Doctor’s boos show Obama has hard road on health care

By RICARDO ALONSO-ZALDIVAR

WASHINGTON — Barack Obama isn’t used to hearing boos.

For all the young president’s popularity, the response he got Monday from doctors at an American Medical Association meeting was a sign his road is only going to get rockier as he tries to sell his plan to overhaul the nation’s health-care system.

The boos erupted when Obama told the doctors in Chicago he wouldn’t try to help them win their top legislative priority — limits on jury damages in medical-malpractice cases.

But what could they expect? If Obama announced support for malpractice limits, that would set trial lawyers and unions — major supporters of Democratic candidates — on the attack. Not to mention consumer groups.

Every other group in the health-care debate has a wish list and a top priority. Insurers don’t want competition from the government. Employers don’t want to be told they have to offer medical coverage to their workers. Hospitals want to stave off Medicare cuts. Drug companies want to charge what the market will bear.

Obama can’t give all of them what they want. Instead, he’s got to figure what’s just enough to keep as many groups as possible on board — without alienating others. It’s a fine line for him — and sometimes for them.

“It’s a coalition issue,” said Robert Blendon of the Harvard School of Public Health, an expert on public opinion and the politics of health care. “No major group is able by itself to sink health reform. But if numbers of them come together for different reasons, it could really hurt the direction the president wants to go in.”

The doctors were only Obama’s first house call. He’ll be making his case to the other groups — and to the nation at large — in an increasingly energetic campaign to get a bill passed by the end of his first year in office.

AMA insiders shouldn’t have been surprised by Obama’s upfront refusal to consider malpractice caps.

The group couldn’t get that idea passed by a Republican Congress and president a few years ago. Some states have such curbs, but anyone who can count votes knows the chances for national limits are slim to none with Democrats in charge of Congress.

Instead, Obama left the door open to some kind of compromise on malpractice.

The president said he’s willing to explore alternatives to taking doctors to court. In the past, he supported special programs in which hospitals and doctors are encouraged to admit mistakes, correct them and offer compensation. Studies have shown the approach can work, because doctors’ refusal to acknowledge mistakes is one reason many families file suit.

Doctors have special reasons to be wary of the president’s plans to overhaul the health-care system.

Not long ago, doctors’ decisions were rarely questioned. Now they are being blamed for a big part of the wasteful spending in the nation’s $2.5 trillion health-care system. Studies have shown that as much as 30 cents of the U.S. health-care dollar may be going for tests and procedures that are of little or no value to patients.