The Senate may be in a temporary healthcare reform holding pattern for a day or two as the Congressional Budget Office continues to "score," or estimate, the related costs spent or saved in the Finance Committee bill approved Friday. However, blocks away on Pennsylvania Avenue, President Obama on Monday was rallying the "troops"—in this case physicians from every state in this union—for reform in the White House Rose Garden.
The friendly crowd represented groups such as the American Medical Association, the National Medical Association, the Academy of Family Physicians, the American College of Physicians, the American College of Pediatrics, and American College of Cardiology. They also represented workers in hospitals, clinics, and private practices. A number of the physicians were members of a group called Doctors for America, a grassroots organization backing healthcare reform efforts.
"These men and women here would not be supporting health insurance reform if they really believed that it would lead to government bureaucrats making decisions that are best left to doctors," Obama told the audience. "They wouldn't be here today if they believed that reform in any way would damage the very critical and sacred doctor patient relationship."
"Every one of you here today took an oath when you entered the medical profession. It was not an oath that you would spend a lot of time on the phone with insurance companies," Obama joked.
He did talk about prohibiting insurers from denying coverage because of preexisting conditions, placing limits on out-of-pocket expenses, removing caps on lifetime coverage, implementing electronic records, fixing the Sustainable Growth Rate formula by which doctors are reimbursed under Medicare, providing loan forgiveness for primary care physicians who choose to practice in rural and underserved areas, and implementing an insurance exchange. What was not mentioned directly: a public insurance option.
On a related note, Peter Orszag, director of the White House Office of Management and Budget, said in his blog Monday that the "need for health insurance reform just became clearer with the release from the non partisan Institute of Medicine (IOM) of an estimate that the health care system contains over $800 billion in excess costs."
Citing the report, he said that "excess costs” come from a variety of sources such as high administrative costs for insurers, physicians, and hospitals ($200 billion); unnecessary services, such as using more expensive brand name drugs or overusing tests and treatments ($200 billion); errors and avoidable complications ($75 billion); and fraud ($75 billion).
To reduce the costs, he noted that the IOM study identified "different levers to push change" such as: uniform administrative requirements for paperwork; reform of payment incentives oriented toward results and quality; increased reliance on evidence based quality practices; and use of electronic clinical records that can be shared.
"As one goes down the list, almost all these changes have been endorsed by the administration and most are included in the reform bills making their way through Congress, including the legislation currently being considered by the Finance Committee," he said.