The State of the Union: What It Said to Physicians

Last night, President Barack Obama delivered his second State of the Union Address to Congress and the nation, highlighting a number of topics, including healthcare in the United States. We asked two members of the Physicians Practice staff to share their impressions of the speech and how it did or did not address physician concerns.

Here are their thoughts. Feel free to share yours in the comments section below.

Associate Editor Marisa Torrieri:
President Obama’s cautiously optimistic State of the Union speech last night raised more questions than it answered about the future of healthcare, education, and the economy. And for physician practices and other professionals in the medical field, the speech reflected a state of uncertainty over what will happen to Medicare, health coverage, and patient care.

“Revolutions and technology have transformed the way we work, live and do business,” said the president, referring, predictably, to influence of the Internet. And as he acknowledged that “in America innovation doesn’t just change our lives, it is how we make our living,” one couldn’t help but think of the medical field as a prime setting for the example.

But with the hopes of technology, which has brought physicians everything from tools to fix patients’ bodily woes to EHRs, there is also the burden of the trillion-dollar national debt: How will the United States deal with this? What programs will be cut? What will happen to Medicare and Social Security?

These are specific questions physicians' practices had as they watched the speech, and unfortunately, the president didn’t spend too much time delving into specific solutions. 

He did, however, call for medical malpractice reform “to rein in frivolous lawsuits.” He also called for “a bipartisan solution to strengthen social security for future generations.”

No doubt Republicans and Democrats alike appreciated his offering a bit of levity regarding the polarizing Affordable Care Act.

“I heard rumors that a few of you had concerns about our new healthcare law,” he said to a chuckling audience, calling on all those “who have ideas” on how to improve the health care law to offer them (We heard a rumor that Republicans certainly do have some ideas!).

Still, it’s comforting to know that the future of healthcare is one of the most pressing issues on his mind (and that he seems to be a fan of patients having “face to face video chats" with doctors.).

“Now that the worse of the recession is over, we have to confront the fact that our government spends more than it takes in," said Obama, as he proposed to freeze annual domestic spending for the next five years.

Healthcare and the national debt were the central issues addressed by Sen. Paul Ryan (R-Wisc.), who gave the official Republican Party response. Echoing sentiments of his party, Ryan lambasted the administration’s stimulus-related spending.

Making note of House Republicans’ actions to repeal the president’s healthcare law, Ryan pointed to our country’s “crushing burden of debt.” He called for repealing the law in lieu of patient-centered reforms.

“Premiums are rising and millions of people will lose the coverage they already have.”

Minnesota Republican Michele Bachmann, who gave the first-ever official Tea Party response (which received limited coverage), echoed a few of Ryan’s sentiments, including the need to repeal the healthcare law, and do something about the nearly 10 percent jobless rate.

But both Bachmann and Ryan fell short of actually making concrete suggestions that would make both parties agree with Obama’s conclusion that “the state of the union is strong.”

Going forward, members of the medical community have many reasons to be worried about the future of the bill, and what will happen to healthcare. But they can at least rest assured that as long as we’re still an innovative nation, we have reason to be optimistic.
 

Associate Editor Keith L. Martin:
My nieces love to play a game where two of them latch themselves to each of my legs as I try to leave their house to prevent me from walking out the door. It is difficult, but eventually, I get to the door and two tiny, disappointed girls drop off in defeat.

President Barack Obama is currently playing a similar game with Republicans and the Tea Party when it comes to healthcare in America. Each is trying to prevent movement under the Affordable Care Act, but I don’t think either group plans to give up as easily as my nieces.

During last night’s State of the Union address, the president continually evoked the image of America as one nation, moving forward in everything from education and innovation to jobs and the wars in Iraq and Afghanistan. He told Americans that,” the future is ours to win; but to get there, we can’t stand still.”

The president even showed he is willing to do a little moving himself, when it came to the Affordable Care Act, indicating “anything can be improved” and showing his support for some shifting to improve a piece of legislation that hasn’t even reached its first anniversary. President Obama made it clear, however, that “instead of re-fighting the battles of the last two years, let’s fix what needs fixing and move forward,” which saw Democrats stand and applaud.

But that fight is exactly what it appears both the Republicans and the Tea Party Caucus seem to want, according to their two representatives in rebuttals given after the president’s address.

Rep. Paul Ryan (R-Wisc.) said the healthcare law stifles jobs, raises costs and premiums, and pledged “to replace” the Affordable Care Act with “fiscally responsible, patient-centered reforms that actually reduce costs and expand coverage.

“…The president’s law is accelerating our country toward bankruptcy,” Ryan said.

Rep. Michele Bachmann (R-Minn.), representing the Tea Party, called upon the president to “repeal Obamacare” and support medical malpractice reform and allow Americans to shop for health insurance across state lines, a key tenet Republicans fought for during the law’s creation last year.

President Obama did make a call for medical malpractice reform “to rein in frivolous lawsuits,” but only in the discussion of our nation’s debt and did speak about Medicare and Medicaid, but again, on the same topic. There was nothing, in my opinion, speaking directly to physicians about the future of their profession. The focus was improving the entire healthcare system, but without specifics, simply reliance on a law with a shaky future at best.

As physicians, perhaps you are in the same shoes as President Obama - struggling to move forward, stymied by the Affordable Care Act, which sets out a path for you, albeit an uncertain one, yet to be paved with sturdy footing. And don’t forget the two big obstacles in the way that could make that path impassable in the long run.