AMA Members Receive Obama's Speech With Cautious Enthusiasm

By Kari Lydersen

The assembled crowd at the American Medical Association's House of Delegates annual meeting Monday gave President Obama multiple standing ovations and loud cheers during his address to members. The enthusiasm was tempered only by a round of booing when the president said he does not support a cap on medical malpractice lawsuits.

The more than 1,200 doctors in the room seemed to agree the president understands their concerns and shares many of their goals, including the AMA's long-held push for universal health coverage. But the real question, they say, is how the president's promises will play out, especially on the controversial question of a public health insurance option.

Pennsylvania ob-gyn Peter Schwartz was glad to hear Obama promise that a public option would not be a road to a single payer system.

"He reassured us that he'd be able to maintain parts of the health care system that we like," said Schwartz, who "used to be Republican" but voted for Obama. "He reaffirmed that he's not moving us toward a single payer system, which many of us were concerned about. We were gratified to hear that."

But Tampa head and neck surgeon Dennis Agliano was not convinced.

"The government shouldn't be running health care," he said. "I think if you have a plurality with private enterprise included, it's fine. But we all know when government takes a foot-hold, it expands. We could end up with a third Medicaid. And Medicare and Medicaid aren't well-run already. He said there will be debate and he's open to suggestions, but I think he's committed to this already."

Tulsa knee and hip surgeon Norman Dunitz was also skeptical.

"He's a wonderful speaker and he told us what we want to hear," said Dunitz. "The question isn't what he said but what he's going to do. He has a reputation of shifting sides, there is a lot of doubt after you saw what went on with the stimulus and the auto industry. If he comes up with a strict single payer program, that could create chaos and medical error."

Donna Sweet, a Kansas internal medicine practitioner who largely treats impoverished AIDS patients, thinks a public option is crucial to health care reform.

"We've said we can work with any option that allows choice," she said. "I think he understands the market value of having some competition in the system."

Many of her patients are "very needy, poor people who count on government help," she said. "It would be nice to have much more government funding so we don't have to rely as much on the private foundations. It won't be easy. There are tremendous dollars involved, and there are people who want to maintain the status quo."

She was impressed with Obama's knowledge of the daily issues doctors face.

"What the president showed us today is he understands the problems with the American health-care system," she said. "I don't think I've ever heard a politician who understood so well all the problems we face. The lack of insurance, the denial for pre-existing conditions, the excess paperwork, how we're forced to be bean counters. I think he gets it."

A number of doctors were concerned about Obama's suggestion they cut costs by reducing excess medical tests, for fear foregoing tests could increase their liability.

"When you talk about less tests to save money, there might be a situation where the test doesn't make sense if you look at the data, but an attorney will find that situation where you didn't do the test for that one person in 100,000 who needed it," said Ohio family medicine practitioner Colette R. Willins, who otherwise was thrilled with Obama's speech.

Though the crowd cheered when the president mentioned protecting doctors from exorbitant malpractice claims and insurance premiums, many didn't hear as much as they wanted to on the liability issue.

"Everybody clapped, then he didn't give any substance to it," said Agliano, a registered Democrat who votes both ways. "He made it sound like if you practice better medicine you won't be sued."

He cited a $200 million jury award in a Florida emergency room malpractice case. "I think the patients should be able to get something, but this was a nebulous case," he said. "That's why doctors are practicing defensive medicine, and that's what causes the high cost of health care. Obama skirted those issues. He's a Democrat, and Democrats are supported by trial lawyers and don't want to change the legal system."

Chicago thoracic surgeon Robert Vanecko and his local colleague Mark Morasch, a vascular surgeon, called the speech "wonderful" but admitted cynicism about the prospects of Obama's plans.

"Maybe at least he can get some of these things moving," said Vanecko. "To get all these major groups in the same room without having to call an ambulance was a good start."

By Paul Volpe | June 15, 2009; 4:32 PM ET
Categories: Daily Dose , Health Reform
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Comments

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Posted by: letsgobuffalo | June 15, 2009 6:27 PM | Report abuse

Under Obamedicine, doctors need no longer be concerned with medical malpractice.

As government employees, they will be protected by the same sovereign immunity that allows police to murder people with impunity and, in those rare cases when they are caught on tape, the taxpayers will pay for the malpractice just as they now do for cops.

Posted by: RUKidding0 | June 15, 2009 7:16 PM | Report abuse

On the news this evening I heard the following: The proposed plan will bring 39 million new people into the program. On the other hand it will remove 23 million from coverage. For a net increase of 16 million, the cost is going to be a Trillion dollars over ten years. If that is going to be the cost, they everybody but the poorest of the poor is going to have to pay - something so we can afford this. Real reform means tort reform which would save billions. There has to be other ways to save and still provide services to all with out bankrupting the country.

Posted by: saelij | June 15, 2009 7:17 PM | Report abuse

Medicare DOES work. I have two aging parents with serious and long-term health problems. A few doctors try to run up the visits and tests to get re-imbursements while others don't accept Medicare at all. But it is possible to find pretty good doctors that use it responsibly,...on both coasts. Medicare works best for in-patient and ICU. The paperwork is excessive. But, over twenty years I have only seen a few cases of abuse or waste.

Posted by: YoungAtheart | June 15, 2009 7:26 PM | Report abuse

First of all, to YoungAtheart, Medicare does work if the only metric you have is whether a Medicare participant can be seen by a doctor and receive treatment for his/her illness. I'll grant you that.

But it is going BANKRUPT!! It will NOT WORK forever. How do we fix that? The obvious solution is to charge all the participants premiums that actually cover the cost of the insurance they receive. You think you've heard howling and squealing so far? Buy some ear plugs.

The AMA conference had some wise doctors there, particularly those who recognize that Mr. Obama can warble like a canary, but one must really see what he actually does.

Anyone who thinks every liberal in the House and Senate would love to see the public plan as the nose under the tent for single payer, collect the kewpie doll.

Posted by: Curmudgeon10 | June 15, 2009 8:11 PM | Report abuse

Compared to other government run programs, Medicare is outstanding. That doesn't mean there is much that can be reformed. Medicare processes claims and doesn't have control over most of the areas of waste. The changes that need to be made must happen on the state and local delivery level. Local billing services continue to bill years after the delivery of the medical procedure or service. That is ridiculous! Medicare can't control such craziness. Massive health industry reform will automatically result in better efficiency and savings for Medicare.

I love hearing conservatives decry the costs of Medicare and Social Security, yet they keep silent about the even more egregious waste and fraud in the defense industry.

Posted by: TeddyRoosevelt | June 15, 2009 8:48 PM | Report abuse

Year after year, decade after decade I have heard Republican politicians talk about healthcare reform while the situation worsened exponentially. You had you're chance. Doctors, pharma, insurance companies - want you to believe their propaganda about how terrible healthcare is in countries that have socialized medicine. People are brainwashed and cannot get past the word "socialized". They need to get a clue. The US does not have the best statistics on the health of its citizens while countries that have socialized medicine do. There are good doctors and then there are those that view their practice as a production line. Yes, capitalism is what makes this country great, but you wouldn't want to privatize the military would you? Healthcare should not be about the bottom line. France has healthier people and they spend LESS on healthcare. Healthcare costs are higher in this country not because the standards are higher, it is because of GREED! WAKE UP AMERICA!

Posted by: pavrerichard | June 15, 2009 9:03 PM | Report abuse

Kudos to Obama for taking on the health care debacle--but shame on him for offering up those injured by preventable medical injuries as a "bargaining chip" to win favor from those who might challenge him. http://tinyurl.com/l3l8n6

Posted by: ahoffmanCJD | June 15, 2009 10:24 PM | Report abuse

AMERICA’S NATIONAL HEALTHCARE EMERGENCY!

It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

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AMA Members Receive Obama's Speech With Cautious Enthusiasm