President Obama has moved beyond invoking the physician's creed of "Do no harm" when it comes to treating the nation's ailing health-care system. This is about a lot more than avoiding harm. It is about changes that in effect will recognize affordable, high-quality health care in the United States as a right, not a privilege. It is about putting control of treatment in the hands of doctors, and loosening the control over care now exercised by insurance and drug companies.
Doctors at the annual American Medical Association conference in Chicago seemed cautiously receptive to the president's address Monday. For if anyone knows that the American system has some serious flaws, it is physicians, who entered the profession to help people, and not, as the president said, "to be bean counters and paper pushers."
That support was clear despite some bristling at Obama's refusal to support a cap on malpractice awards. Fear of malpractice claims may lead some doctors to perform unnecessary tests, thus driving up costs, but malpractice awards themselves constitute only a tiny fraction of the expense in health care.
The president has touted an insurance option that would have a government-sponsored insurance plan such as the one that covers Congress in place to compete with private insurers. It would not, Obama said, mean a single-payer government system, but would keep private companies honest. He should stand by this option.
Americans have seen their premiums rise and their choices diminish even as insurance and drug company executives made millions and have transparently fought reform every step of the way. Meantime, another stop on this cycle has the nearly 50 million uninsured in this country receiving their care at emergency rooms, where costs are higher – and where those costs are passed on to those covered by insurance to make up for hospitals' losses.
If expenses can be held in check and more people covered, along with medical students gaining more incentives to go into primary medicine, where the need is greatest, the system will just make more sense. And doctors can focus on patients and not be burdened with creating bureaucracies to deal with the varying machinations of insurers driven by the profit margin and often making coverage calls based not on medicine but on mammon.
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