Clinton's Procedure Offers Lessons In Heart Care, Rationing

Bill Clinton, the last president to attempt to overhaul the health system, had an unplanned heart procedure yesterday at New York Presbyterian Hospital. He's already left the hospital and appears to doing fine.

Bill Clinton at the SOS Saving Ourselves Help for Haiti Live Concert on February 5, 2010.

Bill Clinton at the SOS Saving Ourselves Help for Haiti Live Concert on February 5, 2010. The former President was hospitalized yesterday. Donald Traill/AP hide caption

itoggle caption Donald Traill/AP

President Clinton's procedure is a common one - up to one million Americans get one each year. Doctors inflated a tiny ballon to reopen blocked arteries, and then inserted tubes made of steel mesh — called stents — to keep them open. But, given that the patient is no ordinary one, some commentators are searching for a teaching moment in the former president's case.

For one thing, the former president's condition has fueled discussions about heart health. But, the episode has also cued conservative pundits to speculate that he must be glad his own health reform effort didn't squeeze through Congress back in 1994.

Critics who saw "rationing" under that plan — not to mention, in today's industry-and-Democrat-driven overhaul effort — suggest a reformed health system may limit access to exactly that type of procedure. Michelle Malkin, the conservative blogger, says, "Stents don't grow on trees. They were not created, developed, marketed, or sold by government bureaucrats and lawmakers."

Actually, the type of procedure Clinton underwent has been a target for critics who say the U.S. Health system overuses the costly procedure. For people with first-time chest pain for the first, a major study found doctors implant stents too often and that patients fared no better, when it came to heart attacks and death, than when they didn't have the procedure. This finding doesn't apply to Clinton, who has already had a major heart surgery.

But, presidents who propose curbing medical costs have also found themselves in the sights of critics when their own — or their families' — medical needs cause them to seek care in a way that appears to contradict their policies.

After President Jimmy Carter proposed capping hospital revenues, his wife discovered a lump on her breast, the New York Times reported in a 1977 Economic Scene column. (We've discussed this column, which also echoed last summer's death-panel controversy, before.) Mrs. Carter was rushed to surgery, where a biopsy determined the lump was benign, but the writer wondered whether Carter realized how much it might cost if everyone received such rapid, personalized care.

Weaver is a reporter for Kaiser Health News, a nonprofit news service.



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