Obama urges health care changes
CHICAGO -- President Obama continued to push for an overhaul of health care Monday, saying the spiraling costs of the current system are "unsustainable" for Americans and a "ticking time bomb" for the federal government.
"The reform is not a luxury, but a necessity," Obama said before the American Medical Association in Chicago. "If we fail to act, premiums will climb higher, benefits will erode further, and the rolls of uninsured will swell to include millions more Americans."
The president asked for the AMA's help in getting legislation passed that replicates best practices, gives incentives for excellence and closes cost disparities.
"I need your help, doctors," Obama said. "To most Americans, you are the health care system. The fact is, Americans … we just do what you tell us to do … That's why I will listen to you and work with you to pursue reform that works for you."
Incoming AMA President J. James Rohack said Obama's visit to the group's annual meeting suggests the president recognizes doctors' role in overhauling the health care system.
"If the doctors don't believe it's going to be better for our patients, we're going to let our patients know," he said.
Obama pushed for a public option plan where the government would provide health insurance to compete with health insurance offered by private companies.
He said a public option would give people a broader range of choices and inject competition into the health care market "so that we can force waste out of the system and keep the insurance companies honest."
"The public option is not your enemy; it's your friend, I believe," Obama said.
Obama acknowledged there are concerns a public option plan is "a Trojan horse for a single-payer system" and a move toward socialized medicine.
"So, when you hear the naysayers claim that I'm trying to bring about government-run health care, know this — they are not telling the truth," he said.
AMA leaders said they share Obama's goal of covering the nation's more than 46 million uninsured people, but some members of the group said they have qualms about the details.
"Physicians are burdened right now with a lot of rules and regulations in dealing with patients where their reimbursement is subsidized by the federal government, and I guess we're not very confident that the government's going to be able to take over the whole system and do any better," said J. Gregory Cooper, a family doctor in Cynthiana, Ky.
Obama said making health care affordable for all Americans will cost more than a trillion dollars over the next 10 years.
He said his proposals, from adjusting Medicare payments to introducing generic biologic drugs into the marketplace, would generate $950 billion in savings to pay for an overhaul of the system.
Among the steps the president cited are necessary to overhaul the health care system:
• Upgrade medical records by switching from a paper to an electronic system of record keeping, something the administration has started doing as part of the Recovery Act. "As Newt Gingrich has rightly pointed out, and I don't quote Newt Gingrich that often, we do a better job tracking a FedEx package in this country than we do tracking a patient's health records," Obama said to laughter.
• Invest more in preventive care, spending more health care dollars on wellness programs and public health. "That starts with each of us taking more responsibility for our health and the health of our children," he said.
• Explore ways to reduce the number of unnecessary medical tests or procedures that sometimes are conducted to stave off possible malpractice lawsuits. "What accounts for the bulk of our costs is the nature of our health care delivery system itself," Obama said. "A system where we spend vast amounts of money on things that aren't making our people any healthier; a system that automatically equates more expensive care with better care."
• Make medical training more affordable for primary care doctors and nurse practitioners, "so they aren't drowning in debt when they enter the workforce," he said.
• Improve the quality of medical information making its way to doctors and patients. "Less than 1% of our health care spending goes to examining what treatments are most effective," Obama said. "And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table."
The AMA, the nation's largest physician group, represents 250,000 doctors and medical students.
After Obama's speech, AMA leaders emphasized areas of agreement with the president.
"Like the president, the AMA is committed to covering all Americans through health reform this year," said outgoing President Nancy Nielsen. "Every American deserves affordable, high-quality health insurance coverage."
Asked about scattered boos in the audience when Obama said he does not support caps on malpractice awards, Nielsen said she wasn't surprised.
Still, she said, the AMA was "thrilled" to hear a Democratic president promise changes in liability laws.
Obama said caps on awards to patients hurt by doctors' mistakes "can be unfair to people who have been wrongfully harmed."
He added that he hopes to "scale back the excessive defensive medicine" that prompts some doctors to order more tests and procedures to avoid being accused of not doing everything possible to treat patients.
Obama has made an overhaul of the health care system a top priority.
Last week, he said at a town hall in Green Bay, Wis., that a public insurance option is necessary "because if the private insurance companies have to compete with a public option, it will keep them honest and help keep prices down."
Vice President Biden said Sunday on NBC's Meet the Press that the administration is committed to creation of a government-run plan. He said the administration could support the concept in a number of forms, including an expansion of the Medicare program.
"You've got to have some competition," Biden said.
On CBS' Face the Nation, Senate Minority Leader Mitch McConnell, R-Ky., said health care can be improved, "but I don't think having more government — in effect, putting Washington between you and your doctor — is the way to go."
Contributing: John Fritze and David Jackson in Washington