Allahpundit posted this clip from Barack Obama’s town halls, adding feet stealers to the new ObamaCare lexicon of Evil Medical Professionals, a new entry after Tonsil Vultures. There is a point that the well-deserved avalanche of criticism misses, though.  The clip has Obama explaining that government needs to take over the American health-care system to stop doctors from getting rich off of amputations of limbs from diabetic patients:

On the doctors’ front, one of the things we can do is to reimburse doctors who are providing preventive care and not just the surgeon who provides care after somebody is sick. (Applause.) Nothing against surgeons. I want surgeons — I don’t want to be getting a bunch of letters from surgeons now. I’m not dissing surgeons here. (Laughter.)

All I’m saying is let’s take the example of something like diabetes, one of — a disease that’s skyrocketing, partly because of obesity, partly because it’s not treated as effectively as it could be. Right now if we paid a family — if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they’re taking their medications in a timely fashion, they might get reimbursed a pittance.

But if that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed. Well, why not make sure that we’re also reimbursing the care that prevents the amputation, right? That will save us money. (Applause.)

But here’s what the Really Smart Guy in the Oval Office apparently doesn’t understand about the medical system.  Diabetics are treated by general practitioners and endocrinologists, neither of whom perform amputations.  The AMA pointed out that Obama was off by a factor of 100 on the costs, but thus far no one has pointed out that the incentive structure he assumes doesn’t exist.  Only after a GP and the endocrinologist, plus probably an orthopedist and a couple of other specialists, decide that the limb cannot be saved does the surgeon remove the limb.  It has nothing to do with the compensation that the GP and the endocrinologist receives, or an imaginary windfall for an amputation that will have nothing to do with either a GP or an endocrinologist.  I know this from long-time personal experience as the spouse of a Type 1 diabetic who lost her eyesight and kidneys to the disease, and who worried about amputations for years before her pancreas transplant.

If Barack Obama doesn’t understand that much about medical care in the US, why should we be listening to his ideas to radically restructure it?  Maybe he should quit shooting off his mouth, withdraw this bill, and learn something about the industry he expects to dismantle and reassemble.

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