Chicago » President Barack Obama bluntly told doctors Monday he is against their highest legislative priority -- limiting malpractice awards -- and earned a smattering of boos from an audience he was here to court for his health care overhaul plans.
Pushing anew to reshape the nation's health care delivery system and extend coverage to the millions who don't have it, Obama went before the annual meeting of the American Medical Association and took on others who take issue with parts of his plan as well.
Calling them "naysayers," "fear-mongers" and peddlers of "Trojan horse" falsehoods, Obama warned interest groups, lobbyists and others against using "fear tactics to paint any effort to achieve reform as an attempt to socialize medicine."
"There are those who will try and scuttle this opportunity no matter what," Obama said.
Addressing the doctors in Chicago, the president said for the first time publicly that health care reform, including covering the almost 50 million Americans who have no insurance, would cost about $1 trillion over 10 years.
"That's real money, even in Washington," he said. "But remember: That's less than we are projected to have spent on the war in Iraq. And also remember: Failing to reform our health care system in a way that genuinely reduces cost growth will cost us trillions of dollars more in lost economic growth and lower wages."
But the malpractice issue is the most provocative with this audience, which chafes at the heavy expense of malpractice insurance.
Obama started by sympathizing with doctors "who feel like they are constantly looking over their shoulder for fear of lawsuits" and said he recognizes any health overhaul will be hard to accomplish without changing that. The crowd burst into loud support.
"Don't get too excited yet. ... Just hold onto your horses here, guys," Obama said as he prepared to deliver what he knew would be disappointing news.
"I want to be honest with you. I'm not advocating caps on malpractice awards," the president said, greeted by a smattering of boos, a remarkable public response to a popular president accustomed to cheering audiences.
He added, without offering specifics, that "excessive defensive medicine" that is conducted out of fear of lawsuits and that increases health costs should be curbed.
Though he offered no support for limiting lawsuits, Obama raised the antennas of trial lawyers' groups just by mentioning the issue.
The Center for Justice and Democracy, which says it advocates for injured consumers, attorneys and others, released a letter to Obama signed by 64 survivors of medical malpractice saying they were "extremely concerned that the rights of medical malpractice patients may be stripped away as part of your national health care proposal."
Physicians divided » The president traveled to Chicago to talk to the 250,000-physician group in hope of persuading doctors not to fight him on reform. The nation's doctors, like many other groups, are divided over the president's proposals. Many are skeptical of his plan to create government-sponsored insurance as an option alongside private coverage.
Capping lawsuits » They also want limits on jury awards in medical malpractice lawsuits -- caps that Democrats, including Obama, have long opposed and Republicans led by former President George W. Bush long pushed for.
Not 'bean-counters' » Obama drew hearty applause with a focus on the particular concerns of the medical profession: telling them any system that relies on them "to be bean-counters and paper-pushers" is out of whack and that his push to investigate best-practices and eliminate unnecessary procedures "is not about dictating what kind of care should be provided."
