Obama takes public plan case to doctors, push-back continues

Jun 17 2009

President Barack Obama told the American Medical Association Monday that a health care fix can't wait, The New York Times reports.

"'The public option is not your enemy,' Mr. Obama said. 'It is your friend, I believe.' Saying it would 'keep the insurance companies honest,' the president dismissed as 'illegitimate' the claims of critics that a public insurance option amounts to 'a Trojan horse for a single-payer system' run by the government. Mr. Obama twice referred to the use of such 'fear tactics' about 'socialized medicine' in past legislative battles, without pointing out that the A.M.A., a traditionally Republican-leaning group, was among those using the charge, as in the mid-1960s debate over creating Medicare for people 65 and older"

But one of the major Democratic proposals for reform could cost $1 trillion over 10 years and would cover only 16 million more Americans, according to new Congressional Budget Office estimates. The Times reports "That finding came as a surprise. Robert D. Reischauer, an economist who headed the budget office when Congress tackled the health care issue in the Clinton administration, said that if so many people remained uninsured, it might not be feasible to cut special federal payments to hospitals that serve many low-income people.

"Mr. Obama said Saturday that the government could save $106 billion over 10 years by cutting such hospital payments as more people gained coverage.

Senator Orrin G. Hatch of Utah, a senior Republican on both committees drafting health legislation, said he found the office’s numbers stunning. He calculated that the Kennedy bill would cost taxpayers $62,500 per uninsured person over the 10 years"  (Pear and Calmes, 6/15).

Obama faced some skepticism from the crowd of doctors, The Associated Press/Seattle Times reports: "The difficulty of his sales job was evident when he said he was against limiting awards in malpractice lawsuits, a top priority for doctors. That statement brought him a smattering of boos" (Babington, 6/15).

A transcript of President Obama's remarks to the AMA can be found here.

Politico: "Less than an hour after President Barack Obama finished a wide-ranging speech on health care reform Monday, (AMA) head Nancy Nielsen declared herself most pleased with one small section of it. 'What we are thrilled about is that this is the first Democratic president who has talked to us about any kind of liability reform,' Nielsen told reporters." But Obama drew fire for his talk on liability reform and "defensive medicine" from the American Association for Justice: "'The notion that "defensive medicine" is leading to higher health care costs is not supported by empirical data or academic literature,' the group said in a statement. 'Limiting the legal rights of injured patients will do nothing to lower health care costs or aid the uninsured'" (Brown, 6/16).

The Washington Post: "The president's good-news, bad-news message to the physicians marked what White House senior adviser David Axelrod described as a higher level of engagement by the president on his top domestic priority. For months, Obama remained on the sidelines of the health-care debate because 'he felt it was important to not be too proscriptive,' Axelrod said in an interview. 'Now we're into a different phase, where decisions are being made very quickly, so it's time to weigh in to a greater degree'" (Connolly, 6/16).

CQPolitics says Obama targeted more than just doctors with the speech: "Obama was simultaneously speaking to a broader segment of voters that polling indicates is still ambivalent about his plan to extend medical coverage to all Americans and put the health system under greater government control" (Bettelheim, 6/15).

Roll Call details Republican lawmaker push back on a public plan: "In a conference call organized by the Republican National Committee for reporters before the speech, Rep. Tom Price, R-Ga., a practicing physician who is attending the AMA convention in Chicago, suggested Obama could do little to sway the doctors to support a public plan. 'I think the concept will be looked on with some suspicion and concern,' he said" (Koffler, 6/15).

Time further reports on opposition to a public plan: "But given the levels of Republican and even some moderate Democratic opposition — and the sizeable wiggle room the Administration has left itself in order to compromise down the line — it seems very unlikely that it would end up being a liberal approach: a system heavily subsidized by the federal government that pays medical providers the same rates they are currently reimbursed by Medicare. Such a proposal would be a battle cry for doctors and hospitals, already reeling from low Medicare rates which have not kept pace with inflation, and the private insurance industry, which argues it could never compete on such an uneven playing field" (Pickert, 6/16).