Obama’s counterattack on healthcare

CHICAGO — President Obama switched to attack mode Monday, taking on critics of his healthcare plan and saying any claims that he favors a government takeover are false.

Obama visited his hometown to woo doctors, and the public, with an address before the American Medical Association (AMA).

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By appearing before the AMA, Obama sought to win over two vital constituencies: physicians and the patients who listen to them. The AMA is one of the most influential interest groups in Washington and has played key roles in stopping past efforts to reform healthcare, such as President Clinton’s program.

Though Obama has been promoting his principles for healthcare reform all year, Monday’s speech included his strongest-yet condemnations of critics — mainly Republicans — who argue that his plans will lead to a total government takeover of the healthcare system.

“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.

“When you hear the naysayers claim that I’m trying to bring about government-run healthcare, know this: They’re not telling the truth.”

Indeed, that’s precisely what the Senate’s top Republican said after the speech.

“Americans don’t want a government-run system that puts bureaucrats between patients and doctors,” Senate Minority Leader Mitch McConnell (R-Ky.) said. “They certainly don’t want the kind of government boards that exist in places like New Zealand and Great Britain that deny, delay and ration treatments that are currently available to Americans.”

The president has signaled that he is squarely behind the push for healthcare reform, his speech being the second in as many weeks following a townhall meeting in Green Bay, Wis. With Congress readying legislation this week, the political battle over his foremost domestic policy initiative is fully engaged.

Over the course of his 45-minute speech, Obama addressed head on some of the most controversial elements of his healthcare reform platform and made the case that reducing the growth in healthcare costs is vital to the economic future of the public, American business and the federal government.

“If we do not fix our healthcare system, America may go the way of GM: paying more, getting less and going broke,” Obama said.

Obama offered assurances that Americans who like their current healthcare coverage and physician would be able to keep them, repeating one of his administration’s key talking points.

He also laid out a vision for a system that covers everyone at lower costs — and insisted that vision could only be realized through new policies at the center of the political debate.

Obama reiterated his view that healthcare reform must include the creation of a government-run benefits program that would compete with private health insurance, a notion viewed skeptically by the AMA and strenuously opposed by business interests and Republicans.

“What I am trying to do — and what a public option will help do — is put affordable healthcare within reach for millions of Americans,” Obama said.

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“The public option is not your enemy; it is your friend, I believe,” Obama said, though he acknowledged physicians’ “legitimate concerns” about how much a public plan would pay them.

That line of reasoning does not hold sway among Republicans. “I don’t question the president’s motives or his ability,” said Sen. Lamar Alexander (R-Tenn.). “We know from experience that a government-run option is likely to lead to a government-run healthcare system.”

Obama also conceded that healthcare reform would cost more than $1 trillion over 10 years and defended his proposal of tax increases and Medicare and Medicaid cuts as ways to cover the expense.

“There are already voices saying the numbers don’t add up. They’re wrong,” Obama said. “We’ve put about $950 billion on the table — and that doesn’t count some of the long-term savings that we think will come about from reform.”

A Congressional Budget Office analysis issued Monday on one Senate bill confirmed that the price tag would be, at a minimum, $1 trillion over 10 years.

Obama touted the use of comparative effectiveness research on medical treatments to determine which are most effective and providing that information to physicians and patients. The economic stimulus bill set aside more than $1 billion for this research.

Critics of using this type of research derided the practice as “cookbook medicine” and say federal guidelines amount to government interference in the doctor-patient relationship.

Obama rejected that argument. “Let me be clear — I just want to clear something up here — identifying what works is not about dictating what kind of care should be provided,” he said to applause. “It’s about providing patients and doctors with the information they need to make the best medical decisions.”

Underscoring the importance of attracting physicians’ support for his healthcare reform campaign, Obama offered the AMA an olive branch of sorts by saying he is open to some form of limits on medical malpractice lawsuits.

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The physician lobby has long sought a federal cap on malpractice lawsuit damages but has been staunchly opposed by Democrats and their allies in the trial bar. Obama, however, indicated he is open to discussing the issue in order to see healthcare reform passed.

“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,” Obama said to applause. The president endured a smattering of boos, however, when he added, “I’m not advocating caps on malpractice awards, which I personally believe can be unfair to people who’ve been wrongfully harmed.”

Instead, the administration is said to be considering establishing a shield against lawsuits for physicians who abide by clinical practice guidelines.

The trial bar reacted swiftly to the president’s remarks, issuing a statement emphasizing its opposition to changes to the medical tort system.

“Limiting the legal rights of injured patients will do nothing to lower healthcare costs or aid the uninsured,” said Les Weisbrod, the president of the American Association for Justice, a trade group for trial lawyers.

Congress also contributed to the charm offensive on physicians Monday. House Democrats unveiled a proposal to permanently replace the Medicare payment formula for doctors, which has called for annual cuts for most of the decade and a 20 percent cut next year. Fixing these Medicare payments is on par with malpractice reform for the physician lobby.

J. Taylor Rushing contributed to this article.