Obama may consider limits on medical malpractice suits


The AMA agrees with Obama on the need for health care reform but not how to go about it.
President Obama said Monday that limits on medical malpractice lawsuits could be a necessary part of overhauling the nation’s ailing health care system.

In a speech to the 158th annual meeting of the American Medical Association, Obama cited the need for doctors to cut health care costs by reducing the number of unnecessary tests and procedures that are performed to reduce the risk of malpractice claims. Such reductions might require restrictions on malpractice liability to protect doctors, the president said. “I’m not advocating caps on malpractice awards, which I personally believe can be unfair to people who’ve been wrongfully harmed, but I do think we need to explore a range of ideas about how to put patient safety first, how to let doctors focus on practicing medicine, how to encourage broader use of evidence-based guidelines,” he said. Obama also said that reforming health care requires changing the focus from the quantity of treatment to the quality of care. To applause, he said that doctors should be able to concentrate on curing patients instead of worrying about a bureaucratic system that bases pay on the amount of tests and services. “It is a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can’t spend much time with each; and gives you every incentive to order that extra MRI or EKG, even if it’s not necessary,” Obama said. “It is a model that has taken the pursuit of medicine from a profession — a calling — to a business.” Obama also addressed rising health care costs, saying they could force the United States to follow in the footsteps of a bankrupt automaker.

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“If we do not fix our health care system, America may go the way of GM — paying more, getting less and going broke,” he said. Watch more about who pays for health care » The AMA agrees with Obama on the need for health care reforms but has reservations about the creation of a “public option” paid for by the government to ensure coverage for the 46 million uninsured Americans. Obama has made health care reform a top priority of his young administration, and Congress will consider at least three proposals in coming weeks to address an issue that deeply divides Democrats and Republicans. A proposal from Sen. Edward Kennedy, D-Massachusetts, a longtime health care reform proponent, includes a public option as one choice for consumers. The measure also would mandate coverage for all people, either at their own cost or supplied by employers. Obama and Senate Democratic leaders say the idea is to give consumers more choice and provide competition for private insurers. They insist that people will be able to keep their current coverage, with the public option covering those currently without coverage or unable to afford full coverage. Republican leaders adamantly oppose any public option, complaining it will lead to an eventual government takeover of health care similar to the cradle-to-grave coverage in Canada and England. The AMA, which represents the interests of doctors and nurses, opposes any public option plan that forces physicians to participate, expands the fiscally challenged Medicare program for senior citizens or pays Medicare rates. At a Senate committee meeting last week, Dr. Samantha Rosman, an AMA board member, said the association believes all Americans can be covered within a private insurance market supported by tax subsidies and credits that provide proper incentives. For his part, Obama has outlined a series of steps to lower current costs and raise taxes to pay for an overhaul of the health care system. On Saturday, the president proposed $313 billion in cuts and new savings over the next decade, with some of the money coming from expected increases in efficiency, reductions in excessive hospital payments and drug cost savings for individuals enrolled in both Medicare and Medicaid. The money would be in addition to the $635 billion in spending cuts and tax funds Obama has already requested to help ease the transition to a new system that would cover uninsured Americans and do a better job of slowing the surge in medical costs. Obama’s plan includes reducing tax deductions for high-income Americans. Another funding idea under consideration is taxing the medical benefits of employer-provided health coverage, a move the Obama administration opposes but has not ruled out. A national survey released last week by Diageo/Hotline found that 68 percent of those questioned opposed taxing health insurance benefits in order to pay for the enormous cost of expanding health care coverage to all Americans. Possible alternatives to a public health insurance option include private cooperatives, like electricity cooperatives, owned and paid for by communities that would compete with existing insurance programs. Watch Rep. Ron Paul weigh in on health care reform » Supporters say such a program would require initial government support, but eventually would provide the kind of competition Obama seeks without creating a new government bureaucracy. Last week, Rosman of the AMA said the association could support a cooperative plan, depending on the details.

Health and Human Services Secretary Kathleen Sebelius said on CNN’s “State of the Union” on Sunday that Obama is open to whatever ideas will work to address a problem that must be addressed. Watch what Sebelius has to say about the administration’s plan » “The costs are crushing us,” Sebelius said. “It’s hurting families. Our businesses are less competitive. We can’t continue on this pathway.”

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