, whenever death has loomed in the operating room only to be sidestepped at the last moment, I think back on that wise surgeon. Indeed, the old adage explains why an anesthesiologist's life resembles a soldier's life. A soldier plays cards around the campfire, then goes out on routine patrol and ends up dead. The anesthesiologist jokes around with the surgeons and nurses, then, because of some unforeseen complication, his or her patient dies on the table. Although I have not personally faced such a disaster, I know anesthesiologists who have.

Incredibly, Congress's proposed health-care reform plan risks skimping on anesthesia. According to one of the health-care bills in Congress, H.R. 3200, the public option would reduce reimbursement for anesthesia by over 50%....

Dr. Ronald Dworkin has a lot more to say in this intriguing Wall Street Journal op/ed piece.