Wednesday, July 01, 2009

President Obama Talks About Pacemakers

I was one of those who missed the "town hall" meeting aired by ABC on the 24th of June, but was nicely pointed to this video where President Obama speaks about placing pacemakers in 100-year olds by a loyal follower:

The video is remarkable on several fronts.

First, I was impressed with the remarkable footage that suddenly appears of the caretaker with her mother, demonstrating the staged nature of this "spontaneous" town-hall interview. No doubt, this question was asked to reassure our seniors about the choices that will soon be made by Washington.

Second, the number of times the elder woman presented to the Emergency Room for care. We are left wondering, did she have a primary care doctor? What were the other discussions that took place before?

Third, the issue of placing pacers in 100-year olds and the new, proposed reliance on bureaucratic "experts" in Washington that will tell the local doctors what the best course of therapy should be based on "research" (a reference to the 1 billion dollar research boondoggle that is comparative effectiveness research). To think that any research will occur on patients of this age is ridiculous. (I'll let others decide what this means for our elderly).

But this is not to say that we should not make choices in this instance. The issue of "cognitive ability" of the elderly, however, was conveniently dodged, and there was never a discussion about the centurion woman paying for her own pacemaker (seems in this case it would be less than a new car).

But whatever you think, these are choices doctors and patients will have to make head-on in the days of increased pressure on Washington to cut costs. The thought of unknown and poorly-defined "experts" (MedPAC?) making these decisions based on non-existent data, rather than the frank discussions between the doctor and their patients and their families, is what really concerns me.



Gary said...

US$35,000? Does that mean they put in a biventricular defib in a 100-year-old?
I would tend to agree with her first EP guy...

Hey, You said...

I thought this line was really funny (paraphrasing Obama near the end):

if we've got experts who are looking at this...and they are advising doctors across the board...then the pacemaker may ultimately save money.

No kiddin'. How much money will that save if every elderly person who technically needs a pacemaker to maintain a normal heart rhythm has one installed? Goodbye, Grandma!

The President also says he wants to meet her mother. And find out what she is eating.

Open comment to Barak: Eat whatever the hell you want. You'll live a whole lot longer if you'll just STOP SMOKING.