HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, June 15, 2009

President Obama Speaks to the AMA -The Public Option

Earlier today, President Obama spoke to the AMA about health care reform. Sam Stein at the reports,

President Obama walked into the lion's den on Monday, delivering a lengthy speech on his approach to health care reform in front of the annual gathering of the American Medical Association. But he did not dodge the major issue of contention -- the role the government will play in remaking the insurance market.  "The public option is not your enemy, it is your friend," Obama declared at one point.  His prepared remarks were a bit more detailed:

If you don't like your health coverage or don't have any insurance, you will have a chance to take part in what we're calling a Health Insurance Exchange.... You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package. And one of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market so that force waste out of the system and keep the insurance companies honest.

The crowd, comprised of members of the nation's largest physician community, received those remarks with slightly less enthusiasm than other points of the president's lengthy address, including Obama's insistence that insurance companies cover pre-existing conditions, his nod towards the need for medical malpractice reform, and his touting of legislation that would discourage smoking among the nation's youth.  But the discussion of the public plan didn't end there.

"Now, I know there's some concern about a public option," Obama declared. "In particular, I understand that you are concerned that today's Medicare rates will be applied broadly in a way that means our cost savings are coming off your backs. These are legitimate concerns, but ones, I believe, that can be overcome. As I stated earlier, the reforms we propose are to reward best practices, focus on patient care, not the current piece-work reimbursement. What we seek is more stability and a health care system on a sound financial footing. And these reforms need to take place regardless of what happens with a public option..."

The comments about a public option were some of the most widely anticipated of Obama's address. One week earlier, the AMA had expressed its opposition to a public plan before gently backing off their initial critiques. The concerns among its 250,000 physician members are over salary cuts and administrative requirements that could come with greater government involvement in the insurance industry.

There is also a general fear that a public option could be a gateway toward a single-payer system, something that the president dismissed during Monday's speech. .  . .

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