Obama's Speech to the AMA 54 words

But what accounts for the bulk of our costs is the nature of our health care delivery system itself -- a system where we spend vast amounts of money on things that aren't necessarily making our people any healthier.

That's why I'm open to expanding the role of a commission created by a Republican Congress called the Medicare Payment Advisory Commission, which happens to include a number of physicians on the commission.

And yet, as I think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren't any healthier.

And we need to rethink the cost of a medical education, and do more to reward medical students who choose a career as a primary care physician -- -- who choose to work in underserved areas instead of the more lucrative paths.

You didn't enter this profession to be bean-counters and paper-pushers.

And if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation's defense.

We need to end the practice of denying coverage on the basis of preexisting conditions.

And we need to rethink the cost of a medical education, and do more to reward medical students who choose a career as a primary care physician -- -- who choose to work in underserved areas instead of the more lucrative paths.

How do we permanently bring down costs and make quality, affordable health care available to every single American?

Now, a recent article in the New Yorker, for example, showed how McAllen, Texas, is spending twice as much as El Paso County -- twice as much -- not because people in McAllen, Texas, are sicker than they are in El Paso; not because they're getting better care or getting better outcomes.

It's a hidden tax, a hidden bill that will be cut as we insure all Americans.

And we want to make sure that we're helping providers computerize so that we can get this system up and running.

As I stated earlier, the reforms we propose to reimbursement are to reward best practices, focus on patient care, not on the current piecework reimbursements.

It's a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can't spend much time with each, and gives you every incentive to order that extra MRI or EKG, even if it's not necessary.

That means doctors may be doing a bypass operation when placing a stent is equally effective; or placing a stent when adjusting a patient's drug and medical management is equally effective -- all of which drives up costs without improving a patient's health.

Part of the reason is because the different groups involved -- doctors, insurance companies, businesses, workers, and others -- simply couldn't agree on the need for reform or what shape it would take.

And yet, as I think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren't any healthier.

First, we should end overpayments to Medicare Advantage.

But while significant individual reforms have been made -- such as Medicare, Medicaid, and the Children's Health Insurance Program -- efforts at comprehensive reform that covers everyone and brings down costs have largely failed.

That's why we're making a substantial investment in the National Health Service Corps that will make medical training more affordable for primary care doctors and nurse practitioners so they aren't drowning in debt when they enter the workforce.

You didn't enter this profession to be bean-counters and paper-pushers.

And we also know that one essential step on our journey is to control the spiraling cost of health care in America.

First, as part of the budget that was passed a few months ago, we put aside $635 billion over 10 years in what we're calling a Health Reserve Fund.

First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping.

Second, we need to use Medicare reimbursements to reduce preventable hospital readmissions.

Stories like Laura's are being told by women and men all across this country -- by families who've seen out-of-pocket costs soar, and premiums double over the last decade at a rate three times faster than wages.

It's simply because they're using more treatments -- treatments that, in some cases, they don't really need; treatments that, in some cases, can actually do people harm by raising the risk of infection or medical error.

Now, what makes this moment different is that this time -- for the first time -- key stakeholders are aligning not against, but in favor of reform.

And I'm working with AARP to uphold that commitment.

I want them to benefit from a health care system that works for all of us... where orthopedists and nephrologists and oncologists are all working together to treat a single human being.

I want them to benefit from a health care system that works for all of us... where orthopedists and nephrologists and oncologists are all working together to treat a single human being.

And that's why we need to build on the examples of outstanding medicine at places like the Cincinnati Children's Hospital, where the quality of care for cystic fibrosis patients shot up after the hospital began incorporating suggestions from parents.

And if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation's defense.

This is forcing Americans of all ages to go without the checkups or the prescriptions they need -- that you know they need.

And that's starting to change with an investment we're making in prevention and wellness programs that can help us avoid disease that harm our health and the health of our economy.

Second, we need to use Medicare reimbursements to reduce preventable hospital readmissions.

We're here to create new jobs, to unfreeze our credit markets.

Let me also say that -- let me also address a illegitimate concern that's being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system.

Five of the costliest illnesses and conditions -- cancer, cardiovascular disease, diabetes, lung disease, and strokes -- can be prevented.

And in 30 years, it will be about one out of every three -- a trend that will mean lost jobs, lower take-home pay, shuttered businesses, and a lower standard of living for all Americans.

It also means cutting down on all the junk food that's fueling an epidemic of obesity -- -- which puts far too many Americans, young and old, at greater risk of costly, chronic conditions.

It means going in for that mammogram or colon cancer screening.

It's a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can't spend much time with each, and gives you every incentive to order that extra MRI or EKG, even if it's not necessary.

It means going in for that mammogram or colon cancer screening.

You shouldn't have to tell every new doctor you see about your medical history or what prescriptions you're taking.

It's a scenario that will swamp our federal and state budgets, and impose a vicious choice of either unprecedented tax hikes, or overwhelming deficits, or drastic cuts in our federal and state budgets.

Over half of that amount -- more than $300 billion -- will come from raising revenue by doing things like modestly limiting the tax deductions the wealthiest Americans can take to the same level that it was at the end of the Reagan years -- same level that it was under Ronald Reagan.

And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table.

Indeed, it's because I'm confident in our ability to give people the ability to get insurance at an affordable rate that I'm open to a system where every American bears responsibility for owning health insurance -- -- so long as we provide a hardship waiver for those who still can't afford it as we move towards this system.

We can also save about $75 billion through more efficient purchasing of prescription drugs.

It's a ticking time bomb for the federal budget.