Obama Health Care Plan Faces Doctors' Exam

President Barack Obama speaks about health care reform, Monday, May 11, 2009, in the State Dining Room of the White House in Washington. (AP Photo/Charles Dharapak) AP

President Barack Obama, continuing to barnstorm for his health care proposals, will urge doctors gathered in Chicago to support wider insurance coverage and targeted federal spending cuts.

Mr. Obama planned to tell the American Medical Association's annual meeting in his hometown on Monday that overhaul cannot wait and that bringing down costs is the most important thing he can do to ensure the country's long-term fiscal health, a senior administration official said.

The official spoke on the condition of anonymity to discuss the president's remarks before they were delivered.

The nation's doctors, like many other groups, are divided over the president's proposals to reshape the health care delivery system. The White House anticipates heavy spending to cover the almost 50 million Americans who lack health insurance and has taken steps in recent days to outline just where that money could be found.

For instance, Mr. Obama wants to cut federal payments to hospitals by about $200 billion and cut $313 billion from Medicare and Medicaid. He also is proposing a $635 billion "down payment" in tax increases and spending cuts in the health care system.

To an audience of doctors Mr. Obama plans to say the United States spends too much on health care and gets too little in return. He says the health industry is crushing businesses and families and is leading to millions of Americans losing coverage, the administration official said.

Mr. Obama's turn before the 250,000-physician group in his latest effort to persuade skeptics that his goal to provide health care to all Americans is worth the $1 trillion price tag it is expected to run during its first decade.

The president plans to acknowledge the costs. But he also will tell the doctors it is not acceptable for the nation to leave so many without insurance, the official said.

Unified Republicans and some fiscally conservative Democrats on Capitol Hill have said they are nervous about how the administration plans to pay for Mr. Obama's ideas.

The New York Times reported Monday that Mr. Obama has been quietly making a case for reducing malpractice lawsuits to help control costs, long a goal of the AMA and Republicans. Mr. Obama has not endorsed capping jury awards.

Presidents have tried to pass health care reform for 60 years. Most recently, President Clinton failed 15 years ago, reports CBS News senior White House correspondent Bill Plante.

The White House has tried to avoid the kind of fights the Clintons had with Congress - it has deliberately not given Congress much guidance about exactly what they think should be in a health care bill - and that's caused infighting among Democrats.

Mr. Obama has been speaking privately with lawmakers about his ideas and publicly with audiences, such as a town hall style meeting last week in Green Bay, Wis. Mr. Obama and his administration officials have blanketed the nation in support of his broad ideas, and Vice President Joe Biden on Sunday said it's up to Congress to pin down the details on how to pay for them.

"They're either going to have to agree with us, come up with an alternative or we're not going to have health care," Biden told NBC's "Meet the Press."

"And we're going to get health care."

In Chicago, the president's remarks are likely to focus on how his ideas might affect the medical profession.

His proposed cuts in federal payments would hit hospitals more directly than doctors, but physicians will be affected by virtually every change that Congress eventually agrees to. Many medical professionals are not yet convinced Mr. Obama's overhaul is the best for their care or their pocketbooks.

Broadly, the AMA supports a health care "reform" - a term that changes its definition based on who is speaking - although the specifics remain unclear.

In a statement welcoming Mr. Obama, AMA president Dr. Nancy Nielsen said the medical profession wants to "reduce unnecessary costs by focusing on quality improvements, such as developing best practices for care and improving medication reconciliation."

She also said doctors need greater protection from malpractice lawsuits and antitrust restrictions.

Many congressional Republicans, insurance groups and others oppose Mr. Obama's bid for a government-run health insurance program that would compete with private companies. On Sunday, Senate Minority Leader Mitch McConnell, R-Ky., described a government plan as a "nonstarter."

"We can make incredible improvements in American health care, but I don't think having more government - in effect putting Washington between you and your doctor - is the way to go," .

"There are a whole lot of other things we can agree to do on a bipartisan basis that will dramatically improve our system," he said.

To that end, lawmakers were considering a possible compromise that involved a cooperative program that would enjoy taxpayer support without direct governmental control. The concessions could be the smoothest way to deliver the bipartisan health care legislation the administration seeks by its self-imposed August deadline, officials said.

"There is no one-size-fits-all idea," Health and Human Services Secretary Kathleen Sebelius told CNN's "State of the Union" on Sunday.

"The president has said, 'These are the kinds of goals I'm after: lowering costs, covering all Americans, higher-quality care.' And around those goals, there are lots of ways to get there."

Momentum might be on Mr. Obama's side. Aaron Carroll, an Indiana University medical professor who has surveyed doctors' views on U.S. health care delivery, said 59 percent "favor government legislation to establish national health insurance," an increase over a previous poll's finding.

He noted that many doctors are not AMA members, and therefore the association's views should not be overrated.
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