Association of American Medical Colleges 2010 Annual Meeting
November 8, 2010
Remarks as prepared for delivery
Thank you, Dr. Powell, for that nice introduction. It’s great to be here with you all today.
Before I begin, I want to acknowledge Dr. Kirch and the Association of American Medical Colleges for your great leadership in so many areas, from strengthening our health workforce to improving the quality of care.
I especially want to thank you for your steadfast support of the Affordable Care Act. When we reached the end of a marathon debate this spring, you helped push the legislation across the finish line – and put our country on a path towards providing every American with access to affordable health care.
But your actions speak even louder than your words. Whether it’s training the next generation of doctors and nurses, researching the next generation of cures and treatments, or pioneering new models for delivering better care at a better price, you help shape the health care system of the future every day.
And that role has never been more important than it is today.
We’re at a moment of great potential for improving health in America.
There’s an understanding from providers, patients, employers, and government that the status quo is unsustainable.
Health care costs are eating up a growing share of our paychecks, driving up our deficit, and putting a growing burden on our businesses.
Even more troubling, though we lead the world in health care spending, scientific research, and medical technology, we lag behind in health.
In the last two years, the passage of the Affordable Care Act and other health legislation has created a new platform for care delivery, scientific breakthroughs, and health outcomes.
We have an incredible, once-in-a-generation opportunity over the next few years to make a great leap forward in health. But we’re going to need your help.
That starts with making it easier for Americans to stay healthy.
You see patients every day who are suffering from conditions that could have been prevented if they ate a healthier diet, got more exercise, stopped using tobacco products, or had access to preventive care.
Many of these people would like to make the healthy choice, but it’s not always clear or easy or affordable.
That’s why this Administration has launched a historic effort to support some of the most promising local strategies around the country for helping people live healthy from bringing supermarkets to food desserts to creating more walkable communities.
We’re putting better nutritional information in consumers’ hands in chain restaurants and grocery stores so it’s easier to pick out the healthier option.
We’re using new tools to help youth say no to tobacco and help tobacco users quit.
And as part of the Affordable Care Act, we’re making recommended preventive care from cancer screenings to smoking cessation counseling available to many Americans at no additional cost, because no woman should have to skip a mammogram because she can’t afford the co-pay.
Together, these changes will make it much easier for Americans across the country to take care of themselves. But you can help too.
You are our most trusted health messengers. When you recommend a healthier diet or a screening to your patients, it has more impact than it would coming from anyone else.
So as you return to your communities, I hope you will make it a priority to help your patients take advantage of the new opportunities available to them thanks to the recent legislation.
And in particular, as you continue to train the next generation of doctors and nurses, I hope you will put just as much focus on keeping people healthy as you do on healing the sick.
The life we save by preventing a heart attack should be worth just as much as the one we save with a 12-hour open heart surgery.
Still, no matter how much progress we make, Americans are still going to get sick. And when they do, we need to make sure they get the care they need.
In this country, we’re fortunate to have the best doctors and hospitals in the world. But for too long, for too many Americans, they were out of reach.
We had a health insurance market that worked much better for insurance companies than for so many families and small business owners.
You saw this every day in uninsured or underinsured patients who put off treatments and cut their pills in half to make their prescriptions last longer.
You saw it in the people who spent their last minutes before a procedure on the phone fighting with their insurance company.
You saw it in the $56 billion a year of uncompensated care you provided for the uninsured.
Under the new law, there will be some fairness in the health insurance market.
A new marketplace where Americans who had been shut out or priced out of the market will be able to get affordable coverage.
And we’ve already established a Patient’s Bill of Rights with an independent appeals process for claims decisions and new protections for consumers to make sure their coverage isn’t taken away from them without justification.
What this means for you is that many of your patients will no longer have to choose between paying their rent and paying their hospital bills.
And you can spend less time arguing with insurance companies and more time delivering care.
But as important as these health insurance reforms are, we all know that a lack of health insurance is not the only obstacle preventing people from getting the care they need.
There are 60 million Americans today who live in areas with a shortage of primary care doctors.
The Association of American Medical Colleges has been calling attention to this shortfall for years. And I’m pleased that the nation’s medical schools are on pace to educate 30 percent more students in 2019 than in 2004.
But that won’t be enough.
That’s why we’ve undertaken a broad agenda to expand our health care workforce from almost doubling the size of the National Health Service Corps to making it easier for minority students to fulfill their dreams of joining a health profession, since we know that a high-quality health workforce is a diverse health workforce.
When you add all these initiatives together, we’re going to train 16,000 new primary care providers over the next five years, many of who will practice in the rural and inner-city communities where they’re needed most.
As we work toward these goals, I’m grateful for the partnership of America’s medical colleges and research universities.
Many of you know that as part of the new law, we’ve set up a new National Center for Health Workforce Analysis, which is led by Ed Salsburg, a former director of the Association of American Medical colleges. We also recently announced the members of a new National Health Care Workforce Commission, including several members from academic medical centers
These new bodies will help us track supply and demand in health professions, but we will also continue to count on you for innovative ideas for growing our health care workforce from training more doctors outside of major academic centers to reducing the time and cost of that training.
In these challenging economic times, we can’t afford to rely on new funding alone to meet our workforce needs.
In all of these areas – from building healthier communities, to increasing access to health insurance, to expanding our health care workforce – we can work together to remove obstacles standing between Americans and a healthier future.
But we know that health care providers also face significant barriers as you strive to deliver the best care possible. And we’re committed to working with you to reduce them.
That starts with preventing the 23% cut in Medicare payments to doctors that’s scheduled to take effect at the end of the month.
These drastic cuts could force doctors out of the Medicare program and jeopardize the care of our seniors.
On Thursday, I attended a Cabinet meeting where the President stressed that preventing these potentially disastrous cuts must be one of our top priorities.
The American Medical Association has proposed a 13 month extension. And I hope that Congress will act quickly to pass it, so that our doctors and seniors can have some peace of mind while we work on a long-term fix.
There’s been a lot of talk in the last few months about Medicare and its future.
The single biggest step we can take to strengthen Medicare for seniors and disabled Americans is to make sure these disruptive cuts don’t take effect.
As the President has said many times, we will ultimately need a permanent fix, so that the livelihoods of the hard-working doctors who care for seniors and people with disabilities are no longer subject to politics.
But in the meantime, we don’t want any doctor to be stuck in a limbo where they don’t know week to week how much they’ll be paid for the services they deliver.
That’s why we’re urging Congress to act now to make sure that you can continue to provide the high quality care our seniors depend on every day.
We must also continue to work to fix the deeper problems in the way we pay for care. As you see every day, there is often a gap between the care we reward and the care that’s most effective.
Under the Affordable Care Act, we’re trying to change that.
For example, we know that hospitals that provide effective follow-up care from making sure patients eat the right diet to making sure they get the right wound care can significantly lower readmission rates.
Right now, the financial incentives reward preventable readmissions rather than the systems that deliver excellent follow-up care. That needs to change.
We’re also seeing more and more evidence that doctors and nurses can deliver higher-quality, lower-cost care when they work together.
That’s why the new law provides unprecedented support for new models like Accountable Care Organizations and medical homes that allow better collaboration between health care providers.
But these pilots are just a start. As you know, the new law also establishes a Center for Medicare and Medicaid Innovation charged with developing additional models to support patient-centered care in the years to come.
These new care delivery models can make a huge difference. Medicare touches every hospital system in the country and almost every provider.
That means it can be a significant force for maintaining the status quo. Or it can be a force for transforming our health care system to keep patients healthier and lower costs.
We want to make Medicare a force for health care improvement, and these new models will help us do that.
That’s also why I’m so glad that Medicare and Medicaid are now being run by Dr. Don Berwick, one of our country’s premier experts in improving the quality of health care.
Any time you can take one of the smartest people in an area and put them in the position of greatest influence, you have a chance to make a huge difference.
As we work to make it easier for doctors to deliver care in the most effective way you know how, we will continue to work closely with you.
Some of your members are already involved in these efforts though Advisory bodies created by the Affordable Care Act – people like Dr. Eugene Washington and Dr. Steven Lipstein who are helping to lead our Patient-Centered Outcomes Research Institute.
And as educators, you all have a major role to play. You can help make sure that the skills necessary to provide coordinated, patient-centered care an integral part of medical education.
Last month, we got the latest evidence that this kind of training has a huge payoff. In a study of VA hospitals, researchers found that mortality rates were significantly lower in surgical facilities where providers had received training on working as a team.
Many of you have already added this kind of instruction to your curricula. In one recent survey, internal medicine clerkship directors reported that one quarter of medical schools offered training in improving patient safety.
That’s a good start. But it also means that three quarters of medical schools still don’t offer this crucial preparation.
If we want to build a healthier America, we need to make sure the health care providers of the future are trained to delivery high quality, safe, patient-centered, coordinated care in health care settings from communities to intensive care centers.
America’s research and hospitals and medical schools are the crown jewel of our health care system, the finest in the world.
They are stocked with new drugs, equipped with advanced machinery, and staffed by caring doctors and nurses who have mastered sophisticated treatments. Patients travel from around the world to take advantage of the advanced care you provide.
But we won’t have achieved real success until people also travel here to learn about how to deliver patient-centered care, to discover the most effective strategies for reducing health disparities, to improve the health of an entire country.
With your help, we’ve passed historic health legislation that has given us an incredible opportunity to work together to build a healthier America. Now we need your help to make the most of it.