On June 15, 2009, President Barack Obama addressed the Annual Conference of the American Medical Association (AMA) on health care reform. According to the president, there is widespread agreement on the steps necessary to make the health care system work better.
Obama described our health care delivery system as “a system where we spend vast amount of money on things that aren't necessarily making our people any healthier; a system that automatically equates more expensive care with better care.” Obama identified two primary reasons for this. First, we have “a model that rewards the quantity of care rather than the quality of care.” The solution requires “reforming the way we compensate our providers.” According to Obama, these reforms should include: (1) bundling payments so that doctors are not paid by a single treatment offered, but for how well doctors treat the overall disease; (2) creating incentives for doctors to team up to provide patient care; (3) bonuses to doctors for good health outcomes; (4) addressing the rising costs of a medical education; (5) rewarding medical students who choose a career as a primary care doctor; and (6) rewarding doctors who choose to work in under served areas.
The second structural reform recommended by the president is improving the quality of medical information making its way to doctors and patients. According to Obama, too many doctors and patients are making decision without the latest research. “Less than one percent of our health care spending goes to examining what treatments are most effective… And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table.”
For individuals who don't like their present health care coverage or don't have any insurance at all, the administration is proposing a Health Insurance Exchange, which will provide one-stop shopping from a number of health care plans that offer different packages, benefits and price comparisons between plans, and a chance to choose a plan. Because of Obama's confidence in his public exchange plan that would provide insurance at an affordable rate, he is “open to a system where every American bears responsibility for owning health insurance — so long as we provide a hardship waiver for those who still can't afford it as we move towards this system.” This hardship waiver would also apply to employers.
Obama conceded that expanding coverage to all Americans will not come without cost. He stated, however, that the costs “will not add to our deficits. I've set down a rule for my staff, for my team — and I've said this to Congress — health care reform must be, and will be, deficit-neutral in the next decade.” He admits this reform package will cost $1 trillion over the next 10 years, but he believes the price tag can be met.
President Obama's Remarks to the American Medical Association, June 15, 2009.
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