You can make a comment directly on the web-site above. Here is what I wrote...
I have taken care of many patients post-op mastectomy in the PACU (post Anesthesia Care Unit) and the SICU (Surgical Intensive Care Unit). This procedure is extremely invasive and traumatic to the patient, physically and emotionally. Not only is a part of the breast, a whole breast or both breasts removed, but the surgeons have to track down and cut were the margins of the cancerous tissues are in order to prevent the cancer to spread further. It usually means that all the "ganglion" draining the area must be scraped and analyzed, often going all the way up under the woman's arm.Most often nerves,muscles and the lymphatic system are irreversibly damaged during the process, causing a lot of pain and limiting the range of motion of the arm affected (If bilateral mastectomy (on both sides) = both arms are affected).
Risks of infections are high, even more so for the patients who have already started chemo and/or radiation therapy (if it kills the cancerous cells, it also kills the healthy cells, including the ones responsible to naturally fight infection). Because the lymphatic system is often scrapped off during the procedure, the "drainage system" is severally affected or even totally removed. The sequels following such surgery are usually extensive and the patient is in no position to take care of herself. It means that the burden falls back onto the shoulders of their family, whether they are or not able to provide adequate assistance and knowledgeable care. Indirectly, and beyond the risks it exposes the patient to, it can totally paralyze the earning power of their "caregivers" and affects the whole family. The husband or companion must stay at home to take care of their loved one despite the fact that most companies do not offer the option of taking time off (and retaining either their income or even their position). Additionally, General Anesthesia can literally be considered like a poisoning of the whole body.Most patients coming out of anesthesia are in atrocious pain despite being half unconscious. Several hours after awaking from the anesthesia, patients are nauseated and weak in the best of case, but most are downright sick like dogs, throwing up and unable to keep fluids or pain medication in their stomachs long enough to benefit their body. If these patients were allowed to remain in the hospital at least 48 hours post-op, they would be able to receive Intravenous re-hydration, anti-vomiting medication IV, pain killers IV, and all the assistance of nursing care, from washing and using the bathroom to changing the dressing, caring for the drains appropriately and monitoring any signs and symptoms of infection.
It has been my experience that status post-mastectomy patients were too sick to be sent home by the end of the day after their surgery. Because the insurance would not allow to keep them, We have often had to officially discharge the patients,only to send them directly to the Emergency Department so their nausea, vomiting and pain could be relieved (which could have been done post-operatively on a surgical unit or even an observation unit).
Conclusion: It is a very short sighted "solution" to send these patients home the same day. They often are re-admitted via the emergency room to manage their symptoms, which costs more to the insurance in the end. It also increases the incidence of post-op infections, sometime being serious enough for the patient to be admitted and treated in an ICU (most expensive hospital stay of all!), and beyond the costs these complications generate, they surely decrease the chances of recovery for the patient (and therefore their survival).
If you can't find it in your heart to treat these women with the minimal human compassion, crunching numbers of the complications associated costs should convince the insurance companies that a longer post-op in-hospital stay is the way to go; medically, humanly and financially!