Obama Makes Case for Reform to American Medical Association
On Monday, President Obama spoke at the American Medical Association's annual conference in Chicago and defended his health reform plans as necessary to lower health care costs so coverage can be expanded to all U.S. residents, the Chicago Tribune reports (McCormick/Japsen, Chicago Tribune, 6/15).
On Sunday, AMA began discussing its official position on health reform and the organization likely will vote on a resolution expressing its stance this week. The group has spoken out against a proposed public insurance option that would compel physicians to participate and pay them at Medicare rates.
Obama said, "The public option is not your enemy; it is your friend, I believe" (Edney, CongressDaily, 6/15). He added that a public plan would "put affordable health care within reach for millions of Americans," but he acknowledged that physicians have "legitimate concerns" about how much a public plan would pay them (Young/Youngman, The Hill, 6/15).
Obama said, "Let me also address an illegitimate concern that's being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system," adding, "When you hear the naysayers claim that I'm trying to bring about government-run health care, know this: They're not telling the truth" (Connolly, Washington Post, 6/16).
He said, "There are countries where a single-payer system works pretty well," but "I believe â¦ that it is important for our reform efforts to build on our traditions" (Chicago Tribune, 6/15).
Obama said, "No matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period" (Haberkorn, Washington Times, 6/16).
Obama also sought to address doctors' concerns that comparative effectiveness research would limit their ability to choose a patient's course of treatment (The Hill, 6/15).
In addition, the president discussed the need to rein in health care costs, and how this effort would affect doctors. He said, "With reform, we will ensure that you are being reimbursed in a thoughtful way tied to patient outcomes instead of relying on yearly negotiations (over reimbursement rates)," adding, "The alternative is a world where health care costs grow at an unsustainable rate, threatening your reimbursements and the stability of our health care system" (Washington Times, 6/16).
Obama noted that reform will require significant upfront costs but framed this year's reform effort as an opportunity that must be realized.
One of AMA's highest priorities in health reform is lowering physician liability in medical malpractice lawsuits.
Obama told the conference that physicians need a system that allows them to worry less about liability, but he said, "I'm not advocating caps on malpractice awards, which I personally believe can be unfair to people who've been wrongfully harmed."
Â AMA has called specifically for such caps (Chicago Tribune, 6/15).
Obama said, "I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine and encourage broader use of evidence-based guidelines" (Youngman, The Hill, 6/15).
Incoming AMA President James Rohack said that doctors must be guaranteed legal protection if Obama's goal is to be met for reducing extraneous tests and treatments, which contribute to rising health care costs.
Rohack said, "Unless we have protection in the courtroom for not ordering a test, we're going to order those additional tests" (Washington Post, 6/16).
Tampa, Fla., surgeon Dennis Agliano said that when the president said he would seek to reduce the liability burden on doctors without capping jury awards, "Everybody clapped," but "then he didn't give any substance to it," adding, "He made it sound like if you practice better medicine you won't be sued" (Lyderson/Volpe, "Daily Dose," Washington Post, 6/15).
House Minority Leader John Boehner (R-Ohio) said, "We're pleased the president has expressed rhetorical support for medical liability reform, but [the] fact is the effect of even the strongest medical liability reforms would be negated by a government takeover of health care that raises taxes, rations care and drives health care costs even higher," adding, "Real medical liability reform must establish tough standards to reform the medical liability system, encourage the speedy resolution of claims and deter junk lawsuits" (Koffler, Roll Call, 6/15).
Mario Motta -- president of the Massachusetts Medical Society, who was in Chicago for Obama's speech -- said, "If a public plan was designed specifically the way he phrased it today -- to give another option, to make sure all Americans are insured -- and if its rates were adequate for physicians and it could pressure insurers to behave more responsibly," the physicians could get on board. However, he reiterated, doctors will not support a plan that pays at Medicare rates, which are about 20% lower than private insurers' rates.
Donald Palmisano, a former AMA president and head of the Coalition To Protect Patients' Rights, said Obama placed too much emphasis on government-centered approaches. "More than 80% of Americans currently have health insurance, and the vast majority of them are overwhelmingly satisfied with their coverage, so let's fix the problem we have -- not one that doesn't exist," Palmisano said in a statement (Wangsness, Boston Globe, 6/16).
Other physicians at the meeting expressed satisfaction with Obama's pledge that he does not wish to implement a single-payer system. There also was some support for Obama's proposed public plan.
Donna Sweet, a Kansas internal medicine practitioner, said, "We've said we can work with any option that allows choice. I think he understands the market value of having some competition in the system," adding, "It would be nice to have much more government funding so we don't have to rely as much on the private foundations. It won't be easy" because there are "tremendous dollars involved, and there are people who want to maintain the status quo" ("Daily Dose," Washington Post, 6/15).
On Monday, American Public Media's "Marketplace" reported on AMA's reaction to Obama's speech. The segment includes comments from Obama and health care policy analyst Robert Laszewski (Barshay, "Marketplace," American Public Media, 6/15).
PBS' "NewsHour with Jim Lehrer" also reported on Obama's speech and physicians' reactions (Bowser, "NewsHour with Jim Lehrer," PBS, 6/15).NPR's "Morning Edition" on Tuesday examined how the current health care debate is focusing on rhetoric while details on health care reform proposals still are lacking (Welna, "Morning Edition," NPR, 6/16). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.