Obama in the AMA lions' den

Several times during his speech to the American Medical Association (AMA) today, President Barack Obama sought to hold down the applause, assuring doctors he does not agree with them on everything.

The two hardest sells? The need for a public option, a health plan run by the government, and Obama's refusal to accept blanket malpractice reform.

"The public option is not your enemy, it is your friend," he said, noting that it will eliminate the problems of the uninsured, of pre-existing conditions, and will keep insurance companies honest.

"What a public option will do is put affordable health care in the reach of millions of Americans," he added, calling opposition to it a "Senate problem" as opposed to an "American problem."

On MSNBC, Obama's speech was followed immediately by Sen. Joe Lieberman dismissing the public option, saying simply "the votes aren't there."

But the President was adamant. "I refuse to endorse a system where insurance companies have a bunch of new customers, on Uncle Sam's dime, but fail to recognize their responsibility," he said.

"This is personal for me. This is for my mother and every other mother," he said, recounting how his mother fought her insurance company during her losing struggle with cancer in the 1990s, when the current President was an obscure state senator and college teacher.

Throughout the speech the President saved his toughest shots for insurance companies and drug companies. He said overpayments to Medicare Advantage should be ended, and that competitive bidding on drugs can save $177 billion over 10 years.

The President was expected to get a see a tough crowd, but those in the room were ready to applaud everything he said.

This may have been because he couched some of his more controversial proposals in friendly terms. Comparative effectiveness, for instance, became best practices. He insisted his reform plan would be "deficit neutral," requiring no new taxes when spread over 10 years.

One more point. The President said savings from health IT and a move to more preventive medicine were not part of his budget projections because they could not be "scored" by the Congressional Budget Office. Any savings from eliminating paper and fighting obesity would come on top of the savings already in his proposal.

None of this may be enough to end resistance to meaningful reform, but it should be noted that the President is also willing to accept Senate rules that will prevent a filibuster. He only needs a majority. He doesn't need Joe Lieberman.

This post was originally published on Smartplanet.com