8/12/09 Statement from the American College of Surgeons Regarding Recent Comments from President Obama

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President’s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world.

Web site: www.facs.org
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Hospice Community Urges President Obama to Stop Funding Cuts

/PRNewswire/ -- Today, 3,524 hospice providers from across the country sent a letter to President Barack Obama urging him to stop cuts to the Medicare hospice benefit beginning on October 1, 2009.

The cuts threaten to jeopardize availability of the compassionate and high-quality care that 1.5 million patients and their family caregivers receive from hospice providers each year.

In addition to the letter, more than 500 providers of the hospice community submitted comments to the Centers for Medicare and Medicaid Services (CMS) on how the cuts will cause them to decrease services, reduce staffing, and in some cases, close their programs.

This follows two Congressional letters sent to President Obama by 45 U.S. Senators and 171 U.S. Representatives, demonstrating that he has strong, bipartisan support to stop the cuts in hospice funding.

The cuts come from a 2008 federal rule that eliminates a component of the Medicare hospice benefit known as the budget neutrality adjustment factor (BNAF). Members of the hospice community have been calling and emailing the Administration requesting that implementation of this rule be stopped.

"The sheer number of hospice programs represented by this letter and those recently sent by Members of Congress should send a strong message to the White House about the urgency in stopping these cuts," said J. Donald Schumacher, NHPCO president/CEO.

Earlier this year, President Obama and Congress approved a moratorium on the hospice funding cuts that expires on September 30, 2009. Without further action, hospice reimbursements will drop by 3.1 percent, leaving hospice programs, particularly smaller and rural ones, facing cutbacks in services and possible closure.

Hospice is a proven Medicare cost saver. In 2007, an independent, Robert Wood Johnson Foundation-funded study by Duke University found that hospice reduced Medicare costs by $2,300 per patient, saving more than $2 billion per year.

Hospice is considered to be the model of high-quality care at the end of life. Research from NHPCO shows that 98 percent of families served by hospice are willing to recommend its care and services to others.

For more information about NHPCO's efforts to protect hospice funding, please visit NHPCO's Advocacy Web page at: www.nhpco.org/advocacy (the letter sent to President Obama is available online).

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SCHIP Provides Health Coverage to 7.4 Million Children in 2008

Some 7.4 million children were enrolled in the State Children's Health
Insurance Program (SCHIP) in 2008 -- a four percent increase over the
previous year, the U.S. Department of Health and Human Services
announced today. The announcement comes as Congress is debating
reauthorization of SCHIP, which is projected to expand coverage to an
additional four million children.

"With unemployment numbers rising and the economy struggling to regain
momentum, more and more American families are relying on SCHIP to insure
their children get the health coverage they need," said Acting HHS
Secretary Charles Johnson. "It is no surprise that SCHIP enrollment
went up in 2008 and we expect this trend to continue well into 2009 if
the program is reauthorized."

Created in 1997, SCHIP is a state and federal partnership designed to
help uninsured children. SCHIP received $40 billion in federal funds
over 10 years through 2007. The Medicare, Medicaid and SCHIP Extension
Act of 2007 extended the program until March 31, 2009, with an
appropriation of $5 billion for each of fiscal years 2008 and 2009, with
fiscal year 2009 funding available only through March 31, 2009. The
legislation also provided $1.6 billion in funding for states with SCHIP
budget shortfalls for fiscal year 2008 and $275 million for state
shortfalls through the first two quarters of fiscal year 2009.

Enrollment data, compiled by the Centers for Medicare & Medicaid
Services (CMS), and based on state reports, show that 7.4 million
children were enrolled in SCHIP at some point during federal fiscal year
(FFY) 2008, compared to 7.1 million for fiscal 2007. During FFY 2008,
334,616 adults were covered with SCHIP funds.

"While more children are relying on the program, we know millions more
children need health care coverage and that is why we need a strong
SCHIP to meet the nation's growing need," said Acting Secretary Johnson.
"President Obama believes that healthy children are the key to a healthy
economy and a healthy future for our country. We look forward to
working closely with Congress to reauthorize SCHIP and to working with
the States to do every thing we can to enroll every eligible child in
the program."

The SCHIP targets uninsured children who live in families with incomes
generally around 200 percent of the federal poverty level ($42,000 for a
family of four in 2008), which is too high in most states to qualify for
Medicaid, but in many cases, too low to afford private coverage.

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