President Obama lays out health care plan, addresses medical liability reform

During a joint session of Congress, the President discussed the commission of medical experts and authorized an initiative toward medical liability reform.

President Obama addressed a joint session of Congress last night to announce his proposed health care plan and discussed how physicians, health care systems, medical staff and citizens can contribute to making the plan a success.

Following yesterday’s letter urging the President and Congress to reach an agreement on reform, the American Medical Association last night issued a statement in reaction to the President’s address. The association acknowledged the three goals of the plan that President Obama laid out — to provide further security and stability to insured Americans; provide insurance to the uninsured; and slow down the growth of health care costs.

The AMA said it “believes these core goals are ones that the majority of the American people can and do support, and we urge Congress to find common ground in achieving them. … We will stay constructively engaged in the legislative process to ensure the final bill improves the health system for patients and the dedicated physicians who care for them.”

The basics of the plan

The plan will meet the first of the three goals by placing requirements on insurance companies. It will be illegal for insurance companies to deny coverage for preexisting conditions or drop coverage when a patient is sick. Insurance companies would also be unable to place caps on the amount of coverage a person can receive in a year or in a lifetime, and the plan will limit the amount of money that a person can be charged for out-of-pocket expenses.

For the uninsured, those who lose or change their jobs and small business owners, the plan will set up an insurance exchange where individuals and small businesses can shop for health insurance. The plan will provide tax credits for those who cannot afford the insurance available in the exchange. While the exchange will take four years to develop, the President said that the plan will immediately offer low-cost coverage to those Americans without insurance because of a preexisting condition.

Individuals will also be required to carry insurance, and businesses will be required to offer health care to employees or at least contribute to cover the workers’ costs. The plan will offer a hardship waiver to those individuals who cannot afford coverage, and 95% of small businesses would be exempt from these requirements because of their size and small profit margins.

Commission of medical experts, malpractice reform

The plan will also create an independent commission of doctors and medical experts who will be tasked with identifying waste in the system in the years after the new system is in place. The President envisioned that the commission will encourage other health systems and medical professionals to adopt the approaches of systems like Geisinger Health Care in Pennsylvania, which offers quality care at below-average cost. The commission would focus on “everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.”

The President also addressed the issue of malpractice reform, and said that “defensive medicine” may be driving up costs. He proposed that the government move forward on several ideas that will “put patient safety first and let doctors focus on medicine.” He directed the Secretary of Health and Human Services to move forward on an initiative just last night — a plan considered by the Bush administration that will authorize demonstration projects in individual states to test the issues of malpractice.

“Every day, physicians across the country are forced to consider the broken medical liability system when making decisions, resulting in defensive medicine that adds to unnecessary health costs. We cannot ignore this problem if health-system reform is going to address the growing cost of care,” the AMA wrote in its statement.

The public option

The President acknowledged what he called scare tactics by some politicians and the partisan divide over health care reform. “The time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together and show the American people that we can still do what we were sent to do. Now is the time to deliver on health care,” the President said.

He told Congress that he will not back down on the public option portion of the plan but did say he was open to ideas for how to implement the plan. He assured Americans that the not-for-profit public option will not put insurance companies out of service but will serve as an additional means to make insurance companies accountable, and he said that no one will be forced to choose the plan. In fact, the Congressional Budget Office estimates that less than 5% of Americans will sign up for the plan.

Most of the plan will be paid for by savings in the existing health care system once the new system is in place. The public option will be self-sufficient and will rely on the premiums it collects. The President assured Americans that the $900 billion price tag will not “add one dime to our deficits — either now or in the future.” He is proposing a provision in the plan that will require the government to implement more spending cuts if the savings that the plan promises do not occur. He also assured seniors that no part of the Medicare trust fund will be used to pay for the plan. – by Tina DiMarcantonio