Obama Prods AMA On Health Care Overhaul

President Obama Monday called the nation's health care system "a ticking bomb" for the federal budget. He told the American Medical Association that not fixing the ailing system could force the country to go the way of the nation's troubled automakers.

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MICHELE NORRIS, host:

President Obama took his proposal for overhauling healthcare to a prominent group of doctors today. He spoke to a meeting of the American Medical Association in Chicago. NPR's Scott Horsley was there and he joins us now to talk about this. Scott, the AMA is traditionally very skeptical of the government taking a bigger role in healthcare. How did the president try to win these doctors over?

SCOTT HORSLEY: Well, Michele, he buttered the doctors up a little bit. He said that look, Americans listen to their doctors when it comes to healthcare and that he's going to listen to them too. He said he needs their help to pass meaningful reform. And he also said that not only individuals and businesses have something to gain but that doctors too could benefit from a streamlined healthcare system.

President BARACK OBAMA: You didn't enter this profession to be bean counters and paper pushers. You entered this profession to be healers and that's what our healthcare system should let you be.

(Soundbite of applause)

HORSLEY: That line got a standing ovation from the doctors. At the same time, the president confronted the docs with some inconvenient truths saying one reason the healthcare system is so expensive is that in many cases doctors are doing more and more even though it's not necessarily making their patients any healthier.

NORRIS: So it seems like the president was describing the healthcare system as an ailing patient in need of a remedy and what did - how did he suggest fixing this problem?

HORSLEY: Well, he talked about changing the payment system - changing the incentives - so that doctors are rewarded for actually achieving healthier outcomes with their patients, not just doing more and more tests and procedures. He talked about taking the best practices that we know about and then making sure that they're disseminated more widely and more evenly across the country. And here's where he threw a bone to the doctors, saying, he understands one reason it might be hard for them to cut back on some of those unnecessary procedures.

Pres. OBAMA: I recognize that it will be hard to make some of these changes if doctors feel like they're constantly looking over their shoulders for fear of lawsuits. I recognize that.

(Soundbite of applause)

Pres. OBAMA: Don't get too excited yet.

(Soundbite of applause)

HORSLEY: Now, as you can see that was another big applause line, but the president quickly squelched it. He said he was not in favor of capping malpractice damage awards, which is something that many members of the AMA would like to see. But he said he is open to other reforms that would provide some protection for doctors who follow a standard of care and in that way discourage what he called defensive medicine.

NORRIS: Now the AMA has expressed some concern about the president's call for a public insurance plan. That's something that the president has been advocating for quite a while. He mentioned that today in his speech - very long speech, he talked for about 45 minutes. What did Mr. Obama say about that today?

HORSLEY: Well, he continued to insist that a public plan should be a part of the package. Now aides say that could be structured in a variety of ways. The doctors' biggest concern is that it looks something like Medicare writ large with what they consider below-market payments to physicians. But they said if there's a public plan where the plan pays competitive rates with other insurance companies they could maybe go for that. And Mr. Obama says if you don't have a public plan what you're in effect doing is just delivering more customers to the insurance companies, all at taxpayers' expense as you use taxpayer money to make healthcare coverage more widely available, and yet you don't have a check on the insurance companies and their costs and services. So he says a public plan is important to keep the insurance companies honest.

NORRIS: We heard applause there. Did the president overall get a positive reaction today?

HORSLEY: I think warmer than people might have expected.

NORRIS: Thank you, Scott.

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