George W. Gets a Heart Stent and Obamacare is Evil. Yeah, That Makes Sense.

Categories: Schutze

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Must be more to the President George W. Bush arterial stent operation than we have heard so far. About the only conclusion fair to draw, in fact, is that not all the facts have been made public.

The Dallas Morning News has an op-ed page piece in the paper this morning by Dr. Marc K. Siegel defending the decision by Dallas heart doctors two weeks ago to stick a wire mesh stent into the former president's arteries to keep him from getting a heart attack. Siegel is a Fox News anti-Obamacare polemicist who tells people that medical studies are a socialist conspiracy to take away their health care. He cites among his other credentials that he rides bikes with Bush.

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foxinsider.com
Dr. Marc K. Siegel, defender of stents

Bush's operation reignited a public debate about arterial stents ongoing for at least three years, spurred initially by a series of investigative articles by The Baltimore Sun, followed by a scathing report from the U.S. Senate Finance Committee. It's a money-and-policy debate wrapped around a science debate, with lots of science on both sides of a basic underlying question: Do doctors stick too many wire meshes in people's arteries?

Siegel apparently didn't think that was true for Bush. "The Affordable Care Act may be pushing us in the direction of one-size-fits-all medicine, but Bush's case demonstrates that a more personalized approach often still works the best," he wrote in the Morning News.

The Baltimore Sun stories were based on a guy in Baltimore who got kicked out of a hospital and was barred from practice by the Maryland Board of Physicians, according to the Senate report, for sticking way too much wire in people and getting paid way too much money by the government for doing it. The accusation was that he was putting the wire in people who didn't need it.

After Bush got wired two weeks ago, the Morning News carried an op-ed piece by two experts who said his stent was probably unnecessary. The question reverberated all over the blogosphere. Nobody says stents are useless. They save lives of people who have severe symptoms or who are undergoing heart attacks. The questions are all about people like Bush, who had no symptoms, according to the statements released by his own staff.

Two major studies since 2007 have indicated that drug therapy may be safer and actually work better for people who have some blockage in their arteries but not enough to produce physical symptoms.

In spite of my English degree from a real college 92 years ago, I may not be fully qualified to tell you whether you need a stent in your arteries. I could give you my opinion, but you would be required to sign lengthy release forms first. That's not my piece here.

What intrigues me is this: I do notice that at the end of last week when Siegel, the anti-Obamacare guy, was on Fox News venting about all this, he made this remark: "President Bush's people reached out to me, and I found out some facts about this case that are completely in the opposite direction."

So did that really happen? Did George W. Bush's people ask this Fox News whack-job to go on TV and say Obama's trying to deny our 28th amendment constitutional right to arterial stents? I have a message in to the former president's office. I will let you know when they invite me over for a fireside chat. In the meantime, who knows? He could have dreamed it.

In the meantime in all the blogalizing the consensus seems to be this: If Bush truly was as asymptomatic as official statements have indicated, then there is legitimate mystery in the decision to take him straight from his stress test at the Cooper Fitness Center to Presbyterian Hospital for an invasive procedure. If his condition was actually more threatening than the statements have let on, then there's no mystery.

Somebody is feeling very uncomfortable with the debate itself and pressure is being brought to bear. Witness the decision of the News to allow this Fox dude to appear on its op-ed page today posing as Louis Pasteur. But who is it really who wants to stir the issue? The former president's people? The docs who stuck the wire in him? The International League of Stent-hating Socialists? Stents-R-Us?

Say this for the Fox guy: By making it a debate about Obamacare, he has at least given it a nice news hook. With legs like that, maybe this story can become the Benghazi of heart stents.


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57 comments
tongue_twister_for_t
tongue_twister_for_t topcommenter

So tell me something, why are they exempt from having to follow the rules and the average citizen is not? Is that because of a money issue and the insane difference between rich and poor inheritance? After all the poor cannot inherit anything except maybe the wind. After all GWB lied 444+ times and avoided Veitnam through his family influence. Instead I see him in a paper picture holding up a fish on a boat in Kennebunkport Maine.

tongue_twister_for_t
tongue_twister_for_t topcommenter

That's Funny, There's an advertisement at the top of the page for the Stent Report for Econo Lube and Tune. (LOL).

Does the mean I can get my tubes greased too?

Mirror_man
Mirror_man

Schutze, Myra and the other Big D fishes out of water-

Evil is nationalizing 1/6 of the economy on a party-line vote.

whocareswhatithink
whocareswhatithink

Have you not heard....Congress, IRS etc etc are exempt from the Affordable Health Care Act, thus making this piece a little out of touch when it comes to healthcare and polticians (retired or not). If it ever comes time for Obama to get a get a operation, Obamacare wont come into it either.

Dan Pettit
Dan Pettit

George W. will get a heart stent whether the Affordable Care Act is in affect or not.

animas
animas

This is a fantastic piece touching on several ethical questions in today's healthcare environment.  I say this with some sadness, since today I was informed that a fellow professional, who was within one year of Medicare eligibility, now has metastatic cancer.  Insurance coverage is essential and in the national interest.  The Republicans when in power did nothing about the escalating numbers of uninsured in the population, and even now attack any remedy without offering a viable solution.  The state controlled by a Republican majority also refuses to start insurance exchanges or expand Medicaid. There is also the ethical dilemma of physicans performing too many unnecessary but remunerative surgeries (see WSJ July 25 re:Physician Owned Distributorships--Spinal surgery).  Abbott (cardiac stents) and Medtronics (spinal surgery) have an interesting history in this regard.  Cardiac stenting,btw is not harmless and may lead to death via sudden occlusion or require complicated  plavix dependent maintanance : (see controversy regading drug eluting stents vs. bare metal coronary artery stents-2013)

lane.atkins
lane.atkins

Although everyone is naturally curious, Mr.Bush's health is really nobody's business.  I wish him the best and pray he gets well soon. I don't get what Obamacare has to do with President Bush's Medical care.  All the politicians seem to be exempt from that nightmare anyway.

rbeezlee
rbeezlee

Are you for real?  Surely you can't be this stupid, Jim?  I refuse to believe it.  Must be a slow day.  Has to be. . . .

Blake Wilson
Blake Wilson

most of the "Top Comments" didn't read the article or the opeds...seems legit.

mavdog
mavdog topcommenter

First, it is important to point out that George Bush was able to have the physical exam, and to be taken to the hospital with angioplasty done, because he had health insurance. For the millions of Americans who lack health insurance coverage, the physical exam and the procedure would likely never have been achievable. They would go on with blockage until they suffered a heart attack, with much higher cost of treatment, much more difficult and costly rehab, and a high possibility of death.

Second, it is important to note the 2 authors of the DMN op-ed criticizing the procedure on Bush are not cardiologists. The M.D. after their names does not mean they have in depth knowledge on the current state of the art thinking of heart specialists.

stents are proven to be a positive tool for patients with angina, as the COURAGE study points out those who had stents placed were 50% less likely to suffer repeat issues.

Thank goodness those who need this procedure can get it done with health coverage accesible to all, and those who have the prior issue of angina or heart attack cannot have coverage denied going forward, both due to the Affordable Care Act.

MikeWestEast
MikeWestEast

Your article makes pretty clear you deep research somehow missed the original Op Ed that began this argument.  Two doctors, based only on the scanty news reports, claimed President Bush should have just relied on his overall health, not gotten the extra tests and not gotten the stent.  They were the ones that raised the idea that Affordable Care Act can only work if everyone follows the guidelines and does not do anything extra.  If Presidents get extras, everyone will want extras, defeating the idea of cost control.  The odds, based on their limited knowledge, were with the President and he should have stopped treatment and tests.

The original Op Ed was stupid and probably the response, evidently your only research, was just as stupid.  Only the doctors concerned know the real story and it is frankly none of our business.  The ONLY message from the Bush Family was a note that no matter how healthy you feel, you need to get checked.  Do not be like that example of good health, President Clinton, that on his own decided to stop taking his blood pressure pills "because he seemed to do ok without them."  He did nearly die solely because of basic attitude.  Not as dumb as what Steve Jobs did with his cancer, but pretty close.

If someone tells me I have a blocked artery, I am getting the stent. 

Dianna Orender
Dianna Orender

The Affordable Care Act is NOT the government taking over your health care. It ensures that your insurance company can't screw you over any more. There is a HUGE difference.

Myrna.Minkoff-Katz
Myrna.Minkoff-Katz topcommenter

The republican party is in free-fall.  Infighting, nutsos, perverts and racists are all that's left in the GOP.

Josh Wilemon
Josh Wilemon

i think the better question is - who gives a shit what the DMN has to say about anything?

Marvin Remmers
Marvin Remmers

I prefer a more personalized approach, so I'll have to take Siegel's side on this. I want to be in control of my healthcare, not the government, an insurance company, or a big corporate employer.

Jon Jackson
Jon Jackson

Just post what you know about....pretty skylines and where to get the best tacos. You're over your head when it comes to healthcare.

Obummer
Obummer

Yo duez toz Obummerdon’tcare tooz manyz doxz iz gettingz outz o' da bidness. Too manyz OB/GYNs aren't ablez taz practice theirz lovez wif beotches allz across daz country.

Montemalone
Montemalone topcommenter

Don't you know that government paid health care for Republican bike riders performed by their bike riding buddies is all good and as God intended. 

Obamacare is bad, because that means individual people have to pay insurance premiums to private for profit insurance companies that will have the power to decide whether or not inserting a preventative care device into the heart of a liberal is a good idea or not.

See the dif?

JimSX
JimSX topcommenter

@rbeezlee 

You were not on the debate team, were you, RB? 

JimSX
JimSX topcommenter

@mavdog

"After an average follow-up of four and a half years, the two groups were remarkably similar. Getting angioplasty and a stent to hold open a narrowed artery didn’t offer any extra protection against a heart attack, stroke, hospitalization for acute coronary syndrome (the umbrella for heart attack and unstable angina), or premature death.

The only big differences were in freedom from angina and the need for follow-up procedures. After one year, 66% of those who underwent angioplasty were free from angina, compared with 58% of those on medical therapy. By five years, though, there was no difference, with about 73% of both groups reporting no angina."

http://www.health.harvard.edu/family-health-guide/updates/medication-vs-stents-for-heart-disease-treatment

"The COURAGE study showed no meaningful difference in survival or reduced risk of heart attack with the use of interventional device procedures (angioplasty, bare metal stents) plus optimal drug therapy compared with optimal drug therapy alone." 

http://www.metairieinstitute.org/sitebuildercontent/sitebuilderfiles/Courage.pdf

JimSX
JimSX topcommenter

@MikeWestEast 

Well, Mike, I have my own concerns about your reading abilities as well, since my piece very clearly discusses and links to the article you claim I missed. You missed the point of that article,too, which was not stupid but was based on the overwhelming body evidence from recent research finding that some doctors have been sticking stents in people who don't need them and then gouging the government for millions of dollars in compensation. Of course those doctors are now concerned that Obamacare may reduce their ability to engage in fraud, which they call freedom, and bring about  greater efficiency and reduced costs, which they call socialism. 

animas
animas

You might be underestimating the "resourcefulness" of the insurance industry in that regard.

Mirror_man
Mirror_man

Love your wishful thinking and ad hominem arguments MMK. So persuasive...

rbeezlee
rbeezlee

@Myrna.Minkoff-KatzThe day you realize that none of this has anything to do with Democrats and Republicans; that they are all on the same side of the issue. . . is the day you take your first step towards adulthood. 

JimSX
JimSX topcommenter

@Marvin Remmers

Obamacare does nothing to reduce personalized care. It would reduce fraud, however. 

PeterBrady
PeterBrady

@Marvin Remmers But how do you want to pay for it, chief? May I assume you already have a private physician?

RTGolden1
RTGolden1 topcommenter

@Marvin Remmers I hope you've got a lot of cash or easily transferable liquid assets.  That's the only way you're going to be in control of your own healthcare.

JimSX
JimSX topcommenter

@Jon Jackson 

My medical advice for you, pal? Shove it.

mavdog
mavdog topcommenter

@Obummer

you know, I put your posts into Babelfish to try and translate into english, but it can't give me anything that makes sense.....go figure.

leftocenter
leftocenter

@Obummer

You realize nobody reads your crap?  You need a new hobby...

RTGolden1
RTGolden1 topcommenter

@Margaret Groves Kilbury  I LIVES Macabre, aO.

JRuggaber
JRuggaber

@Montemalone Public option was chopped off of the Affordable Healthcare Act, the center of your complaint is the Republican Party's primary contribution to the AHA.

mavdog
mavdog topcommenter

@JimSX

you missed this:

"In follow-up procedures, about 20% of those who initially underwent angioplasty needed a repeat angioplasty or bypass surgery, while 31% of those who started on medical therapy eventually needed to have angioplasty or bypass surgery."

long and short, if you have SOME blockage that is not restricting blood flow and causing angina or more dangerous conditions, a stent is not shown to be any more productive than non-invasive therapy. The non-invasive therapy will likely produce the same benefits as the stent.

However if you have angina or more dangerous condition such as a full blown heart attack, the non-invasive therapy will more often result in a need for future surgery.

MikeWestEast
MikeWestEast

@JimSX @MikeWestEast Your comments indicated you were aware of the original Op Ed only because the response mentioned it.  Your article stated the reference to Affordable Care Act came out of the blue when it was central to the original Op Ed.  If you read the original Op Ed, I did not see anything of substance that reflected that action.  I think you read the response, cruised the blogs for a few comments and went to post.

PlanoDave
PlanoDave

@JimSX Really?  Like the non-existant fraud in HARP or any of the other Obama give-aways?


You seem to be a well-read guy.  May I suggest that you read "Bailout" by Neil Barofsky to get a better feel for how the Obama administration feels about policing their give-away programs?


mavdog
mavdog topcommenter

gee Jim, I've never read you post about where to get the best tacos. are you keeping your culinary side from us?

CogitoErgoSum
CogitoErgoSum topcommenter

@mavdog Don't feed the trolls! Ignore them and they might get tired and go away.

Obummer
Obummer

Yo if use don’ts disparage whats eyez sayz ah won’tz disparage whatz use sayz e.g. it’z notz muhz faultz ifz use don’tz knowz howz ta votez right.

PlanoDave
PlanoDave

Nice try, but Joe Lieberman was the individual with who required the Public Option to be omitted in order to garner his support.

epicmale
epicmale

@JimSX @mavdog We can't, and neither can you, unless you wish to continue speculating with little to no hard facts in hand.  It is President Bush' private medical information.  His health and how he addresses it is not critical to the security of the nation.  So all your conjecture and postulates are pure fantasy.  However, I do have confidence that his doctor gave him excellent advice.  I also suspect that President Bush consulted other medical professionals before he let anyone start poking around the arteries in his heart.

Look, Jim, he has served his country well, whether you agree or not.  Show the man some respect and let him enjoy his privacy and retirement.

animas
animas

  Moral of the story- to be in the lucky 70% group-Start therapy  earlier-while asymptomatic- and don't smoke. (of course  these remedies require access to appropriate medical advice via health insurance).

animas
animas

I think that Jim may be onto something here. During the course of an otherwise routine  (i.e. performed in an outpatient facility) adenosine or Bruce protocol Nuclear Medicine cardiac stress evaluation, patients may experience "discomfort" but are rarely rushed to the cath lab.  I suspect something else was going on just by the immediacy of the course of events.

mavdog
mavdog topcommenter

@JimSX

In my "partial medical opinion"?

I'll analogize with a friend of mine. My 52 yr old  friend was in absolute phenomenal condition, 80 mile bike rides 2x a week and almost no body fat. He went to do his yearly physical, had an EKG every year.

One night he was having dinner wth his wife and dropped dead at the kitchen table. Apparently he had 95% blockage in an artery and his heart gave out. Boom, he was gone.

Great fitness can hide problems, and what we don't know is the level of blockage in Bush's artery(ies). The fact that he was not reported to have felt any discomfort is interesting, his fitness could easily mask the problem. we don't know the facts.

Were the Dr.s too eager to place the stent? Could be. or they saw the extent of the problem and decided putting in the stent was the best remedy.

disclosure: I have had a stent inserted, and it was done by the physicians group that did Bush (not the same Dr). They are well regarded, and I  believe they acted in my best interests, not acting in how they could reap the most $....

mavdog
mavdog topcommenter

@JimSX

well then, I have to say that John Jackson is wrong. If you write those Leslie Brenner reviews, which are awful to tell you the truth, clearly you know squat about "where to get the best tacos"!

JimSX
JimSX topcommenter

@mavdog 

I sometimes use the nom de plume, Leslie Brennar.

PlanoDave
PlanoDave

@RTGolden1 I totally agree.  Absent a single payer solution, the root problem will not get addressed.  

The problem with ACA is that it is a demand side solution, without a supply side component.  That is, it is going to increase the demand for insurance subsidized healthcare while not doing anything to increase the supply of available healthcare at the prices demanded by the insurance companies.  Economics 101 says that the result will either be an increase in cost or unavailability and scarcity.  Neither is desirable.

RTGolden1
RTGolden1 topcommenter

@mavdog @PlanoDave Which is where the ACA failed.  The insurance companies got their mandate, the consumers got exactly zip.

I was behind ACA 100% (dont tell the Libertarians, they'll revoke my card) until the President caved in on the public option.  Actually I'm for a 100% single-payer system.

mavdog
mavdog topcommenter

@PlanoDave 

nope, Baucus and Grassley were the primary one's responsible. No bill that included a public option would get out of their commitee. Second, the White House agreed to not require a public option in a deal with the insurance cos. the cos. agreed to not oppose the bill if the public option was left out.

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