Why the AMA Doesn't Speak for Me

This week President Obama addressed a meeting of the American Medical Association (AMA), amid media reports that the AMA will oppose the president's call for a public health insurance option.

Over the last 50 years, the AMA has stood on the opposing side of numerous positive proposals for health care improvement. As a result, AMA membership has dwindled to less than 20% of practicing physicians. Most of their members no longer represent the views of most American physicians. Unfortunately, the AMA may again stand against a reasonable approach to providing assistance to unemployed and middle class families struggling to buy health insurance -- the proposed public health plan.

The AMA opposed a similar proposal introduced in the 1960's, which we now know as Medicare. The AMA spent heavily to oppose Medicare, driven primarily over concerns for physician's wages. If the AMA had their way in the 1960's most seniors would have gone bankrupt in order to get needed care. Fortunately, Medicare survived and has been improving coverage and care for seniors ever since. Hopefully, a public sponsored health insurance plan will survive and serve the public, as well.

The proposed public health plan would allow people who do not have employee sponsored insurance and cannot afford expensive, individual plans to pool their risk with others in similar circumstances and buy insurance at a more affordable rate. A similar concept has existed in Massachusetts since 2006. The Massachusetts health system has not fallen apart and the care provided at their world-renowned medical centers has not deteriorated. Similarly, doctors have not fled for the state's borders.

Instead, the Massachusetts Health Insurance Connector has produced the lowest incidence of uninsured in the country (2.6%). Their public health insurance plan is called Commonwealth Care. It is available for as little as $39/month and free if an individual makes less than 150% of the poverty level. In recent surveys, support for the program is up, with nearly 70% of residents holding a favorable view.

As for the AMA, I almost feel sorry for them. I joined the AMA as a medical student, because it was cheaper than buying the atlas and journal that came free with membership, but I have not subscribed since. Instead, a new generation of physicians have found a voice in organizations like the National Physicians Alliance and Doctors for America, which seek to improve and enhance health care, through initiatives that focus on our patients and society first. These organizations do not accept money from pharmaceutical companies or sell members addresses to marketing companies.

Most physicians went into medicine because it allowed us to heal, comfort and help people. Sadly, the AMA feels like it exists only to help doctors help themselves. That is why the AMA does not speak for me.

I do hope that the AMA reconsiders its initial stance on a public health insurance option. Similarly, I hope the Obama administration reconsiders concerns voiced by the AMA regarding the need for malpractice reform. Tort reform is critical, as it adversely affects our whole system... but more on that in my next post.

Comments

[Oregonlady]

Like Dr. Klatsky, I hope for a public healthplan option so everyone may be covered for healthcare. Unlike Mr. Obama or most our legislators, however, I do not believe we should pay for this by an approximately 9 percent cut in Medicare/Medicaid, as has been proposed. Such a cut removes more than "waste." Like Mr. Orszag of Obama's budget office, I have read the Dartmouth Health Atlas on which are based the "less is more" arguments for "trimming" healthcare costs by cutting Medicare patients' access to specialist visits, tests, etc. And that Atlas only shows that the number of such tests, etc. varies by region and hospital--NOT that this variation does not affect outcomes. It CANNOT show that "less intensive" treatment (tests, etc.) prolongs life as well as "more intensive" treatment--because it is not an outcome study: all records studied for the Atlas were of patients' last two years of life, so obviously, no matter what treatments patients received, they died in exactly two years. For Mr. Orszag, our legislators, or our president to claim this study shows "trimming" care will not cost Medicare patients' health--even lives--is disingenuous. We need a program of healthcare for everyone that cuts costs only where humanity and common sense says to: not by cutting treatment for our old, disabled, and poor but by cutting out the insurance industry with its profit-taking. We need single-payer health coverage.

[Lymaniii]

I'm currently posting my comment from within the House of Delegates of the AMA. We've just passed policy that supports any health system reform option that fulfills our principles of plurality, universal access to care, and freedom of choice.

I also joined the AMA as a medical student, but I chose to respond tot he AMA differently than Dr. Klatsky. I've been involved and working for dialog and change within the organization, and young leaders within the AMA have made great progress to overcome fears and skepticism about public versions of healthcare financing. While Dr. Klatzke disparages and criticizes, conscientious physicians who care about their patients work toward consensus building and incremental improvements in the AMA, and I'm pleased to have real evidence that that process is alive and well in the AMA today.

The AMA had President Obama here this week and gave multiple standing ovations as he discussed all we have in common when advocating for our patients and the future of health in this country. Sideline whining doesn't make our patients any healthier. Get in and get involved in the AMA if you want to see changes made. The doors are open and I've seen it work. Together we are stronger as physicians advocating for our patients.

[karela]

Having been a nurse and worked with Drs. for thirty years, I have to say that I found Dr. Klatsky more credible. The AMA has functioned as a very rich, very powerful labor union whose main function has been to make physicians as rich as possible----and they've done a very good job of it. You Dr. are being not completely truthful in your comments unless your increments in bringing the welfare of all Americans out in front of physicians annual income are so small as to be invisible. I'm betting that you guys are aware of what doctors are doing in McAllen, Texas to enhance their incomes by ordering twice as much stuff as the Mayo Clinic for patients who don't need it---------and I'm betting that you haven't even tried to do a thing about it. Right? Were you a doctor in the bad old days when doctors beefed up the number of hysterectomies they did in a week to pay for special vacations? You know, the days when a lot more than 20% of America's doctors belonged to the AMA and it was a real money maker to take the uterus out of every menopausal woman in America? Was that the trust worthy AMA you were trying to make us believe in? The AMA always goes for the money. And you know it.

[jakiew]

YOU GO GIRL !! THANKS FOR THAT POST

[marktheknife]

How are Dr. Klatzky's criticisms of the AMA merely "sideline whining" if he advocates for change via membership in other professional organizations like National Physicians Alliance and Doctors for America? Your comment is based on an invalid assumption that the AMA is the only legitimate organization through which doctors can take collective action.
Were the black doctors who founded the National Medical Association in 1895 also sideline whiners because they weren't willing to wait OVER 100 YEARS for the AMA to officially acknowledge that it discriminated against black doctors for decades, which didn't occur until 2008?

[pontesisto]

If you would like to help pressure Congress to pass single payer health care please join our voting bloc at:
http://www.votingbloc.org/Health_Bloc.php