In perhaps the single most important moment thus far in the healthcare reform debate, President Obama took his case to America’s doctors with a speech before the American Medical Association. This speech was significant for several reasons. First, it was the first time the President pitched healthcare reform to a skeptical non-partisan crowd. Second, the very people the President pitched the plan to are those who will be most responsible for implementing healthcare reform. Finally, this was an opportunity for the President to tell America - and America’s healthcare providers - just how healthcare reform would work. Unfortunately for those of us following the Healthcare Horserace, we were left wanting much more than we got from President Obama’s speech.
Obama began his speech by repeating the economic case for healthcare reform - a tired argument at best and one that has no other side. We heard an emotional appeal on behalf of a young mother with cancer, the tale of a doctor who wishes he could spend less time filling out forms and more with his patients, and the story of altruistic small business owners forced to downsize in the face of rising healthcare costs for their employees. Mr. President, we are all onboard with the need to rein in the excesses of the healthcare industry - starting with the government waste and fraud associated with Medicare and Medicaid. Can we move on now?
We also learned that if healthcare reform had only come earlier, the auto industry would not have needed a bailout and General Motors and Chrylser would still be viable companies. Really, Mr. President? And, here I thought that was the end result of the American auto industry’s inability to adapt to a changing marketplace crowded by foreign auto manufacturers making cheaper and more fuel efficient vehicles at a time when America gas prices continue to rise as Congress refuses to let the oil industry tap into offshore oil reserves. Of course, the sweetheart deals forced on auto companies by labor unions over the past several decades probably didn’t help the bottom line any. It seems to me, the Chrysler/GM card was not the smart play here.
Perhaps the bravest part of the speech was the following exchange between Obama and the gathered physicians:
Now, I recognize that it will be hard to make some of these changes if doctors feel like they’re constantly looking over their shoulders for fear of lawsuits. I recognize that. (Applause.) Don’t get too excited yet. Now, I understand some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That’s a real issue. (Applause.) Now, just hold on to your horses here, guys. (Laughter.) I want to be honest with you. I’m not advocating caps on malpractice awards — (boos from some in audience) — (laughter) — which I personally believe can be unfair to people who’ve been wrongfully harmed.
Despite the unwelcome nature of the President’s position on tort reform, here was a truly honest moment - something we’ve seen all too little of in Obama’s speeches on healthcare reform to date. It had some of us thinking he would continue down this path in addressing one of the most contentious items on his healthcare reform to-do list - public-option health insurance. Again, we were left wanting.
When Senator Kennedy and his HELP (Health Education Labor and Pensions) Committee released the Affordable Health Choices Act last week, those of us following this debate got our first real look at what path Democrats intend to take American healthcare down. We learned that healthcare insurance would be mandatory for all Americans. We learned that insurance companies could not deny coverage based on risk factors or pre-existing conditions - something the President refers to a “cherry picking”. Employers learned that they would be required to provide healthcare insurance for all of their employees or pay a penalty. And, we learned that the government would create and run its own public-option insurance company to promote honest competition among private healthcare insurers. What we did not learn was the role Democrats saw doctors playing in a government-controlled healthcare scheme.
As I followed Obama’s speech, I waited for that big moment. In our healthcare present, doctors decide what insurance plans they will or will not accept - or if they will accept insurance at all - from their patients. Many doctors simply don’t accept Medicare and Medicaid patients under the current system because payments can take six months to a year to arrive in many cases or because they simply do not agree with the bureaucratically prescribed methods of care dictated in order to receive those payments. Will this change in the Democrats healthcare reform future? What happens to the public-option insurance plan if doctors don’t accept patients who subscribe to it? Will doctors be forced to accept these patients? What is the penalty if they do not?
The success of any healthcare reform regime will rest on the shoulders of America’s doctors. Until we get an honest answer from Congressional Democrats and the White House on the role doctors will play in their grand design for our healthcare future, all of their political posturing and promises will hold little weight with the American people.
