MR. CUTHBERT: Let’s go next to Illinois and talk with Caroline with her question. Caroline, you’re on the tele-town hall.
Q Thank you. Hello, Mr. President, from Joliet.
THE PRESIDENT: Good to — tell everybody in Joliet I said hi. (Laughter.)
Q I will, thank you. I came from our AARP chapter meeting this morning and I asked for questions. There were two big fears that came out of the discussion. One had to do with the fear of losing a preferred insurance plan, which I think you’ve addressed to some extent this morning.
THE PRESIDENT: Right.
Q The other has to do with the knowledge that there will be millions of dollars of cuts in Medicare over the years to accommodate baby boomers. So the question is, does this translate into dictation of what can and cannot be given to a senior as service? For example, will there be fewer hip and knee replacements? Even if I decide when I’m 80 that I want a hip replacement, am I going to be able to get that? Am I going to be able to see a cardiologist if I have a heart condition, or other specialist? Or is that going to all be primary care?
I’m calling it rationing of care, I’m coining it that.
THE PRESIDENT: Yes — no, I think it’s an excellent question, Caroline, and I appreciate it because I do think this is a concern that people have generally.
My interest is not in getting between you and your doctor, although keep in mind right now, insurance companies are often getting between you and your doctor. So it’s not as if these choices aren’t already being made; it’s just they’re being made by private insurance companies, without any real guidance as to whether the decisions that are being made are good decisions to make people healthier or not. So what we’ve said is we just want to provide some guidelines to Medicare, and by extension, the private sector, about what works and what doesn’t.
Some of you may have heard we wanted to set up what we’re a IMAC — an independent medical advisory committee — that would, on an annual basis, provide recommendations about what treatments work best and what gives you the best value for your health care dollar. And this is modeled on something called MedPAC, which, by the way, Jennie, who is sitting right next to me, is currently on, and gives terrific recommendations every year about how we could improve care — to reduce the number of tests, or to make sure that we’re getting more generic drugs in the system if those work and are cheaper — all kinds of recommendations like that. Unfortunately, right now they’re just sitting on a shelf.