second, we need to use medicare reimbursements to reduce preventable hospital we admissions. almost 20% of medicare patients discharged from hospitals are be admitted within one month because they are not getting the comprehensive care they need. this puts people at risk, and it drives up costs. by changing how medicare reimburses hospitals, we can discourage them from acting in a way that boost profits and drive up costs for everybody else. that will save us $25 billion over the next decade. third, we need to introduce a generic biologic drugs into the marketplace. [applause] these are drugs used to treat illnesses like anemia, but right now there is no pathway for the fda to approve these versions of drugs. creating such a pathway will save as billions of dollars. we can save another $30 billion

by getting a better deal for our seniors who are poor will asking our while all seniors to pay a little bit more. that is what is in the health reserve fund. i want to save another $313 billion in medicare and medicaid spending in several other ways. one way is by adjusting medicare payments by reflecting advancements and productivity gains in our economy. medicare payments are rising each year by more than they should. these adjustments will create incentives for providers to deliver care more efficiently as a buzz about $109 billion in costs. -- a efficiently by saving us about $109 billion in costs. if we put in a system where people have coverage and the

number of uninsured people close down with our reforms, the amount we pay hospitals to treat uninsured people should go down as well. reducing these payments gradually as more people have coverage will save us over $106 billion. we will make sure the difference goes to the hospitals who need it most. we can save about $75 billion through more efficient purchasing of prescription jugs -- address. we can save by removing from from our health care system. let me be -- prescription drugs. we can save more money by removing from of health care system fraud.

let me be clear that i am working to save as much money as possible. for those of you who took out your pencil and paper, altogether, these savings mean that we have put about $950 billion on the table. that does not count on some of the long-term savings that we think will come about from reform such as from increased prevention. that congressional jargon is not so horrible. the congressional budget office will not count that as savings. -- is not so horribcorable. the congressional budget office will not count that as savings. i look forward to working with congress to make up the difference so that health care

reform is fully paid for in a real, accountable way. let me add that this does not count longer-term savings. i want to repeat that, by insisting that the reforms that we are introducing our deficit neutral over the next decade. by making the reforms that will help slow the growth rate of health care costs for the coming decades, bending the curve, which can look forward to faster economic growth, higher living standards, and falling budget deficits. let me back up by saying this. i know people are cynical about whether we can do this or not. i know there are disagreements about how to proceed in the days ahead. there is healthy debate within the ama. that is good. we cannot let this moment pass us by. the other day, a friend of mine

handed me a magazine with a special issue titled the crisis in american medicine. one article notes soaring charges. another war is about the volume of utilization of services. -- another warns about the volume of utilization of services. it speaks to many of the challenges we face today. this special issue was published in october of 1960. before a was born. -- before i was born. my fellow americans and members of the ama, i am here today because i do not want our children and their children to still be speaking of a crisis in american medicine and 50 years from now. i do not want them to still be suffering from spiraling costs that we did not stem or sickness is that we did not cure.

i do not want them to be burdened with massive deficits that we did not curb or a worsening economy that we did not rebuild. i want them to benefit from a health-care system that works for all of us. families can open a doctor's bill without a dreading what is inside. where parents are talking to their kids and getting regular checkups and testing themselves for preventable illness. where parents are beating their kids healthier foods and children are exercising more and patience are spending more time with their doctors. drs. temple on a computer all the latest medical information -- doctors can pull up on their computer all the latest medical information. where doctors are working together to treat one single human being.

that is the health care system we can build. that is the future i am convinced is within our reach. if we come together and bring about the future, we will make americans healthier and we will unleashed our economic potential as well as real form -- reaffirm the ideas that led to into this noble profession. thank you very much, and may. i appreciate you. thank you. -- thank you very much, amwaa. i appreciate you. thank you. [applause] ♪ ♪

♪ [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] ♪ ♪

>> and our reaction to the president's speech from the president and president-elect of the ama. this is 10 minutes >> this is the first democratic president that has talked to us about any kind of liability reform. that was good news. the others were no surprise. >> the president said today the public auction is your friend. he was speaking two positions.

i think the house of delegates will consider a resolution that could oppose the public auction. what do you think about the president's view on the public auction? -- public option? >> what you heard today was a call for a thoughtful analysis of all the options. what is going to happen here of the next three days is the american medical association will figure out a way that we can best help the president reach the goals that we share which are affordable health insurance for all americans. i think that it was something we share. >> if they approve the resolution, how much would it tie your hands in terms of being able to negotiate a bill with

the president and congress? >> i think our house of delegates tend to be very thoughtful. we are not at the end yet. the debate has occurred and we have begun voting over the next several days. the resolution may or may not be rescinded. it may be changed. that is the glory and the annoyance of democracy. you have to wait until we finish. we are exploring the options. people have had very thoughtful comment at the microphone yesterday. we will wait and see how they respond. do you want to add anything to that? >> as nancy has highlighted, the goal that both the president and the american medical association has is to make sure that all americans have affordable health insurance coverage to prevent the diseases that we know we can prevent and to not use the emergency room as the access point for health care.

the emergency room should be used for emergencies and not for routine, preventative care. the president is signaling the important investment in prevention. we have discussed with the president the importance that even if we do health system reform, the disease burden that is coming down the road with the demographics of our baby boomers reaching the age of 65 and the obesity epidemic and the challenge on the health of individuals that we have to put the proper investment to prevent diseases. we are excited about working with the president on this front. >> yes, please. >> what did you hear that you like to relative to the liability reform aspect? what kind of public option to

ucb ama favorin-- do you see th? >> we were very pleased about him being open to consider options that would lower the cost of defensive medicine. he acknowledged that it is an issue. he put it in the context of the overall rising and unsustainable and crippling health care costs. he has not taken that off of the table. he is the first one to put it on the table. that is what we were really pleased about. in terms of the other options, he described several things. he described an exchange. it will be very interesting to see as bills come forward with the particular options will be. what we want to do and i think

what the president appealed people to do is not to get hung up on labels but look at what is being described. we want to make sure that a label does not engender a reaction that may not be irrational reaction. that is the best i can do for that one. >> i am with cbs news. why is this -- are you afraid of being seen as [unintelligible] ? we are delighted this year. every organization changes because of the society and the environment we are in. where we are right now is a reality that 16% of gross domestic product is anticipated to be 20% within a short time frame. because of the advances of medical science, the average life expectancy is now 10 years longer than it was in 1965 when

the medicare program was first created and people injured at the age of 65. what we have is a wonderful advent of unproved technology and improved ways to take care of patients. but we find 50 million americans not having affordable health insurance. for that reason, we are committed with the president to reform our system. to try to do things right and get rid of the things that to not add value. the id minister of the burdens that we have laid upon -- the administrative burdens that we have laid upon the practice of medicine is uncalled for. we need to follow evidence basic guidelines. the important signal is that we

are at a watershed moment in our country. as the president indicated, our economy is driven by the health of our population. unless we get our arms around the prevention aspect and make sure people have a strong primary-care medical home, and we have incentives for specialties, that we are in short supply of, we need to start moving our system more toward a system so we can make sure that wherever the patient enters the system, the electronic records allows the position to know what is going on with the patient. we have a system -- incentives to keep people well. we want to move forward with the president over the next year.

>> you say you are happy that the president has put more practice reform on the table. what exactly is it that he has put on the table? we know he has taken some things off of the table. can you elaborate for us what is on the table? >> i cannot elaborate more than what you heard today. we appreciate the fact that he has a acknowledged that it is a problem and it needs to be addressed, and there will be ways of looking at it. he will work with us to look at it. >> you said in your opening speech something. the president said they need to move to a system that is more centered on patient outcomes. were you disappointed that he

did not focus on the sgr? >> let us give him credit where credit is due. when he crafted his budget and released the budget, he was the first president to a knowledge that we need to pour cement into that effort. he put up a reality-based budget, not one that presumes that 21% cut to a physician services was going to occur. he did that, and we are very grateful. that was the point of the introductory remarks. >>wgn news. he said the ama is working to cover all americans. can you talk about your plan and your proposal as the president did today? >> we have been developing a plan over the last decade.

i am not sure that you knew that. we have been working on this issue for a long time. we are committed to those who are lawmakers and who are helping to develop the plans to make sure we get to a solution this year. our plan -- the details of our plan are available on our website. i am happy to go over that with you. it is not our plan that is on the table right now. we are committed to americans having choice. you heard the president talk about that today as well. we want them to have choice of coverage, doctors, and i am happy to discuss other areas that are part of our plan. you probably want to hear more about what is in play right now. >> members of congress also reacted to the president's speech on health care. this is a little bit more than half an hour.

intensifies, one thing is already clear: both republicans and democrats agree that health care is in serious need of reform. the only thing that remains to be seen >> the only thing that remains to be seen is what kind of reform will deliver. americans are increasingly worried about what they are hearing from washington. americans want an costs and the freedom to choose their own doctors and their own care. but they do not want is a washington takeover of health care along the lines of what we have are the scene with banks, insurance companies, and the auto industry. americans did not want a government run system that puts bureaucrats between patients and doctors. they do not want the kind that exist in new zealand in great britain that the delay in ration treatments that are available. americans want change, but they

do not want changes that will make existing programs worse. that is what a government run system would do. the notion of a government run plan is gaining steam. over the past couple of weeks, when democratic leader after another has insisted that it be included as a part of any reform. the reaction to this should tell us something. among those who have mobilized a reaction to this is america's doctors. many americans could be kicked off of health care plans that they currently have as a result. the u.s. chamber of commerce has warned that the creation of a government plan would lead to a government run health care system. the ceo of the mayo clinic ward that some of the best providers could go out of business. -- warned that some of the best

providers could go out of business. one of the nation's leading association of small businesses also expressed concern about a government run plan. americans do not want this type of plan that is being proposed. they do not want politicians to use the real problems we have in our health-care system as an excuse to tear down the whole thing and take away everything that is good about it, and replace it with something that is worse. the one practical solutions to specific problems. that is what the rest of us are proposing. we all agree that health care in this country is to expecto said. basic procedures -- health care in this country is too expensive. basic procedures can cost a lot.

we need a cost-effective solutions. some propose making test -- cuts to medicare which is the wrong approach. america's seniors expect congress to stabilize medicare so that it continues to service their needs and not a drain its resources to pay for a nother and bigger government plan. changes to medicare should be made to make medicare solvent for seniors today and those who are paying into it and the will rely on the system tomorrow, not to build a brand new government plan on top of one that is on an unsustainable course. if we want to cut costs, we need to make medicare solvent itself and find ways to improve the current health-care system. one way to do that is to implement reforms that we know will save money.

we could start with illness prevention programs that encourage people to quit smoking and control their weight. it is no mystery that smoking and obesity are leading causes of the chronic diseases that are driving up health care costs. finding ways to reduce these illnesses would reduce costs. we should allow employers to create incentives for workers to adopt healthier lifestyles. we should also encourage the same kind of robust competition in health insurance in the health insurance market that has worked well with medicare prescription drug apart be. -- "b." doctors pass these higher costs to patients driving up the cost of care. most people think the health

care dollars should be spent on health care not insurance premiums. doctors across america are passing on the cost of higher premiums, they are ordering expensive and unnecessary tests and procedures to protect themselves against losses. one study suggests that nine out of 10 u.s. doctors practice some form of defensive medicine like this and the cost to patients is a massive. some doctors shut their practices and discontinue services as a result of these pressures. patients like one person lose out. her first babies were born at the hospital about 10 minutes from her home. her third child had to be delivered about 30 miles away because of rising rates because doctors at that hospital to stop delivering babies altogether. this is not just a problem for

obstetricians. nearly 2300 doctors are short of the national average in one area. it is a shortage that could be reduced by reforming medical malpractice laws. comprehensive health care reform is long overdue. a government-run plan is not the way to do it. there are other solutions that address our problems without undermining our insurance. i have warned about the dangers of government-run health care pointing to the kinds of problems this has created in places like britain, canada, and new zealand. these countries are living proof that when the government is in charge, health care is denied, the late, and rationed. the main culprits in this case of the government to decide which medicines patients can and

cannot have. one country has denied cancer patient treatments because they are very expensive. others have refused to these drugs because they cost too much but have proven to be effective. some said they are not a cost- effective use of resources. i have discussed how the government-run health care system in canada routinely delays care. the delay for a hip replacement is about 196 days. the knee replacement surgery at the same hospital takes an average of 340 days. the american people to not want to be told they have to wait six months for a hip replacement or a year for a knee replacement. that is what could happen in a

government-run health care system. i have discussed town new zealand government has rationed care by deciding which ones are cost-effective. they got depressed care treatment was too expensive. new zealand is a good tourist destination, but options for cancer treatment are not so attractive right now. americans want health care reform, but they do not want the kind of reform that delays, the nice, and rations care like the system in -- delays, denies, and rations care like the system in new zealand. they want health care decisions

left to doctors and patients not remote bureaucrats. but that is what we can expect if we have a government-run health care system. >> thank you. today i would like to talk about a bill that we introduced. a companion bill will also be introduced. the number of the bill is 1259. it is called the patient act. -- patients's act. the idea is to focus on health care as it relates to patients. it should be patient-centered. nothing should come between the position and the patient. we are concerned that there is something that is being done that needs to