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Reductions in spending and health testing under Obama Health Law will lead to missed diagnoses

by | Oct 16, 2013

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics

Former President George W. Bush

Former President George W. Bush

New information indicates that former President George W. Bush’s life may recently have been saved because of a diagnostic test that would likely have been prevented by the sort of limits Obamacare “quality measures” will impose.

According to an October 11th National Journal piece, “George Bush’s Close Call,” Tom DeFrank writes,

“Sources familiar with the former president’s medical situation told National Journal that a major blockage in a coronary artery discovered during Bush’s annual physical exam in August had almost completely shut off blood flow to one of his heart chambers. ‘He was more than 95% occluded,’ an authoritative source said. ‘With a blockage like that in a main artery you’re supposed to die. He was pretty lucky they caught it.’”

Yet before the 95% figure became public, the doctors who had ordered the test whose results sent Bush into urgent surgery were denounced for having done so.

For example, in an August 9th opinion written for the Washington Post titled, “President Bush’s unnecessary heart surgery,” Vinay Prasad and Adam Cifu lamented that George Bush received the heart health test. They wrote:

“If Mr. Bush had visited a general internist practicing sound, evidence-based care, he would not have had cardiac testing. Instead, the doctor would have had conducted age-appropriate cancer screening. For the former president, this would include only colon cancer screening. It no longer would include even prostate-specific antigen testing for cancer. The doctor would have screened for cholesterol, checked for hypertension and made sure the patient was up to date on age-appropriate vaccinations, including those for pneumococcal pneumonia and shingles. Presumably Mr. Bush got these things, and he got the cardiac test as well. What value does a stress test add for an otherwise healthy 67-year-old? No study has shown that this examination improves outcomes.” 

Note the emphasis on “age-appropriate” testing. Does it bespeak an unstated assumption that when you’re old spend we shouldn’t waste too much money on checking for life-threatening illnesses?

Reducing the number of “unnecessary and expensive tests” has long been a goal of those seeking to cut health care costs. While we would all prefer to spend less on healthcare, these tests, although sometimes expensive, do save lives. It is a fact that an otherwise seemingly healthy former president’s extra testing probably saved his life.

By contrast, in another Post opinion piece, “The unnecessary test that saved my mother’s life,” Dr. Jason Wasfy described how one inconclusive test after another finally led to a very early diagnosis of his mother’s lung cancer that made the condition treatable.

“Typically, patients do not know they have lung cancer until they notice symptoms such as a cough or weight loss. At that point, lung cancer is usually incurable. My mother was lucky. An unwarranted liver test led to a discovery in the lung, which spotlighted cancer caught early enough to be cured.” 

However, reducing the use of a number of tests like the ones Dr. Wasfy’s mother and former President Bush received may become the new normal under the Obama health care law.

Doctors, hospitals, and other health care providers can essentially be told by Washington just what diagnostic tests and medical care are authorized under “quality and efficiency” standards imposed by the federal Department of Health and Human Services.

Even if the patient is willing and able to pay for it, treatment that a doctor and patient deem needed or advisable to save the patient’s life or preserve or improve the patient’s health will have to be denied if it exceeds the imposed standards.

Documentation of this element of Obamacare can be found at:

The Obama Health Law’s blind insistence on limiting health care spending threatens access to life-saving medical treatment – now, and in the future.

Categories: ObamaCare
Tags: ObamaCare