Even President Obama Doesn't Understand the Cost of a Diabetic Foot Amputation

click here for President Obama's Video of Getting the Cost of Diabetes Wrong

http://www.youtube.com/watch?v=SG56B2et4M8

Diabetic foot amputations are preventable. True. But only with diabetic patients and doctors working together diligently.

The reality is that nearly all health problems related to diabetes could (in theory) be prevented if medical intervention was started early enough. But that is not what typically happens with diabetes.

On average, it is believed that most people are diabetic for 2-5 years before diagnosis. This has been changing in recent years with more screening and early testing. If a person has diabetes that is out of control, damage happens. If the diabetes is out of control with skyrocketing blood sugar for a number of years, lots of damage happens.

If the nerves to the feet are damaged one is placed at enormous risk of diabetic foot ulcers that can easily become infected and lead to amputation. Once a sore begins, poor blood flow to the feet (common in diabetes) makes healing slow. Infections set in. If the skin infection spreads rapidly or spreads to the underlying bone (osteomyelitis) then an amputation becomes necessary.

There has ben a great deal of discussion in the media about the cost of diabetic foot amputations. After all they are expensive. The talk however has reached conspiracy theory fever with the misspoken words of President Obama while he was running for the office.

He said that if a surgeon amputates a foot, Medicare directly pays the surgeon $30,000-$50,000.

That statement is, of course, ridiculous at best.

We do know that the total cost (to Medicare) of an amputation related to diabetes is upwards of $50,000. However that cost includes hospitalization for the associated infection, antibiotics (which can cost as much as $1,000 per dose), lab tests, Xrays, MRI studies, follow-up care after the surgery and custom made prosthetic limbs, wheelchairs, home-health care, etc.

You might be surprised to know how little Medicare pays a surgeon for an amputation. Depending upon the level of a diabetic foot amputation, the surgeon would be paid anywhere from just over $200 to just over $1,000. That fee included surgery AND all of the postoperative care for 90 days. That means office all follow-up visits, hospital visits, removing stitches, wound care to get it all healed, and the cost of all bandages applied in the office.

In most cases the doctor who performs an amputation related to diabetes actually makes very little money or actually loses money providing this care.

With this in mind see the video clip and you will understand where much of the confusion about health care reform comes from, given that even the President seems to misunderstand some of the details.

click here for President Obama's Video of Getting the Cost of Diabetes Wrong