President Barack Obama told a national doctor’s association that health care reform will not mean that patients lose access to the doctors and health plans they like.

Barack Obama

In a speech to the American Medical Association in Chicago today (June 15), Obama also said insurance companies should no longer exclude coverage because of pre-existing conditions, must force individual and employer mandates and should include a public-pay option to compete with private insurance companies.

“If you like your doctor, you will be able to keep your doctor. Period,” Obama told members of the AMA. “If you like your health care plan, you will be able to keep your health care plan, period. No one will take it away.”

Later in the speech, Obama simplified the message: “If you like what you have, keep it. Nobody is forcing you to shift.”

Obama said reform will mean coverage with a doctor or health plan people like “will cost less.”

He said he supports an individual coverage mandate, if a “hardship waiver” were available to those who could not afford it. He said employers also must bear the responsibility to provide coverage for their employees, but said “a waiver” must be available if they cannot afford to provide coverage to their employees.

He said people who do not like their doctors or health plan can use a Health Insurance Exchange, a system in place for members of Congress and federal employees, to choose from options.

Obama said a public option will provide a “broader range of choices and inject competition into the health care market so we can force waste out of the system and keep insurance companies honest.”

A government-run plan would compete with private health plans nationally, an approach that has rankled much of the insurance industry, which says a public program will discourage participation in a private plan and drive up costs. The AMA opposes a public-pay plan if it means doctors will be reimbursed at lower rates than what private insurers pay.

Obama said reform without a public-pay option would allow insurance companies to have “a bunch more customers on Uncle Sam’s dime” while providing the same level of coverage.

To further improve care, Obama called for the end of denials of coverage for pre-existing conditions, saying “the days of cherry-picking…are over.”

He also argued against the view that a public-pay option is a Trojan horse that will lead to a single-payer or universal health care system. This argument was recently made by former U.S. Health and Human Services Secretary Mike Leavitt, who criticized the president’s plan for not being all that meets the eye.

“When you hear the naysayers say I am trying to bring about a public health system, they are not telling the truth,” he said. Instead, Obama said, he is trying to provide people with affordable options so the 46.5 million U.S. residents without health insurance will be able to obtain it.

The president said he wants Medicare Advantage plans to be competitively bid, which he said would save millions in costs.

In his speech, Obama pledged additional efforts to encourage wellness programs, electronic delivery of medical records and preventive care. He said these “preliminary steps” would only make a “dent” in health care spending.

“I need your help, doctors, because you are the health system,” Obama told the audience. He pledged to work with doctors to create “reform that works for you,” a statement that elicited a great response from doctors in attendance.

In the early 1990s, when the Clinton Administration attempted health care reform, it did not include the medical community in much of the discussions. Later, doctors balked, and it is now seen as a key reason why the effort led by then First Lady Hillary Clinton failed.

The president said his health care plans seek to “fix what’s broken and build on what works.”

Speaking to the nation’s largest organization of doctors, Obama said health care reform is key to economic recovery in the U.S.

“The cost of our health care is a threat to our economy,” Obama said, noting that health care costs nearly $2 trillion a year, almost 50% more than the next most expensive health spending among countries. He said in 10 years health spending will be $1 of every $5 in the U.S. and within 30 years it will cost $1 in every $3.

“When it comes to the cost of health care, the status quo is unacceptable,” he said.

The president explained that the quantity of care and quality of care are in conflict in the current model for doctors, saying the model has taken the pursuit “from a profession, a calling, to a business.”