In the way America “used” to be, the better biomedical technology we had, the more Americans could live longer, healthier lives. However, in the world of Obamacare and the “new” normal, health ingenuity will be too costly for everyone except the wealthy.
According to a recent study by the Journal of the American Medical Association (JAMA), the number of knee replacements paid for by Medicare has more than doubled over the past 20 years. In 2010, 243,802 Medicare recipients underwent knee replacements, up from 93,230 in 1991. According to the study, demand for the popular surgery, which costs approximately $15,000 per replacement, could reach $3.5 million annually by the year 2030.
“There’s no doubt this is a successful operation,” said Joseph Zuckerman, chairman of the orthopedic surgery department at the New York University Hospital for Joint Diseases. Zuckerman added that more older people want the procedure so they can remain active or improve the quality of their lives. Further, the introduction of better quality devices has allowed more people -- even those who have not yet reached their senior years -- to obtain the surgery....
Study: Obamacare May Make Knee Replacements Less Available to Seniors
Studies of this nature will likely be used to support the “necessity” of the ObamaCare Independent Payment Advisory Board (IPAB), the group of unelected officials who will be responsible for handing down the “rules” to physicians about who gets the knee surgery and who does not. The IPAB will, indeed, be in charge of “rationing” knee replacement surgery and other treatments and procedures, as well.
In this issue of JAMA, Cram and colleagues1 report detailed analysis of primary and revision total knee replacement (TKR) performed on more than 3.2 million Medicare beneficiaries from 1991 to 2010. This analysis confirms and quantifies several important findings. First, the use of primary and revision TKRs in Medicare beneficiaries has increased both in absolute volume from 93 230 procedures in 1991 to 226 177 procedures in 2010 and in per capita usage. Second, the pattern of care has changed substantially. Between 1991 and 2010, length of hospital stay for primary TKR decreased from 7.9 to 3.5 days and revision TKR from 8.9 to 5.0 days. However, 30-day all-cause readmission rates after primary TKR increased from 4.2% in the years 1991-1994 to 5.0% in the years 2007-2010 and after revision TKR increased from 6.1% in the years 1991-1994 to 8.9% in the years 2007-2010. A clear change in the pattern of discharge status also occurred with a shift initially to a more institutionalized setting, and recently to a discharge to home with home care services (ie, discharges to patients' homes decreased from 67.5% in the years 1991-1994 to 39.9% in the years 1999-2001 then increased to 56.2% in years 2007-2010). In addition to the increase in readmissions, the data demonstrated an important increase in infection rates for revision cases, increasing from 1.4% in the years 1991-1994 to 3.0% in the years 2007-2010.
Originally posted by xuenchen
reply to post by Hefficide
I tend to agree.
Obviously it's a speculative article.
Some people might think it's better to look deeper before somebody else says I told ya so.
All right, we won't call them "death panels." How about "You don't get any more medical treatment this year panels?"
WE need death panels.
Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.
Medicare needs to take a cue from Willie Sutton, who reportedly said he robbed banks because that’s where the money was. The big money in Medicare is not to be found in Mr. Ryan’s competition or Mr. Obama’s innovation, but in reducing the cost of treating people in the last year of life, which consumes more than a quarter of the program’s budget.
No one wants to lose an aging parent. And with price out of the equation, it’s natural for patients and their families to try every treatment, regardless of expense or efficacy. But that imposes an enormous societal cost that few other nations have been willing to bear.
Take Britain, which provides universal coverage with spending at proportionately almost half of American levels. Its National Institute for Health and Clinical Excellence uses a complex quality-adjusted life year system to put an explicit value (up to about $48,000 per year) on a treatment’s ability to extend life.
At the least, the Independent Payment Advisory Board should be allowed to offer changes in services and costs. We may shrink from such stomach-wrenching choices, but they are inescapable.