CHICAGO — President Barack Obama wooed the American Medical Association on Monday with talk of curbing malpractice lawsuits and canceling a proposed 21 percent cut in Medicare payments as he ramped up an effort to win support for a major overhaul of the nation’s health system.
But he pointedly refused to endorse the group’s top goal — caps on legal damage awards — and he steadfastly defended creation of a government-sponsored health insurance program that many physicians oppose. “The public option is not your enemy; it is your friend,” Obama told the doctors.
Obama’s good-news, bad-news message to the physicians marked what White House senior adviser David Axelrod described as a higher level of engagement by the president on his top domestic priority.
For months, Obama remained on the sidelines of the health care debate because “he felt it was important to not be too prescriptive,” Axelrod said in an interview. “Now we’re into a different phase where decisions are being made very quickly, so it’s time to weigh in to a greater degree.”
The Obama strategy, articulated in the speech and a series of private meetings, is to present each major stakeholder with an enticement in return for a bit of sacrifice.
To insurers, Obama offered a concession and a warning. In a shift from his position as a candidate, he now is willing to support a requirement that every American have health insurance, which could translate into more than 40 million new customers for the industry.
“Insurance companies have expressed support for the idea of covering the uninsured — and I welcome their willingness to engage constructively in the reform debate. I’m glad they’re at the table,” Obama said. “But what I refuse to do is simply create a system where insurance companies suddenly have a whole bunch more customers on Uncle Sam’s dime but still fail to meet their responsibilities.”
Over the weekend, Obama spelled out $300 billion in cuts to Medicare and Medicaid aimed primarily at the revenues of hospitals and drug makers.
The American Hospital Association released a statement saying it was “deeply disappointed and concerned” by the announcement.
“Hospitals have long supported expanding health care coverage to all Americans but feel this must happen while maintaining adequate financing for hospitals that serve large numbers of poor and uninsured patients,” the group said.
Lobbyists for leading drug companies were also unenthusiastic, saying privately that Obama cannot expect to pay for his ambitious expansion of health coverage by squeezing the private sector.
“The message is everybody has got to put something on the table,” said Sen. Ron Wyden, D-Ore., who has participated in several White House health meetings.
In Chicago, Obama brought the doctors to their feet with a hint he is willing to provide some level of malpractice relief, perhaps the top legislative priority of the physicians’ lobby.
But he drew a smattering of boos when he warned he would not give them what they most desire.
“I want to be honest with you,” he added. “I’m not advocating caps on malpractice awards, which I personally believe can be unfair to people who’ve been wrongfully harmed.”
Incoming AMA president James Rohack said physicians must receive some type of legal protection if they are going to be expected to reduce extraneous tests and treatments, as Obama urged.
