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Doctors for America

April 23, 2012
Washington, DC

Good evening.

I am delighted to address such a diverse group of doctors, practicing every type of medicine. You come from big cities and small towns in every corner of the nation.  Some of you are veteran physicians who have practiced for decades. Some are just getting started in medical school.

But despite your different stories and backgrounds, I know that most doctors have a few things in common. You have all chosen a profession that allows you to help people. You are all healers. And I also know you could have chosen another field that offered a bigger, faster paycheck.   But what drew you to medicine is the unique opportunity to make a difference in people’s lives. 

Now, all of you here today have even gone one step further. You’re here because you want to reach beyond the vital care you provide your patients and build a better, more effective health system for everyone.

So I’d like to start by thanking you for that commitment to make affordable, quality health care accessible to all Americans.

Your efforts are paying off. Over the last three years, this Administration has advanced one of the most successful health policy agendas in recent history. And we couldn’t have done it without the support and guidance of leaders like you.

Just think about what we have accomplished with your help. Just a few days into President Obama’s term we dramatically expanded health coverage for children with the reauthorization of the CHIP program.  Usually, in tough economic times, we see more children falling into the ranks of the uninsured.  Instead, more kids today have health coverage than ever before in American history.

With your support, we passed a Recovery Act that prevented dramatic Medicaid cuts, keeping health care services for millions of Americans. The Recovery Act also expanded community health centers, boosted local prevention efforts, and started the national system of electronic health records that will help doctors across America deliver better care.  In the process, we created tens of thousands of good new health care jobs.

Also in 2009, the toughest anti-tobacco legislation was passed, including new rules to crack down on backdoor tactics for marketing cigarettes to kids.  And then we passed new child nutrition legislation that will help millions of kids get more nutritious meals in school.

Now, if we had stopped right there, we could have been proud of what we achieved.  And that’s exactly the advice that a lot of people gave.  Look at the history of health reform, they said. We have seen 70 years of debate and failure. This is not a political winner. 

But this President came into office to address the tough problems, not run away from them.  There were a dozen different moments during the health care debate when we could have given up, but we did not.  Congress didn’t give up.  And you did not give up either. 

In March 2010, the Affordable Care Act was signed into law. Since then, I have had the opportunity to travel around the country to meet many Americans who are already benefitting from the law. And I know you are seeing some of these patients in your practices every day. 

We have a new Patient’s Bill of Rights and it has already outlawed a number of the worst abuses of the insurance industry.

It is illegal for insurance companies to do things like cancel your coverage when you get sick by finding a mistake on your paperwork. Or deny coverage to children because of a pre-existing condition like asthma and diabetes. 

There are a lot of other benefits that have really begun to make a difference.  Already, two and half million additional young adults now have coverage on their parents’ health plans.

I remember at an event a few years ago a woman came up and tapped me on the shoulder.  She said: “My son had a liver transplant when he was ten months old.”  I was taken aback because that’s pretty serious.  I said, “Well, how is he?”  She said, “He’s fine.  He’s 23, but I have been terrified his whole life that he would never be able to get coverage because he will have a pre-existing condition.”  

Now, that mother and countless others have peace of mind.  Her son can be on her plan until he turns 26, and then he – and millions of others will have insurance regardless of pre-existing conditions.

I recently met a 25-year-old law student named Ashley in Miami.  Ashley is one of those young people who make you have faith in the future of the country.  She’s smart, incredibly capable, and wants to devote her career to working on social justice.  And she can go ahead and pursue that dream now because she no longer has to worry about getting health coverage.

In the past, far too many health decisions were dictated not by what a patient and their doctor thought was best, but by what an insurance company or patient’s finances would allow.

That has already begun to change. And in 2014, for the first time in our history, every American will have access to affordable health coverage.

I met a physician in Baltimore, Dr. Sherill Mason, who provides primary care at a local community health center.  She told me that she’s grateful for the law because it means her patients will no longer be afraid to come get care for a condition that an insurer could use to deny them coverage.

What this means for all of us is that we are moving toward a health care system where you will be able to begin far more conversations by saying: what can I do to help?  Not asking: what coverage do you have?

But these snapshots don’t capture the full picture of the change we’re seeing in doctors’ offices and health centers and hospitals around the country. 

Under the law, we’re helping the best new models of care spread across the country. Our goal is to create a health care system that rewards you for all the time and hard work that you put into keeping your patients healthy – not just paying for treatment once your patients are sick.  

That’s why we launched a new Center for Medicare and Medicaid Innovation with your former Executive Director, Mandy Cohen, as one of its senior leaders.

In the past, when doctors looked for ways to spark innovation in health care at a national scale, they too often were told that “We’ve always done things this way, and change takes a long time.”

Now, with the Innovation Center leading the way, we have the flexibility to test new models for delivering higher-quality, lower-cost care. Not every new approach is going to succeed. But what is important, is that when models do work, we have the authority and the resources to make them into policy across the country.

And this is not just going to happen at Medicare. These reforms -- from bundling payments to Accountable Care Organizations to integrated care for dual eligibles -- will have an even bigger impact when they are adopted by private payers, creating powerful incentives for change across the health care system.

When you add all these pieces together, they represent the most ambitious agenda for improving the health of our nation in decades.

And you have been there every step of the way. You know the details well.  But they are worth repeating because we need everyone to understand exactly what’s at stake when people talk about repealing the health care law. 

I have been to the Town Halls. I have been asked questions about government takeovers and death panels. And I know you have gotten them from many of your patients too.

We know why this confusion persists. It persists because we have had a battle for more than 3 years where some people have pitched only mistruths, smears, and horror stories.  We responded by talking about what was actually in the law: common sense reforms that most Americans already support.

But what the American people saw and heard was just another bitter Washington fight.

And because lots of Americans with decent insurance weren’t yet seeing the benefits in their own lives, they were skeptical. So, even though most Americans weren’t happy with the status quo, they also doubted that the Affordable Care Act could help them personally.

The good news is that as people’s understanding of the law improves, they appreciate what has happened.

First, they are seeing that the worst predictions about the law are not coming true.

When the health care law passed, some people forecasted everything short of Armageddon.  But today, we can simply look at the facts.  Instead of the economy crashing, we’ve had steady job growth, with health care leading the way.  Instead of Medicare crumbling, seniors have seen their premiums fall as they enjoy key new benefits.  Instead of providers rebelling, we’ve seen unprecedented interest in the new tools the law gives doctors and nurses to improve care. 

That may explain one of several encouraging data points from a recent Kaiser poll, showing that the number of Americans who say their family will be worse off under the law has now dropped to 25 percent -- a two year low.

The second reason for optimism is that -- whether it’s a senior who can now afford his medications or a recent college grad who can pursue her dream job -- more people are beginning to see the benefits for themselves and their families.

But if we want even more people to take advantage of the positive changes, we have to make sure they understand the benefits.

There was recently an article in the Clarion-Ledger about a Jackson, Mississippi woman who went to the doctor to have several tests including a colonoscopy and a mammogram. The bill came, and under the final balance it said “Zero.” She couldn’t believe it. But she said “I didn’t even know why it was free.”   

Our job now is to educate people. We don’t need to tell them that the Affordable Care Act is going to change the world. We just need to tell them how the law can help, right now.

We know that the best way to do that is by sharing concrete examples and personal experiences. And no one can do that with more authority than you – America’s health care providers.

Doctors for America have become expert practitioners of this approach: training a national team of physician educators, publishing countless opeds, and building partnerships with outside organizations. I want to thank you and encourage you to continue reaching out, not only to your patients but also to your peers.

Now there’s another place we need your help and that is in implementing the law. I am not just talking about submitting comments the next time we go through a rulemaking process -- although that is important.

I’m also talking about your participation in new models of care. As our system moves from a focus on quantity to quality -- from sick care to health care -- we need you to be first in line.

If you look at all of the most exciting new initiatives and pilot projects taking place across the country right now, they all have one thing in common: strong physician leaders.  

Physicians are driving the Comprehensive Primary Care Initiative we recently launched where Medicare teamed up with commercial and state health insurance plans to offer additional payments to primary care doctors to better coordinate care for their patients.

Physician leaders are at the heart of the 27 additional Accountable Care Organizations selected a few weeks ago to participate in the Medicare Shared Saving Program, bringing the total number to 65, serving more than 1.1 million Americans.

Doctors across the country are making the switch to electronic health records. In the last three years alone, the share of primary care doctors switching to digital records to improve care has almost doubled from 20 percent to 39 percent. Our projection is that by the end of 2012, more than half of America’s primary care doctors electronic medical records, improving care coordination, reducing duplication and errors, and lowering costs.

The common thread running through all of these efforts is committed physicians who have envisioned a stronger health care system for tomorrow and are working to achieve it today.

The Affordable Care Act has provided us a powerful new set of tools to begin this work. Now we need to make the most of it. And we cannot do that without you.

This is a pivotal moment. Today, we all have an opportunity to steer our nation toward a brighter future. The hard work continues. We will face many more obstacles in the days ahead. But I know that with your commitment and leadership, we can rise to meet those challenges and move forward together to become a healthier, stronger, more prosperous America.