still going to be working for themselves. They're still going to be
focused on patient care. And in terms of how doctors are reimbursed,
it's going to be the same system that we have now, except we can start
making some changes so that, for example, we're rewarding quality of
outcomes rather than the number of procedures that are done.
And this is true not just for doctors, it's also true for
hospitals. One of the things that we could say to hospitals is, reduce
your readmission rate, which is also often a sign that health outcomes
have not been so good.
And it turns out that hospitals, when they're incentivized, actually
can find ways to do it that, every study shows, does not have adverse
effects on outcomes.
GIBSON: You keep coming back to that point, about, if you like what
you have, you can keep it.
GIBSON: I will return to that subject when we get to the issue of
the public option and whether the government should be in the insuring
But one of the things when we talk about the kinds of changes that
may occur, the elderly are affected. Medicare will be affected.
Twenty-eight percent -- 26-28 percent of money in Medicare is spent in
the last year of life. The elderly are very critically affected.
Just a quick sound bite from a couple of people to lay out the
parameters of the problem.
(BEGIN VIDEO CLIP)
DR. MICHAEL JENSON, MAYO CLINIC: I'm Dr. Michael Jenson
at the Mayo Clinic in Rochester, Minnesota.
I see too many patients who have terminal illnesses or no hope of
recovery who receive weeks or months of intensive care unit treatment,
only to prolong their death. I find this approach very distressing and
the waste of money is appalling.
We just can't afford to provide all treatments to all people.
ROBERT WASSON: My name is Robert Wasson. My mother is 74
years old. She has terminal cancer in the stomach lining that has
spread to the lungs. She deserves to be treated medically to the best
of their ability.
To say it's too expensive is not right. I just don't think you can
put a price tag on quality time with loved ones, especially at the end
of their lives.
(END VIDEO CLIP)
SAWYER: And we have with us a couple of people who really represent
the opposite ends on this spectrum too. I want to talk, if I can, to
Your mother, Hazel...
JANE STURM: Caregiver for 105-year-old mother: Yes.
SAWYER: Hazel Homer (ph), 100 years old and she wanted...
STURM: She's 105 now. Over 105. But at 100 the doctor had said to her, I can't do anything more unless you have a pacemaker. I said, go for it. She said, go for it. But the arrhythmia specialist said, no, it's too old.
Her doctor said, I'm going to make an appointment, because a picture
is worth a thousand words. And when the other arrhythmia specialist saw
her, saw her joy of life and so on, he said, I'm going for it.
So that was over five years ago. My question to you is, outside the
medical criteria for prolonging life for somebody elderly, is there any
consideration that can be given for a certain spirit, a certain joy of
living, quality of life? Or is it just a medical cutoff at a certain age?
OBAMA: Well, first of all, I want to meet your mom.
OBAMA: And I want to find out what's she's eating.
OBAMA: But, look, the first thing for all of us to understand is
that we actually have some -- some choices to make about how we want to