We’re in for an exciting couple of days here in Chicago, and all of it is wrapped up in the future of American health care and your great profession. President Barack Obama spoke to the American Medical Association House of Delegates this morning on his plans for health system reform. “I need your help doctors,” he said. “To most Americans, you are the health care system. We just do what you tell us to do. That's what we do. We listen to you. We trust you. That's why I will listen to you and work with you to pursue reform that works for you." The president addressed all of the controversial elements of his plan:
Mr. Obama said it is an "illegitimate concern" that "a public option is somehow a Trojan horse for a single-payer system. …I believe that it's important for our reform efforts to build on our traditions here in the United States. 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."
In place of Medicare’s sustainable growth rate, he said, “We will ensure that you will be reimbursed in a thoughtful way that's based on patient outcome.”
Several times, the president said he wants to keep what works in the current system and fix what’s broken. “We will make this promise to the American people: If you like your doctor, you will be able to keep your doctor, period,” he said. “If you like your health care plan, you will be able to keep your health care plan, period. No one will take it away.”
Referring to a widely circulated New Yorker magazine article concerning Medicare spending in McAllen, Mr. Obama said, “We spend vast amounts of money on things that aren't necessarily making our people healthier.” He said he wants the government to invest in comparative effectiveness research. “Identifying what works is not about dictating what kind of care should be provided. It's about providing patients and doctors with the information they need to make the best decision. I have the assumption that if you have the information, you're going to make the best decision. I have confidence in that.” TMA disagrees with many of the conclusions in The New Yorker article because it ignores many of the stark realities of practicing medicine in the poorest metropolitan community in the country. We are working with local physician leaders to invite the president to visit the Rio Grande Valley to see the situation firsthand.
The president was warmly received by the AMA audience. Many who disagreed with his policy positions said they were impressed that he came to Chicago to speak directly to the organization. You can read the highlights of the president’s address on TMA’s Blogged Arteries.
The AMA house meeting thus far has been dominated by discussions of what health system reform physicians want for their patients and their practices. Is the so-called “public health insurance option” just a stepping stone to a single-payer system? How can we expand affordable coverage for all Americans, do away with the sustainable growth rate formula for physician Medicare payments, and bring about both antitrust reform and liability reform? Will physicians have the right to choose what plans they will join? Should the AMA demand that physicians have the right to contract privately with patients outside of Medicare? How will physicians – and it must be physicians, not government – deal with variations in the cost and quality of health care across the country? How can all the major players in health care work together for the sake of the patients? As AMA President Nancy Nielsen, MD, PhD, said, “We can’t keep on hating everyone all the time.”
Here are some additional resources you might find useful:
Stay tuned to Blogged Arteries through Wednesday for complete coverage of the AMA meeting.