bread & butter

Surgical “Bread & Butter” Cases to be Reimbursed with Bread & Butter

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BALTIMORE, MD – In a new initiative to cut costs, the head of the Centers for Medicare & Medicaid Services (CMS), Charles Kaine, has announced that starting next quarter those cases colloquially-known as “bread & butter” cases will actually be reimbursed with bread & butter.

bread & butter
“The bread & butter is yours. The tray and parsley, that’s ours. You didn’t EARN that.”

“As we’ve known for years, Medicare costs are spiraling out of control,” Kaine explained.  “We needed to investigate new ways of cutting costs.  For example, instead of being reimbursed six-hundred dollars for a laparoscopic cholecystectomy, a general surgeon will receive a loaf of white bread with half a stick of unsalted butter worth approximately three dollars, representing a 99.5% reduction in cost.”

Kaine said this would work on multiple levels.

Neurosurgeon and ACDF?” Kaine asked rhetorically.  “Bread & butter.  Transplant surgeon doing a liver?  Bread & butter!!  ENT doing a tonsillectomy?  You guessed it, BREAD & BUTTER!!!  This will provide much needed jobs in the baking and dairy industry, plus the surgeon will be able to feed his family with nutritious carbohydrates and delicious butter.  Provided surgeons fill out the appropriate paperwork and there are no issues with billing and coding, they will receive the bread & butter in the mail in approximately six to eight weeks.”

What do surgeons have to say about this?  Johns Hopkins trauma surgeon Dr. Jo Nell spoke with the Gomerblog and offered some insight.

“Listen, we’ve been sarcastically talking about bread & butter cases for years and now and now it’s finally reared it’s ugly head,” Nell commented.  “Sure I’m disappointed my three-hour ex-laps are now worth less than minimum wage.  Maybe if we were allowed to choose the food we are reimbursed with, it would be different.  For example, I’m a big fan of really fresh fish, or sometimes a solid mac and cheese, but that’s not going the last in the mail.  Honestly, we should have referred to these cases as [filet] mignon & [Dom] Perignon cases.  But even then it’s barely worth it.”

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