Doctors' boos show Obama's tough road

Doctors' boos show Obama's tough road

– Obama: Health Care System Is 'Ticking Time Bomb'
ABC News AP – President Barack Obama address the American Medical Association during their annual meeting in Chicago, … By RICARDO ALONSO-ZALDIVAR, Associated Press Writer Ricardo Alonso-zaldivar, Associated Press Writer – Mon Jun 15, 5:24 pm ET
WASHINGTON – Barack Obama isn't used to hearing boos.

For all the young president's popularity, the response he got Monday from doctors at an American Medical Association meeting was a sign his road is only going to get rockier as he tries to sell his plan to overhaul the nation's health care system.

The boos erupted when Obama told the doctors in Chicago he wouldn't try to help them win their top legislative priority — limits on jury damages in medical malpractice cases.

But what could they expect? If Obama announced support for malpractice limits, that would set trial lawyers and unions — major supporters of Democratic candidates — on the attack. Not to mention consumer groups.

Every other group in the health care debate has a wish list and a top priority. Insurers don't want competition from the government. Employers don't want to be told they have to offer medical coverage to their workers. Hospitals want to stave off Medicare cuts. Drug companies want to charge what the market will bear.

Obama can't give all of them what they want. Instead, he's got to figure what's just enough to keep as many groups as possible on board — without alienating others. It's a fine line for him — and sometimes for them.

"It's a coalition issue," said Robert Blendon of the Harvard School of Public Health, an expert on public opinion and the politics of health care. "No major group is able by itself to sink health reform. But if numbers of them come together for different reasons, it could really hurt the direction the president wants to go in."

The doctors were only Obama's first house call. He'll be making his case to the other groups — and to the nation at large — in an increasingly energetic campaign to get a bill passed by the end of his first year in office.

AMA insiders shouldn't have been surprised by Obama's upfront refusal to consider malpractice caps.

The group couldn't get that idea passed by a Republican Congress and president a few years ago. Some states have such curbs, but anyone who can count votes knows the chances for national limits are slim to none with Democrats in charge of Congress.

Instead, Obama left the door open to some kind of compromise on malpractice.

The president said he's willing to explore alternatives to taking doctors to court. In the past, he supported special programs in which hospitals and doctors are encouraged to admit mistakes, correct them and offer compensation. Studies have shown the approach can work, because doctors' refusal to acknowledge mistakes is one reason many families file suit.

Doctors have special reasons to be wary of the president's plans to overhaul the health care system.

Not long ago, doctors' decisions were rarely questioned. Now they are being blamed for a big part of the wasteful spending in the nation's $2.5 trillion health care system. Studies have shown that as much as 30 cents of the U.S. health care dollar may be going for tests and procedures that are of little or no value to patients.

The Obama administration has cited such findings as evidence that the system is broken. Since doctors are the ones responsible for ordering tests and procedures, health care costs cannot be brought under control unless they change their decision-making habits.

"Change is scary," said Dartmouth University's Dr. Elliott Fisher, a doctor turned costs researcher. "I think there is a fear of loss of autonomy, that someone is going to tell you what to do." Fisher collaborated on research that showed wild differences in health care spending around the country — and no signs of better health in the high-cost areas.

But Obama did not blame the doctors. Instead, he tried to woo them, much as he has done with recalcitrant foreign leaders.

"It's the equivalent of international diplomacy. He's got to make them feel like it's possible to have dialogue about what the future looks like," said Blendon. "I think he's starting out with the AMA, but before the summer's over he's going to reach out to a lot of the other groups."

Obama assured the doctors that his plan would provide them with objective information on what treatments work best, with new computerized tools to better manage their patient case loads, and with support for harried solo practitioners to form networks.

He promised that Washington would not dictate clinical decisions. And he asked the doctors to imagine a world in which nearly every patient has insurance coverage and they can devote their full attention to the practice of medicine.

"You did not enter this profession to be bean-counters and paper-pushers," Obama said. "You entered this profession to be healers — and that's what our health care system should let you be."

4 Comments

5 years 23 weeks ago, 9:58 PM

catfish88

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Ordering medical testing like MRI's bone scans lab work etc. is not done carelessly, at least not with most doctors I know. Sometimes these are ordered out of the "covering my own ass" reason. In the world of litigation we live in, some people are looking for a reason, any reason, to sue. So, I think sometimes docs will order tests that they know may not change to outcome of the patients care out of fear that if they don't, it might come back to haunt them. No doctor wants to sit in front of a jury and have to answer the question "well doc, why didn't you get an MRI". And answering, "because I didn't feel it necessary and I thought it wasteful of tax payers dollars" is not the right answer. And the ordering of the test is not the real problem. It's the cost of the things. Doctors fee schedules have been drastically cut over the last 10 years. What a doc got 500 dollars for 15 years ago, now gets 150. That's not the bad thing. The bad thing is the facility fees. Facility fees have not been cut. The hospitals charge way too much and get it paid. It doesn't matter what a doctor charges for a procedure, medicare has their own fee schedule and is going to pay you what they want to pay you no matter what you charge. A surgery that a doctor may get 150 dollars for, the hospital will get 1500 dollars just to have the surgery there no matter what the procedure was. Plus you really are paying 25 dollars for that aspirin at the hospital. 2000 dollars for an MRI is ridiculous. But, nobody complains about paying the facilities that money, they just complain that the doctor ordered it. Drug companies are greedy little bitches. I know some medications that cost 80 dollars per pill and that's just an antibiotic. Why, becuase it is one of the best out there for certain infections and they know you need it so they take you to the cleaners. Doctors aren't getting rich. It's the hospitals and facilities that are. I know hospital administrators that push paper all day and get paid more money than some doctors I know. And they don't assume any risk of litigation. Just my 2 cents.

5 years 23 weeks ago, 1:08 AM

charley9toe

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My Healthcare Dollar

I don't know where my Health Care dollars are best spent. I have MEDICARE for only one reason, I have to because the government makes me get it. How is that you say? Because I have TRICARE for Life (Military insurance) and that insurance won't be validated unless I have MEDICARE. I've had TRICARE for 29 years. in addition to TRICARE, I took out the BS/BC my employer offered. Why you ask, because TRICARE only pays 80 percent of the bill. After unexpectedly spending a few days in the hospital and having to pay that 20percent. Additional insurance was a no brainer. Ah, but charley, you could afford it. Bullshit, the fact is I could not afford, to not, have more insurance. So, today I have Primary MEDICARE, Secondary(which was Primary until I retired)BS/BC and Tertiary TRICARE for Life. Not to mention that I am still paying for some prescriptions. Let there not be anyone out there that believes MEDICARE is free, you pay into that insurance too. At this point I don't want anyone f------ with my Healthcare alternatives. I have a Doctor and three nurses(one of them my wife)in our family. Nobody's getting rich, I can tell you that.

(You have to look behind all of that outer space stuff)
5 years 23 weeks ago, 1:47 AM

charley9toe

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The Obama Administration acts like the Medical profession is using stone tablets to communicate with and keep patient records. 1st, a lot of patients don't want their records kept on computer systems (I don't). If the DoD and the rest of the government can't keep their computer systems secure (not enough money to secure them), how would the Medical profession do any better. Well they reason, the records would belong to the government and the government would secure them. Huh ? Anytime you network any computer you are at risk, unless it is totally encrypted (additional cost)(and it is still at risk). "NO" computer is safe if it is on the INTERNET, period. Banks, pay out big bucks to secure their information. So, why is it they keep losing your information. So, think about that bag of bullshit(it will be cheaper, because the government will be doing it) that's being thrown out there. How much will it cost YOU !

(You have to look behind all of that outer space stuff)
5 years 23 weeks ago, 1:07 PM

runawaygun762

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the non-lifesaving medical treatment of someone who doesn't work and doesn't contribute to society. I have no problem with my taxes paying for immediate life-saving measures for citizens of this country, but to pay for emergency room visits that could be taken care of by treatment at home is ridiculous. I've said it before. You want to see what universal health care will look like in this country? look at the military treatment system. When i was a kid, all medical care for army dependents, to include dental, was completely free. Of course, people love free things, so they abused it and now we pay. Granted, we don't pay much, but this was just within the military. Imagine 300,000,000 people with free health care. Not going to be pretty. I should not have to pay because of your life choices that prevent you from paying. Sure, there are people who cannot get medical mangement of ailments through no fault of their own, but that's where charity comes in.

"I have always been a soldier. I have known no other life. The calling of arms, I have followed from boyhood. I have never sought another." From The Virtues of War, by Steven Pressfield.
samD's picture
Posted by: samD
5 years 23 weeks ago
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