This Week’s Podcast: The Great Health Care Reform Debate

May 15, 2009 9:08am

On this week’s Shuffle podcast, we spoke to the incoming president of American Medical Association Dr. James Rohack, who met with President Obama to discuss cutting health care costs by $2 trillion over the next decade.

You can listen to the podcast HERE or on iTunes.

As we reported Monday, Rohack at the meeting said that one of the reasons doctors conduct so many unnecessary tests is because they practice "defensive medicine" for fear of malpractice lawsuits.

"What we asked the president is that if we as physicians are willing to tackle the issue of looking at variation of care and reducing unnecessary tests, we also have to have protection in the courtroom," Rohack told us, that "if we didn’t order a test, that we subsequently aren’t going to get sued because we didn’t order that test that shouldn’t have been done in the first place."

So for example, not everyone who comes into the emergency room complaining about a headache would automatically get an MRI, Rohack said.

But what about the idea that these measures to save money could cost more lives? That some people’s lives might be saved because of that MRI?

"I think we need to highlight that life is a matter of risk," Dr. Rohack, a cardiologist, responded. "We know that 24 percent of Americans purchase tobacco products and use them every day knowing there’s a well documented risk of heart disease as well as cancer so life is a decision of choice. We have people who drink alcohol and get behind the wheel of a car and create a burden on our current American economy with trauma funds because of some of them being uninsured and still our government has said that any one who shows up to the emergency room, regardless of their ability to pay, the health care system has to take care of them."

"So all we’re saying is that we need to have a better discussion over what’s the cost of different procedures, what’s the benefit and ultimately have that patient and their physician come down and having some decisions made," Rohack said. "What we don’t want to do is have a process where suddenly someone whose not involved in care is making an arbitrary decision that gee we’re not going to cover this when the patient clearly needs it."

Rohack acknowledged that Democrats in Congress have historically opposed efforts at malpractice reform.

"I think the president recognized that if the commitment to control cost — if it was going to be presented in such a way that this was part of the package to control unnecessary costs but still preserve an ability — that if a patient was harmed because of neglect or clearly improper care — that there still would be a preservation of access to the court system," he said. "So this is not a prevention of being in the court system. This is also looking at again alternatives to the liability system, perhaps there is a dispute resolution, there is a health court, there are expert witness guidelines."

Dr. Rohack also touched upon other issues that came up in the meeting with the president and tough choices for patients.

Listen to the podcast HERE or download it on iTunes.

Jake Tapper and Huma Khan

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