HCR bill fails to address problem of malfunctioning medically critical implants:

[amborin]

"In January, William R. Morris’s artificial hip, just three years old, was failing so badly that it had to be replaced during an extensive procedure that cost about $50,000.

William R. Morris had his three-year-old artificial hip replaced in January because it was failing. It was his third hip replacement since 2006.

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The million or so artificial hips and knees implanted each year in the United States, they say, are normally not guaranteed. Instead, the costs of replacing implants that fail early because of design or mechanical problems — devices that sell for as much as $15,000 each — are largely paid by Medicare, insurance companies and patients.

....... the costs to taxpayers, policyholders and patients can run into the tens of millions of dollars each year, health care experts estimate.

Orthopedic producers may sometimes even profit from the failures because they sell the replacements at full price.

“Companies have dumped these costs into the health care system,” said Dr. Lawrence D. Dorr, an orthopedic surgeon in Los Angeles who two years ago took the unusual step of drawing attention to one problematic hip device. “They don’t have any skin in the game.”

The costs imposed by poorly performing medical devices were not dealt with in the landmark health care legislation that Congress passed last month. To pay for part of the overhaul, lawmakers mandated an excise tax on implant sales that is intended to bring in $20 billion over the next decade.

Patient advocates say an important opportunity was lost. Arthur Levin, the executive director of the Center for Medical Consumers, an advocacy group in New York, said it was appalling that the manufacturers did not provide warranties, given how critical such implants are for patients. By contrast, makers of another widely used and costly category of implants, heart devices like defibrillators, have issued warranties for more than 30 years and have provided free or discounted replacements when devices fail prematurely.

“Either they do not have faith in their products, or they are just saying tough luck to patients,” Mr. Levin said, referring to the makers of orthopedic implants. “It borders on unethical business behavior.”

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http://www.nytimes.com/2010/04/03/business/03ortho.html?ref=todayspaper&pagewanted=all