Obama promises to act on Medicare costs, medical research, and gun control

BMJ 2013; 346 doi: (Published 14 February 2013) Cite this as: BMJ 2013;346:f1034
  1. Edward Davies
  1. 1New York

Barack Obama has pledged to reduce the cost of Medicare, invest in medical research, and review the laws on gun control in his state of the union speech on 12 February.

In a speech that began by discussing the country’s national debt, he acknowledged that “the biggest driver of our long term debt is the rising cost of healthcare for an aging population, and those of us who care deeply about programs like Medicare must embrace the need for modest reforms.”

He added, “On Medicare I’m prepared to enact reforms that will achieve the same amount of healthcare savings by the beginning of the next decade as the reforms proposed by the bipartisan Simpson-Bowles commission.” The Simpson-Bowles commission is the nickname often used for the National Commission on Fiscal Responsibility and Reform, which Obama created in 2010 to identify policies that would give financial sustainability to the United States (

Among the commission’s proposals was to save $341bn (£220bn; €255bn) on healthcare by, among other things, reforming the sustainable growth rate for Medicare, increasing cost sharing in Medicare, reforming healthcare tort, changing provider payments, and increasing drug rebates.

The president continued: “Already the Affordable Care Act is helping to slow the growth of healthcare costs. The reforms I’m proposing go even further. We’ll reduce taxpayer subsidies to prescription drug companies and ask more from the wealthiest seniors. We’ll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn’t be based on the number of tests ordered or days spent in the hospital—they should be based on the quality of care that our seniors receive. And I am open to additional reforms from both parties, so long as they don’t violate the guarantee of a secure retirement. Our government shouldn’t make promises we cannot keep—but we must keep the promises we’ve already made.”

On research he said that every dollar invested to map the human genome returned $140 to the economy. “Today our scientists are mapping the human brain to unlock the answers to Alzheimer’s, developing drugs to regenerate damaged organs, [and] devising new material to make batteries 10 times more powerful. Now is not the time to gut these job creating investments in science and innovation. Now is the time to reach a level of research and development not seen since the height of the space race,” he said.

The speech’s finale dealt with gun laws. Obama proposed changes to background checks to “make it harder for criminals to get their hands on a gun.” He cited police chiefs who “are asking our help to get weapons of war and massive ammunition magazines off our streets, because they are tired of being outgunned.”


Cite this as: BMJ 2013;346:f1034


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