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Obama vs Hillary at the AMA

Sixteen years and two days after then-First Lady and Health Care Czar Hillary Clinton went before the American Medical Association’s House of Delegates to sell her vision of national reform, President Barack Obama is treading the same path. I’m not sure how much greater eventual success Obama will have with the AMA, but having covered the Clinton speech as a reporter for the Chicago Tribune, I have three lingering memories.

The first was the invocation given before Clinton arrived. Its gist was, “Oh, Lord, you have taught us it is impolite to boo our guests, particularly in front of hordes of reporters.” The second memory was that Clinton finished her speech to a standing ovation. And the third is that she spoke fluently and passionately for 50 minutes without a prepared text, much to the chagrin of a national press corps accustomed to being spoon-fed a follow-along text before filing their stories. Fortunately, being a mere “regional reporter” (as the White House called us), I had taken notes.

Obama’s visit promises at least a few contrasts. He runs virtually no risk of being booed. He’s not only the President of the United States, and a very popular one, he’s also a president who has eschewed the perceived doctor-bashing engaged in at times by President and Mrs. Clinton. Obama most assuredly will not be speaking from notes, being as attached to the teleprompter as Ronald Reagan was to his 3×5 cards, but in the Internet Age anyone who cares to will be able to hear him live, anyway. A standing ovation? We’ll have to see.

To the amazement of her audience in 1993, Hillary went out of her way to hit all their hot buttons. For example, she praised the doctor-patient relationship and lashed out at the “excessive oversight” of insurance company reviewers and government bureaucrats who second-guess medical decisions. She talked sympathetically of the need for reforming malpractice laws and amending antitrust laws to allow medical professional societies to discipline poor-quality doctors on their own. (Here, I’m relying on a copy of my story I grabbed from an electronic archive.)

Obama, by contrast, prides himself on seasoning the obligatory political pandering with a soupcon or two of hard, cold reality. While reducing red tape and the need for defensive medicine are sure to be high on his list of promises, I don’t think he’ll hesitate to invoke the harsh global economic challenges that make health care reform so urgent. Look for Obama to remind the doctors how many more uninsured patients they’re seeing today and how much more involved Medicare has become in setting doctor pay scales.

One more contrast: in 1993, the AMA shoved forward Nancy Dickey, the one woman on their nine-person executive committee, to be its public face during the Hillary visit. Today, the organization’s elected president is Nancy Nielsen, the second woman to head the group (Dickey went on to the top job) and, though not publicized, the first who came to the post after holding a senior position in one of those dread health plans.

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CiceroEncarnacion MartinezRadiology Continuing EducationMaltaDeron S. Recent comment authors
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Cicero
Guest
Cicero

Malta – I only wish I would have come across your post sooner so I could have earlier told you how completely wrong you are – in fact 90%+ of what you write is BS and you are simply WRONG – not opinion – this is fact and allow me to clarify for everyone’s benefit… 1) You say that health care is a privilege and not a right as guaranteed by the Constitution – well then, what about privacy? This is not explicitly stated as a right in the Constitution however we all enjoy a liberal and free society in… Read more »

Encarnacion Martinez
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Encarnacion Martinez

If you want to see what will it happen to the health care industry, you might want to look at what it happened to the child care industry in Georgia when the state started to pay for free education for 4 years old. The payments hardy cover the expenses to pay occupancy, supplies and teachers salaries, therefore the additional money used by the program comes from fees paid by infants, twos, and three years old. The school districts refused to carry this program, because it does not pay enough. Most parents refused to pay a fee to take their four… Read more »

Radiology Continuing Education
Guest

I agree with the Donald’s comments, Obama does not know much about the healthcare indutry; what i feel now is we are on the verge of the medicare disaster.
It would be the same as we have seen in the real estate industry collapse(2007-08); Or, it might be worst than it as it belongs to the lives of real people.

Donald E. L. Johnson
Guest

Malta, Great post. Right on. Deron S., No, am for radical changes that I’ve blogged on since 2003. Some are noted in my previous post in this thread. To summarize: Get employers and government out of the health insurance business. They are dishonest players. Eliminated states’ some 1,000 mandated benefits. They add some 30% to the cost of health insurance premiums and mostly benefit the providers who sponsor them, not patients. Give individuals, not employers, the tax incentives to buy health insurance. Let individuals buy insurance that they can easily take with them when they change jobs. This would reduce… Read more »

Malta
Guest

While health care is extremely important it is not a constitutional mandated-right it is a privilege. Obama and the Democrats want to control our health care. It is their intent to jam socialized health care down our throat and force you/me to pay for others that opt not to pay for their own health care coverage. Many individuals that are offered health-care plans on their jobs are opting out to pay their own way. All of us under a national plan would then be responsible for all those that don’t want to carry their own coverage. Once you are under… Read more »

Deron S.
Guest

Donald J. – It sounds to me like you are advocating for something resembling the status quo. Is that a fair statement?

Donald E. L. Johnson
Guest

Debra,
So you’re willing to put millions of restaurant workers and food industry workers out of work just so you can implement your ‘1984’ nanny state scheme and finance Obama’s misguided take over of the health markets? Who’s going to subsidize the unemployed food industry workers? Oh, I know, they’d take stoop labor jobs in the fields and produce organic foods.
Makes no sense to me.

Debra Niemann
Guest
Debra Niemann

While all people need access to health care, we have to be able to pay for it. So instead of taxing the rich (who aren’t going to be rich for much longer), how about a “fat tax”? The reasoning is that access to cheap unhealthy food has contributed to the obesity epidemic which in turn has increased the need for health care and driven up costs. So let’s see some real CHANGE and try financing this in a new way by taxing prepared food (restaurants, cookies, ice cream, donuts, etc.) while not taxing unprepared food (meat, vegetables, milk, bread). People… Read more »

Donald E. L. Johnson
Guest

Michael, Like you, I covered Hillary’s campaign for her plan, but I don’t think I covered the speech you did. Hillary was honest about her efforts to buy votes by promising almost every special interest what they wanted whether it made sense or not. She published a comprehensive plan that was debated for months before it was defeated. I did hear Hillary at an AHA convention that year, I recall how cold and shrill she was. She was no Barack Obama and she still isn’t when it comes to teleprompter speaking. I suspect the fact that the gullibles weren’t in… Read more »

Donald E. L. Johnson
Guest

Hi, Michael. This is one of several blogs I posted today on Obama’s efforts to destroy health care in the U.S.: President Obama today tried to pull the wool over the eyes of physicians, nurses, hospital executives and consumers when he spoke before the American Medical Assn. in Chicago. He called the health care industry a “ticking time bomb” ready to explode. This shows how little he knows about health insurance, health care and health markets, not to mention economics. It also shows he’s willing to create a crisis that he can exploit in his efforts to create a single… Read more »

Michael Millenson
Guest
Michael Millenson

Jason, I thought the content of the speech was excellent. Having said that, Obama’s approach to Middle East peace, race relations and health care reform all rely on his careful appeals to logic as something that should circumvent emotion.
Me? I love that approach — as long as it’s backed up with a little raw power to concentrate the mind wonderfully. His speech was balanced and fair. Having 60 Democrats in the Senate may or may not help special interests decide not to try to roll all over him.

Jason Bloomberg MD
Guest

I’d really like to know more about your reaction and comparisons after you hear the President’s speech. I hope you will point out that there are physicians like me who do support national health care and want a public option to private insurance. I am a member of the AMA. It does not alway reflect my views. I maintain my membership so that I can try to influence it in support of universal access to health care. I’ve put my “money where my mouth is” and opened a clinic primarily for people who are uninsured. If you need more information… Read more »

Michael Millenson
Guest
Michael Millenson

I couldn’t tell from C-SPAN2 whether Obama got a standing ovation, but this speech wasn’t meant for the AMA. It was, in its way, the equivalent of the speech President Bill Clinton gave to a Joint Session of Congress in September, 2003, kicking off his formal reform efforts. So, too, was this speech a kind of health care “State of the Union,” with the AMA allowing him a platform to delve into the kind of detail that would not be appropriate in other places. Since the president of the AMA does not run for re-election, I guess Nancy Nielsen’s political… Read more »

Healthcare Guru
Guest

What I think Obama pulled off with Healthcare Execs…I am not if it was by design or luck – when he had them commit 2 trillion in saving only to retract later.
That showed the hypocracy of these guys. Hope he might do something similar.
It is not clear what he is headed for…I hope he ensures that basic insurance is avalaibale to all….Our proposal has been to make basic free by community clinics and then beyond that it could be insurance driven.
rgds
ravi
blogs.biproinc.com/healthcare
http://www.biproinc.com

David C. Kibbe, MD MBA
Guest
David C. Kibbe, MD MBA

Michael: Your coverage of the Hilary encounter with the AMA as a reporter gives you an amazing opportunity to compare and contrast the experiences. The AMA was much more powerful then, has lost most of it membership in the interim, as physicians owe their allegiance to their specialty groups much more than to the AMA. Doctors still command the public’s respect, but I think this is eroding. It certainly is among policy people, as captured in the Atul Gwande piece in the New Yorker, which put a face on the Dartmouth Atlas and Wennberg variations. I’ll be interested in your… Read more »