AMA President Dr. James Rohack appears on ABC Primetime
June 25, 2009
AMA President J. James Rohack, MD, participated in a special edition of ABC's "Primetime" with Charles Gibson and Diane Sawyer on Wednesday, June 24, at 9 p.m. CT/10 p.m. ET.
During the program, President Obama fielded questions on health care reform from U.S. citizens selected by ABC News—including Dr. Rohack—in a forum telecast from the East Room of the White House.
Dr. Rohack's exchange with President Obama (transcript)
ABC's Diane Sawyer: I want to turn to someone who thinks we should follow up on what we were talking about a while back, namely about in some way reducing the vicious cycle of lots of tests, lots of treatment, what's necessary, what isn't necessary, and saying that somebody has got to enforce this, it's not going to happen if somebody doesn't. And by the way, he is James Rohack, from Texas, and he is president of the AMA, the American Medical Association.
Dr. Rohack: Thank you. Mr. President, clearly, when you spoke to us last week, you said that we entered the medical profession not to be bean counters, not to be paper pushers, but to be healers. And we totally agree. How are you going to assure the American public that medical decisions will still be between the patient and the physician, and not some bureaucracy that will make decisions on cost and not really what the patient needs?
President Obama: Well, first of all, I want to thank the American Medical Association. I did appear before them just last week in Chicago, my hometown, and had a terrific exchange of ideas, and we're continuing to work with all stakeholders—doctors, nurses, insurers, and obviously patients—you name it, folks out there are interested in seeing this happen.
The most important thing I can say, James, on this issue is, if you are happy with your plan and you are happy with your doctor, then we don't want you to have to change. In fact, if we don't do anything, if there's inaction, I think that's where the great danger that you lose your health care exists because of the cost problems that I already talked about.
So what we're saying is, if you are happy with your plan and your doctor, you stick with it. If you don't have insurance, if it's too much for you to afford, if your employer doesn't provide it or you're self-employed, then we will have what's called an exchange, but you can also think of it as a marketplace, where essentially people can compare and look at what options are out there. They'll have a host of different health care plans available, each with their own physicians network. And you will be able to sign up for the plan that works for you.
We will help people who don't have insurance get insurance. Doctors are not going to be working for the government. They're still going to be working for themselves. They're still going to be focused on patient care. And in terms of how doctors are reimbursed, it's going to be the same system that we have now, except we can start making some changes so that, for example, we're rewarding quality of outcomes rather than the number of procedures that are done.
And this is true not just for doctors, it's also true for hospitals. One of the things that we could say to hospitals is, reduce your readmission rate, which is often a sign that health outcomes have not been so good. And it turns out that hospitals, when they're incentivized, actually can find ways to do it that every study shows does not have adverse effects on outcomes.