Obama on the Record: Healthcare Reform Town Hall

Q Well, that is my concern, that your budget proposal has lined up, from MedPAC’s recommendations, cuts for the next several years that will amount to, I don’t know, $13 billion or something like that over the next few years.

THE PRESIDENT: Okay, well, let me just respond. The MedPAC idea is to have health care experts and doctors sit down and figure out how can we improve Medicare, how can we make it more cost-efficient. It is not an exercise in just cutting reimbursement rates. In fact, in some cases, we may need higher reimbursement rates for certain aspects. I actually think home care ends up being cost-efficient in many cases rather than institutional care — and it helps keep people in their homes. (Applause.)

In rural communities, in rural communities, there are certain areas where doctors aren’t reimbursed at an adequate level, and so you’re seeing too many doctors leave those communities.

So what we do want to make sure of, though, is that we are, in our reimbursement systems, we’re incentivizing smart things. So, for example, right now if a hospital is reimbursed for the number of tests that it does, then that may not give them much of an incentive to make their system more efficient so that once you take that first test and you’ve gone in the hospital, then you end up having that test sent around to everybody so you don’t have to take five more tests. But right now the way the reimbursement system is set up, you don’t have that incentive to just have the one test and then use information technology to distribute it throughout the system.

So those are the kinds of changes that we want to make. We think that the more that we’re encouraging efficient, smart care, that’s going to be good for providers, that’s going to be good for patients, that’d actually freeze up more money so that we, in some cases, can provide higher reimbursements for folks who right now are not getting sufficient reimbursement. It’s a matter of using the dollars that we’re spending more wisely than we’re spending them right now. Okay, all right.

Q Thank you.

THE PRESIDENT: Thank you.

Gentleman in the red right there.

Q Well, first, Mr. President, welcome to Shaker Heights.

THE PRESIDENT: Thank you.

Q The city that makes things work. (Laughter and applause.) My question and maybe my request is this: Are you willing to urge Senator Reid and Speaker Pelosi to stay in Washington and get this job done?

THE PRESIDENT: Well, I tell you what, I think Senator Reid said today that he thought that we can get this bill out of the Senate Finance Committee by the time of recess, and that in early fall they will come back and actually vote on the bill. Now, I haven’t talked to him today.

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