Wednesday, June 17, 2009

Obama's address to the AMA

In the wake of President Obama’s remarks to the American Medical Association on Monday, it seems that everyone has an opinion about what should be done with the healthcare system in America.  Unfortunately, there is no consensus , even within the house of medicine.  The president was very clear about his intent, and very little of it surprised those in the audience.  The president led with a condemnation of the status quo, complete with touching stories of patients struggling with tragic circumstances, both medical and economic.  His arguments were the standards in the healthcare debate – providing medical care is too expensive, too complicated, and too poor in quality to continue.  He did stop short of blaming the current state of affairs entirely upon the physicians, perhaps in deference to the audience.


President Obama followed his indictment of the status quo with a description of elements of the reform package that he has long championed:  the electronic health record, comparative effectiveness research, dissolution of healthcare disparities, and universal coverage.  He assured the audience that anyone partaking of a private health insurance plan who was satisfied with that plan would be able to keep it.  However, as he stated long ago on the campaign trail, he supports a government-supported public plan, now called the Health Insurance Exchange.  The president believes that a public option would provide an alternative for Americans who currently cannot obtain affordable health insurance.  He also stated that the public plan would provide “healthy competition” for private insurers. 


There were two things that I noticed today that were a change from the president’s usual discourse on health system delivery.  First, he stated today that all Americans would be required to purchase health insurance of some kind.  In the past, especially during his campaign, he only espoused a requirement  for insurance for children.  Secondly, he stated that he is opposed to caps on damages recovered in malpractice litigation, but that he is “open to consideration of” any number of other methods to  appease physician concern over professional liability.  He said that he has drawn criticism from members of his party over his willingness to consider any changes to the tort system. 


No doubt the president is looking to trade vague, lukewarm promises to consider changes in the tort system for some Republican support of his health system reform plans.  Will it be enough?

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