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White House Healthcare Summit: Obama Calls on All Sectors to Cut Costs

John Commins, for HealthLeaders Media, March 5, 2009

President Barack Obama on Thursday told key stakeholders in the healthcare reform debate that there should be no "sacred cows" in the discussion on healthcare reform, which he said will require sacrifices from everyone involved to address the "exploding cost of healthcare in America today."

"Healthcare reform is no longer just a moral imperative, it is a fiscal imperative," Obama said, in opening remarks at the White House summit on healthcare. "If we want to create jobs and rebuild our economy, then we have to address the crushing cost of healthcare this year, in this administration. Making investments in reform now, investments that will dramatically lower costs, won't add to our budget deficits in the long-term—rather, it is one of the best ways—in fact maybe the only way to reduce those long term costs."

About 150 people from the across the healthcare spectrum, as well as labor and business leaders, and Congressional Republicans and Democrats were called to the half-day summit.

Obama told the group that he wants to sign a healthcare reform bill this year and that every idea will be considered. "There should be no sacred cows. Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect. If that is the measure, we will never get anything done," he says. "But when it comes to addressing our healthcare challenge, we can no longer let the perfect be the enemy of the essential."

He also warned against anyone who would attempt to sabotage or delay the reforms. "While everyone has a right to take part in this discussion, no one has the right to take it over. The status quo is the one option that is not on the table," he said. "Those who seek to block any reform at any cost will not prevail this time around. I did not come here to Washington to work for those interests."

Melody Barnes, director of the White House Domestic Policy Council, said the president came to the summit with no set plan for healthcare reform beyond a set of parameters. "He knows that we have to get costs down. He believes that we have to have a quality healthcare system that is accessible and affordable for everyone," she told C-SPAN. "At the same time, he is being very pragmatic about this. He wants to bring people around the table to hear what they have to say. Then we can start to work together with Congress to make sure we get the policy right."

The president included a $634 billion "down payment" over 10 years for healthcare reforms that could total more than $1 trillion in the budget he sent to Congress last week. "We know that is not enough to take care of the huge problem, but we are going to work with Congress to see how we can get the rest of the revenues or cost savings to afford the healthcare system the American people deserve, and at the same time work on the policy of healthcare reform," Barnes said.

Barnes reiterated that the president expects Congress to draft the healthcare legislation, not the White House, which she noted was a key difference between the Obama administration's efforts and President Bill Clinton's failed healthcare reforms of 16 years ago. "We are not going to Congress with a preset plan. We are open to what they have to say," Barnes says. "We are having a conversation with Congress and we are going to work with them as they write the bill."

Barnes says today's summit also demonstrates that Obama is committed to a transparent process. "Today the American people will be able to go to their television sets, they will be able to go to our Web site and listen to what the president and all the people in the room have to say," she says.

American Hospital Association President Richard J. Umbdenstock, who attended today's summit, said he told President Obama at last week's fiscal responsibility summit that the nation's hospitals will answer his call for "shared responsibility" as long as everybody else does too.

"We believe we have to be part of the solution, but so do vendors, suppliers, other providers, employers, and consumers themselves. It's not going to be solved by one approach or putting it on the shoulders of any one stakeholder," Umbdenstock told HealthLeaders Media.

"Hospitals are the ones that hold this somewhat broken and disjointed system together on Main Street day in and day out for America's communities and patients in need," he says. "We are calling for reform, but not just in the form of short-term payment cuts and reductions, that will just force the system to get more out of kilter and out of balance than it already is."

While the president has said he will consider every option, apparently, single-payer is off the table. Barnes said the president is not interested in a single-payer healthcare system. "The president believes that we have to build on the system that we have right now. He's said that maybe if we were starting from scratch that is what we'd do, but that isn't where we are," she said.


John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
2 comments on "White House Healthcare Summit: Obama Calls on All Sectors to Cut Costs"


hobcarroll (3/6/2009 at 10:00 AM)
It doesn't take the so-called expertise around the summit table to know how to truly reform the system. Those talking heads - politicians, academicians, and patricians - only regurgitate their own group-think worn ideas intended to protect their own territory. The first thing is to accept that cost controls and cost shifting, the implements of illegitimate power wielded by the major culprits causing the current chaos (the government and the BUCAHs of the world), are never going to solve the problem. The one thing that you could do to start a process of arriving at an American solution to the health care financing problem is to create true fairness and transparency in provider pricing. That will allow a revitalized, true, legitimate marketplace to operate where it hasn't for over 40 years, if ever. Providers should be allowed/required to set their charge schedule where they think it is appropriate based on their own costs, quality, and market conditions. Then, no third party may negotiate any discount or favored price status for full "assignment." The government and carriers can establish what they are willing to pay, an allowed schedule for reimbursement to the patient, but the marketplace will determine if patients want to pay the required balanced billing that would result. That will create TRUE consumer empowered health care service economics. Of course, providers will be allowed on a one by one basis to consider waiving or discounting the net amount owed by the patients themselves after third party payment, but not on any basis that favors patients due to who the third party payer is. If this were done, clarity would be brought to the foggy landscape that currently exists, and we could move forward with the other goals of universal coverage (through mandate), reformed insurance company underwriting and pricing practices, and fair tax policy. Until the provider pricing issue is "fixed" correctly, nothing else can work because of the distorting and disrupting impact of the current discounting to large health plans, and the totally inappropriate and what should be illegal price fixing/controls of the federal government. The president will NOT hear this from those attending the summit, because the vested interests have too much to lose by actually transforming the system at its core, which is the only way to fix it.

ljcenter (3/5/2009 at 2:43 PM)
Cutting healthcare costs is a subject deep and wide. It is about the cost of surging technology, about patient demands, about chronic care needs and about the many types of specialty care. What is appropriate and does/will Congress understand the issues well enough to write a bill. A board of stakeholders should be advisory to the Congress and submit the top 10 issues for cost containment. Any bill that is written must be approved by the board in totality; no riders or tags added. This time, make it stick. The bill should also address the roles of various stakeholders in cost containment, including CMS, third party payers, pharmaceutical industry (boundaries), biomedical equipment, hospitals, ambulatory care (in all forms) as well as physicians and physician extenders. There should also be provision for rewarding successful cost containment while maintaining identified quality outcomes. Expectations must be clearly stated. This is a great task and one that must be considered with as much expertise at the table as possible.