Tonsils and Cesareans

The recent debate about health care has brought lots of rhetoric about who is responsible for the skyrocketing costs. The insurance companies have been labeled as villains, and other groups have also been vilified. During his press conference, the president focused on doctors.

He said that if you bring your child in with a sore throat, “the doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out.’” Do we really have evidence of doctors taking out tonsils unnecessarily? Sure, physicians will remove tonsils in a child but usually if the child developed at least seven “significant” episodes of throat infection in a year.

Are there physicians who look at the reimbursement system and make a decision about a tonsillectomy? There are probably a few, but this surgery is hardly on the increase. Let’s talk about a surgery that has increased dramatically: Cesarean sections.

The number of C-sections that were performed in 1965 was 4.5 percent of births. Today C-sections are performed in 31 percent of births. Why the increase? Are obstetricians looking at the reimbursement system and making a decision?

C-sections are not on the increase because of doctors, but because of lawyers. The potential threat of a medical malpractice lawsuit has changed standard medical practice. A story in the New York Times on malpractice lawsuits concluded that “doctors have responded by changing the way they deliver babies, often seeing a relatively minor anomaly on a fetal heart monitor as justification for an immediate Caesarean.”

Who can blame the doctors for ordering a C-section? Even though their best medical judgment might be to wait, most doctors are probably going to take the mother into surgery rather than risk a lawsuit. So why not consider tort reform?

According to an article in Investors Business Daily, the president told the American Medical Association that he is “not advocating caps on malpractice awards.” It might be worth noting that one of the key groups that helped elect this president are trial lawyers.

The increase in health care costs is due to lots of factors. But when the president focused on doctors, he ignored members of his own profession that may be more responsible. I’m Kerby Anderson, and that’s my point of view.