Obama Takes His Case to the AMA

President Barack Obama will attempt to convince a skeptical American Medical Association Monday to drop its resistance to the most controversial element of his health reform effort, a government insurance plan.

In an address to the group's annual meeting in Chicago, Obama will pitch the public insurance plan as a necessary competitor to private insurers, and a tool to ensure choice and lower costs for consumers.

Given its historic resistance to major reform efforts, the AMA would be a tough crowd under normal circumstances. But in pushing the public plan, Obama is looking to persuade a constituency already distrustful of the government's role in health care that a government insurance program won't be as objectionable as they imagine.

"The president will be clear about what a public option does and doesn't mean for patients, physicians, and our broader health care system," according to an outline of the speech provided Sunday by the administration.

Obama's speech to the medical association – the largest physician organization in the country – is also aimed back toward Washington as negotiations on Capitol Hill head into a critical week, with the Senate Finance Committee preparing to unveil its bill. Obama is stepping up his push for a public plan amid resistance from some within his own party, and among Republicans, many of whom call it a deal-breaker that could cause them to withhold their support for a sweeping health care overhaul.

Last week, the AMA came out against the most liberal form of a public plan - one that would pay Medicare rates and require doctors to participate. The AMA considers Medicare a broken system, and would oppose efforts to expand it. But the group said it remains open to an insurance option that was not run by the government.

The group has been participating in the talks on Capitol Hill and at the White House. Although the AMA is not considered as powerful on the Hill as it once was, supporters of Obama's reform effort view physicians as key "validators" with the ability to influence voters on the grassroots level.

Obama will tell the AMA that a system overhaul cannot wait "another year or another administration," the administration wrote in its outline.

"The President will be clear that reform is the single most important thing we can do for America's long-term fiscal health," the outline stated. "He'll stress that as a nation we spend too much and get too little in return, incurring massive costs that are crushing businesses and families and on leading us toward exploding deficits, weaker benefits, and millions more Americans losing coverage.

"The president will thank the AMA for their leadership in promoting comprehensive reform, and he'll pledge to work with AMA to achieve reform that works for everyone," the outline stated.

AMA President Nancy Nielsen said Sunday that the group is looking for a fix to the Medicare payment system that has cut doctor fees, and medical liability reform that puts caps on non-economic damages.

The Obama administration outlined an additional $313 billion in new proposed savings Friday to pay for the president's health care plan. The savings would come from cutting or reducing the growth of payments to hospitals, medical equipment manufacturers and laboratories - though the major cuts don't target doctors, White House budget director Peter Orszag said Friday.

The president will ask the AMA in his speech to help him tackle rising costs in health care.

"The President will address the heart of problem of rising costs: that we're spending too much money on treatments that don't make Americans any healthier, and that our system equates more expensive core with better care," the outline stated. "He'll lay out his vision for a system that replicates best practices, incentivizes excellence, and closes cost disparities — and he'll ask for our medical professionals' help in getting the job done."

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