Government
White House summit takes 1st step in health system reform discussion
■ Obama invited more than 100 people involved with health care to a meeting to search for common ground.
By Doug Trapp — Posted March 16, 2009
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Washington -- Representatives of physicians, health plans, hospitals, patients, businesses, medical researchers, drug companies, the elderly and many others appear to agree on at least one thing: The nation's health system should work better.
President Obama invited more than 100 health care stakeholders and lawmakers to the White House on March 5 to begin an effort to craft legislation aimed at controlling health care costs, improving quality and providing better access for the nation's 46 million uninsured. The goal is to enact a comprehensive health system reform measure this year.
"I'm confident if we come together and work together, we will finally achieve what generations of Americans have fought for and fulfill the promise of health care in our time," Obama said.
Representatives from several physician organizations, including the American Medical Association, attended the White House meeting. AMA President Nancy H. Nielsen, MD, PhD, said after the event that the attendees seemed to agree that every American ought to have health insurance and that the summit was a good start. "The devil is going to be in the details of what happens next."
Dr. Nielsen and other physicians also met again with the Obama administration on March 6. "We've actually had relatively unprecedented access" at the White House, she said.
That same day, Obama announced regional health reform gatherings scheduled for March and early April in California, Iowa, Michigan, North Carolina and Vermont. The governors of each state will host the events, which will include physicians, patients, policy experts and others. The Obama transition team in December 2008 asked Americans to hold community discussions on health care and report the results. More than 30,000 people attended 3,000 meetings in all 50 states and Washington, D.C.
Meanwhile, on Capitol Hill, two key Senate panels have been holding health reform hearings for months. Their House counterparts more recently began hearings on overhauling the health system.
Working group discussion
The White House summit opened with remarks by Obama, broke into five working groups moderated by White House staff, then ended with participants asking Obama questions and offering comments. Dr. Nielsen said her group met for 75 minutes.
The groups, according to press pool reports, avoided heated discussions. Instead, many participants stated their concerns and goals for reform legislation, including the urgency for quick action. Sen. Sheldon Whitehouse (D, R.I.) referred to the series of television advertisements that the health insurance industry used to help derail the Clinton-era health reform efforts. "This isn't a 'Harry and Louise' moment; it's a 'Thelma & Louise' moment. We're in the car, headed towards a cliff, and we must act."
Sen. Edward Kennedy (D, Mass.), who attended the summit despite his poor health, said he was as optimistic as he's ever been about finishing comprehensive health system reform legislation because everyone is involved this time. "You have the insurance companies, you have the medical professions, all represented in one form or another. That has not been the case over the history of the past, going all the way back to [President] Harry Truman's time," said Kennedy, who chairs the Senate Health, Education, Labor and Pensions Committee.
Sen. Mike Enzi (Wyo.), the highest-ranking Republican on the Senate HELP panel, said he agreed with Kennedy on 80% of his proposals for health system reform. The tough work will be finding common ground on the other 20%, Enzi said.
Strange bedfellows
Summit participants mentioned physicians in both critical and sympathetic terms. Sen. Jay Rockefeller (D, W.Va.), chair of the Senate Finance health subcommittee, said physicians stand in the way of nurses taking on greater responsibility in treating patients. Obama said he has close friends who are doctors and that he understands they are feeling tremendous strains from many sides. In addition, he said he recognizes that the cost of medical education is keeping medical students from choosing primary care as a profession.
Many attendees also spoke about the need for true bipartisanship and open-mindedness to different ideas. But advocates for single-payer health plans -- including Physicians for a National Health Plan -- were not invited until the last minute, said PNHP Director Oliver Fein, MD. The organization canceled planned protests once the invitation came through.
Karen Ignagni, president and CEO of America's Health Insurance Plans, said she understands that her organization, which fought health system reform when President Clinton spearheaded it in the early 1990s, must now fight to "earn a seat at the table."
Obama signaled some flexibility in his policy position. He said he would consider legislation that includes more private or public involvement in the health system than outlined in his campaign proposal, which calls for creating a national public health plan with competition from national private plans. Sen. Chuck Grassley (Iowa), the ranking Republican on the Senate Finance Committee, said he fears that a national public plan will erode private insurance coverage.
The president closed the event by addressing worries that Congress and the White House are taking on too much work at one time. "When times were good, we didn't get [reform] done. When we had mild recessions, we didn't get it done. When we were in peacetime, we did not get it done. When we were at war, we did not get it done. There is always a reason not to do it. And it strikes me that now is exactly the time for us to deal with this problem."