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Doctors Consider Health Care Possibilites as White House Pushes Reform

June 15, 2009 at 6:20 PM EDT
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As the health care reform debate heats up on Capitol Hill, health correspondent Betty Ann Bowser speaks with doctors about the pros and cons of a government-funded public plan and other possible changes to the current system.
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JIM LEHRER: But now, the Obama health reform pitch to doctors. NewsHour correspondent Betty Ann Bowser reports for our Health Unit, a partnership with the Robert Wood Johnson Foundation.

BETTY ANN BOWSER, NewsHour Correspondent: Listening to the president today was a group of doctors, many of them skeptical of Mr. Obama’s health care reform plans. They belong to the American Medical Association, the nation’s largest physicians’ organization with some 250,000 members.

In his Chicago speech, for the first time publicly, Mr. Obama put a price tag on providing health insurance for the nation’s 50 million uninsured: about $1 trillion. And he pressed his argument that health care reform is crucial for economic recovery.

BARACK OBAMA, President of the United States: Make no mistake: The cost of our health care is a threat to our economy. It’s an escalating burden on our families and businesses. It’s a ticking time bomb for the federal budget. And it is unsustainable for the United States of America.

BETTY ANN BOWSER: The president had harsh rhetoric for his critics.

BARACK OBAMA: There are those who will try and scuttle this opportunity no matter what, who will use the same scare tactics and fear-mongering that’s worked in the past, who will give warnings about socialized medicine and government takeovers, long lines and rationed care, decisions made by bureaucrats and not doctors.

We have heard this all before. And because these fear tactics have worked, things have kept getting worse.

BETTY ANN BOWSER: The president directly addressed the most contentious issue in today’s debate and one the AMA opposes: imposition of a government-run public insurance plan.

In a statement released last week, the AMA said it opposes any public plan that forces physicians to participate, expands the fiscally challenged Medicare program, or pays Medicare rates. But the group said it is willing to consider other variations of a public plan.

BARACK OBAMA: I understand that you’re concerned that today’s Medicare rates, which many of you already feel are too low, will be applied broadly in a way that means our cost savings are coming off your backs. And these are legitimate concerns, but they’re ones I believe that can be overcome.

As I stated earlier, the reforms we propose to reimbursement are to reward best practices, focus on patient care, not on the current piecework reimbursements.

The public option is not your enemy; it is your friend, I believe. Let me also say that — let me also address an illegitimate concern that’s being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system.

BETTY ANN BOWSER: Backers of the public plan say it will give millions of Americans lower premiums and the private insurance companies some badly needed competition.

President Obama also spoke about another issue important to physicians: malpractice lawsuits. But what he said wasn’t exactly what they wanted to hear.

BARACK OBAMA: I want to be honest with you; I’m not advocating caps on malpractice awards, which I believe — 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. I want to work with the AMA so we can scale back the excessive defensive medicine.

Concern over payment cutbacks

Stephen Rockower
Orthopedic surgeon
I worry about quality of care, and I worry about paying my bills here in the office. You know, when Medicare cuts back on payments..., my landlord doesn't want less money just because Medicare is paying me less.

BETTY ANN BOWSER: Orthopedic surgeon Dr. Steven Rockower of Rockville, Maryland, not only belongs to the AMA. He's also on the board of the state medical society. And he doesn't like what he hears about the public insurance plan.

DR. STEPHEN ROCKOWER: I worry about quality of care, and I worry about paying my bills here in the office. You know, when Medicare cuts back on payments -- and they've been doing that up and down over the last 5 to 10 years -- you know, my landlord doesn't want less money just because Medicare is paying me less. So, you know, my employees don't want less money. So it becomes a very difficult time to be able to run a business.

BETTY ANN BOWSER: Thirty-six-year-old Zaneb Beams is a Columbia, Maryland, pediatrician and a regional director for the pro-Obama Organization Doctors for America. She does not belong to the AMA and says she doesn't know any doctors who do.

Beams says Doctors for America has a growing membership of 13,000...

DR. ZANEB BEAMS: It goes up every day.

BETTY ANN BOWSER: ... that overwhelmingly supports a public plan. She's not worried about government involvement in health care.

Courting doctors' support

Zaneb Beams
Pediatrician
Most of us, if you ask, most of us would be willing to make a teeny bit less in order to provide our patients with better care.

DR. ZANEB BEAMS: Government by the wrong people can be problematic. Government by the right people can be very well done.

BETTY ANN BOWSER: She's also willing to make less money if a public plan becomes reality.

DR. ZANEB BEAMS: A 10 percent reduction in most physicians' salaries, while it's difficult for a lot of us primary care physicians out here to make payroll at the end of every couple of weeks, a 10 percent reduction in our income is really not going to be that painful for us. And most of us, if you ask, most of us would be willing to make a teeny bit less in order to provide our patients with better care.

BETTY ANN BOWSER: The president is hoping he can gain the support of more doctors like Beams, but he made it clear today he wants to work with them.

BARACK OBAMA: I need your help, doctors, because to most Americans you are the health care system. The fact is, Americans -- and I include myself and Michelle and our kids in this -- we just do what you tell us to do.

That's what we do. We listen to you. We trust you. That's why I will listen to you and work with you to pursue reform that works for you.

BETTY ANN BOWSER: Meanwhile, on Wednesday, a key Senate committee starts work on its version of health care reform. Late today, the nonpartisan Congressional Budget Office said that plan will increase the deficit by $1 trillion. President Obama has said his plan will pay for itself.