NEWS OF: 5/10/2006

Drive Thru Breast Cancer Surgery

The NIH’s Outpatient mastectomy: clinical, payer, and geographic influences. documents a seven year trend (1990-96) across five states (Colorado, Connecticut, Maryland, New Jersey, and New York) for complete mastectomies, subtotal mastectomies and lumpectomies to be performed as “outpatient” surgery. In 1993, 1 to 2 percent of complete mastectomies were performed as outpatient surgery in all five states.

By 1996?

  • 8% of complete mastectomies were outpatient in Connecticut
  • 13% were outpatient in Maryland
  • 22% were outpatient in Colorado.

If you were billing Medicare, Medicaid, or a private commercial insurance company? You were more likely to receive inpatient care. If you were insured by an HMO? Outpatient.

Another study (Journal of the National Cancer Institute: Trends and Outcomes of Outpatient Mastectomy in Elderly Women) revealed that older women were much more likely to get their services “outpatient” across the board.

The thought that you could have one or both breasts completely removed surgically in the morning and then be sent home with a baggie of gauze surgical pads is barbaric and uncivilized.

It is a trend driven only by insurance companies.

One that desperately needs to be reversed before your heart bypass surgery is delivered Heathkit-style in a take-out box to your home to keep overhead costs down.

H.R. 1849: The Breast Cancer Patient Protection Act of 2005 is a step in the right direction. Introduced by Rep. Sue Kelly (R-NY) it would require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations.

Did you notice the “2005″ reference? It was introduced April 26, 2005. It’s identical to S. 910: Breast Cancer Patient Protection Act of 2005, introduced by Senator Snowe.

Current fate: languishing in the Committee on Health, Education, Labor, and Pensions.

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