The ACP Advocate Blog

by Bob Doherty

Wednesday, January 26, 2011

State of the Union, Part 1

Last night’s State of the Union didn’t have much to say about health care reform. But what was said by President Obama and the GOP response(s) spoke volumes about how far apart the Democrats and Republicans are.

President Obama extended an olive branch – sort of. He defended the Affordable Care Act and made it clear that he would not go along with efforts to roll back its key protections, citing the examples of specific patients that would lose out from repeal. But he did offer to consider “ideas about how to improve this law by making care better or more affordable.” He mentioned one issue in particular, saying he will “look at other ideas to bring down costs, including one that Republicans suggested last year – medical malpractice reform to rein in frivolous lawsuits.”

Physicians would welcome a serious, bipartisan effort to reform the medical liability system, although the proof is in the pudding.

The official GOP response from Rep. Paul Ryan (R-WI), didn’t show any give – he insisted that the Affordable Care Act had to go “it is driving the explosive growth of our debt.” The “unofficial” Tea Party response from Rep. Michelle Bachmann (R-MN) was a caustic attack on “Obamacare” and pretty much all things Obama.

We will find out over the next few months if there is any room for the parties to find common ground on improving the Affordable Care Act, or will remain dug into a no-win fight over repeal. (Repeal won’t happen, but the law could be undermined and weakened.)

Tomorrow, ACP will be releasing its own State of the Nation’s Health Care report, which will include our recommendations on preserving, sustaining, building and improving on the key elements of the Affordable Care Act. We will describe specific changes in the law that we believe would improve its effectiveness and could attract bipartisan common ground—including a new approach to medical liability reform.

But progress on improving the Affordable Care Act will require that the GOP back off on its insistence that repeal is the only acceptable option, and for President Obama and congressional Democrats to really be willing to consider some GOP ideas, including medical liability reform.

Today’s question: If you could change only three things in the Affordable Care Act, what would they be? (Other than outright repeal.)


Blogger Robert J. Sobel, M.D. said...

1) Include an SGR fix tied to costs of drug and technology commodities and not professional services

2) Simplify bureaucratic requirements to a bare minimum (the unfunded mandate, bureacratic tangle costs)

3) reinforce the state based nature of the insurance industry, outlawing for-profit entities, mandating compliance with fair rules of engagement, and leaving manipulation of providers to a bare minimum (eliminate prior approval and other hassles; protect us all with Regulated Royalties)

January 27, 2011 at 11:39 PM  
Blogger Harrison said...

The ACP's guide to the law may be helpful in picking out things that could stand improvement.

The link is:

The summaries are on pages 6 and 7.
I read through them, and really didn't see anything just yet.
I think it may help to see the laws in practice to know which parts could be improved on.

The states and the industries involved will pick them apart and use the laws to their advantage.
We should too.


January 28, 2011 at 5:46 PM  

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Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog

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