New from PPI | July 23, 2009
Obama's Med School
The President Explains the "Better Medicine" Side of Health Reform
By Ed Kilgore
No matter what you think of the short-term impact of President's performance during last night's press conference, he did something remarkably important in the long run: he began explaining to the American people why it will save both money and lives to change the health care delivery system, even if that means overview of providers to ensure they are offering high-quality care and practicing "good medicine."
As Jonathan Cohn notes today for the New Republic, Obama took a real risk by going there:
Consider that Obama's mission tonight was actually very straightforward: to build support for health reform at a time when it is moving through Congress but, for the first time, running into serious obstacles. To accomplish this, Obama basically had two options at his disposal. He could reassure the public by minimizing the scope of change he was promoting or he could persuade the public by convincing them change, even extensive change, was actually necessary.
In the past, Obama has frequently emphasized the former approach. And at times tonight, he did it again--most clearly when he repeated his promise that people could keep their insurance if they liked it.
But Obama spent most of his time this evening explaining why things had to be different. He did this, first, by talking about the problems of the status quo. He talked about rising premiums, dwindling benefits, and growing costs that are strangling employers and government alike.
The really big moment occurred when the President was challenged to promise that under his proposal Medicare would pay doctors for absolutely anything they decided to order up for patients. Obama wouldn't buy that. While he did observe that many doctors make questionable decisions based on the lack of information technology, and in reaction to the perverse incentives sometimes created by health plans, he also insisted that doctor-patient discretion should be limited by medical best practices and cost-effectiveness, saying that Americans and their health care providers need to become "more discriminating consumers."
As Cohn notes, this took some real courage given an environment in which any tampering with the health care status quo will be attacked by conservatives as some sort of socialist outrage.
If nothing else, criticism of the President for failure to sufficiently talk about real cost containment measures in health care ought to end. The question now is whether Congress and the public will follow him in demanding reform.
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