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Patient Protection Needs Focus in Obama's Second Term

 |  By cclark@healthleadersmedia.com  
   January 24, 2013

Inaugural pomp, tickets for seats with an enviable view of the Capitol balustrade, and the need for a vacation formed a confluence that got me to fly back to my geographical roots this week.

Lucky for me, a college friend's mother owns an apartment high above the parade route, directly across from the National Archives Building in Washington, DC.

We had a good 90-second view of the motorcade, and our parapet provided a long-lens close-up of the spot where, four years earlier, the President and First Lady stepped out of the presidential limousine and walked alongside cheering throngs.

Four years later, we've got to ask ourselves: Can we stop the sniping? Can we get things done? Can we trash the sour grapes?

Already there is catty silliness, so typical of Washington: Did the First Lady really roll her eyes at whatever House Speaker John Boehner (R-OH) was saying during the inauguration lunch?

And in his inaugural remarks about Medicare and Social Security, did President Obama really pull a "switcheroo" and "shadowbox a straw man in order to win an argument by default” as former vice presidential nominee Rep. Paul Ryan (R-WI) has charged?"

Obama's inaugural address did seem to provide a retort to Ryan's 2010 comments, in which the former vice presidential nominee claimed that "60% of the American people get more benefits in dollar value from the federal government than they pay back in taxes."

This came through even as President Obama signaled his commitment to rolling out the rest of the Patient Protection and Affordable Care Act:

"We, the people, still believe that every citizen deserves a basic measure of security and dignity. We must make the hard choices to reduce the cost of health care and the size of our deficit.

But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.

For we remember the lessons of our past, when twilight years were spent in poverty and parents of a child with a disability had nowhere to turn. We do not believe that in this country freedom is reserved for the lucky or happiness for the few.

We recognize that no matter how responsibly we live our lives, any one of us at any time may face a job loss or a sudden illness or a home swept away in a terrible storm. The commitments we make to each other through Medicare and Medicaid and Social Security, these things do not sap our initiative.

They strengthen us. They do not make us a nation of takers. They free us to take the risks that make this country great."

There was joy in the faces and hope in the eyes of those watching. I know that sounds like a platitude. But it's true.

As I bopped around the Baltimore-Washington corridor visiting friends from various chapters of my life and places I used to haunt, I heard many interpretations of what the healthcare law will mean to my generation, as well as the tiniest children who sat on their parents' shoulders during the parade.

Most of those views had to do with the "affordable care" portion of the healthcare reform bill, how people will obtain insurance and how we are going to pay for it all. But very few mentioned their expectations from the "patient protection" part, which is where this quality column usually dwells.

No one I spoke with, from the civics teacher from an inner city Atlanta high school at the airport, to an ailing Medicare beneficiary who sat at a train station, appreciated the provisions designed to improve the quality of care.

I hope that in coming months and years, the Obama administration does a much better job of showing us just how the new law's vice grips will incent providers to work harder. Patients should get only necessary and appropriate care without being harmed in the process.

Four more years lie ahead of us and there's lots of work to do. Let's get started.

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