To: Barack Obama, POTUS
From: Howard Wolinsky, co-author of The Serpent on the Staff: The Unhealthy Politics of the American Medical Association
I hear that you're speaking Monday to the annual meeting of the American Medical Association's policy-setting House of Delegates in Chicago. It's a great idea to present your ideas to this forum, the so-called "legislature of medicine."
You'll be given a hearing amidst the pomp of this gathering of the leaders of medical politics, not necessarily medicine.
I thought I'd share some pointers having spent more than 20 years covering the AMA at the Chicago Sun-Times.
Here's some things to keep in mind:
- The AMA represents a minority of U.S. physicians. The AMA describes itself as America's largest doctor's organization. That's true on its face. But they claim to represent all doctors. Most docs are not members. The AMA's goal for the year 2000 was to have half of U.S. doctors inside its tent. It missed.
Just last year, the AMA belatedly apologized for its transgressions of favoring state's rights over the training of black doctors and standing silent as racism raged in this country.
Still, the AMA has bragging rights. It had a black president before the U.S. did. No doubt they'll have former AMA President Lonnie Bristow, who was inaugurated as AMA president in 1995, escort you. That's a photo-op in the making, maybe with a few black medical students.
Physician's Weekly reported how Joe Miller, the former No. 2 exec at the AMA, had been working as a well-paid AMA consultant as well as a lobbyist for then-apartheid South Africa. (Before 1990, AMA leaders often made trips to support doctors in that embattled land. An AMA CEO even praised South African medical care -- while in a hospital where patients were sleeping on the floor -- saying it was better than care back home at Cook County Hospital.)
Note to Rahm Emmanuel: U. of Pennsylvania biomedical ethicist Art Caplan wrote in his 1992 book, When Medicine Went Mad, how Nazi Germany used the AMA as a model for policies to remove Jews from the professions.
- Long in bed with tobacco interests.
Back in 1964, when the Surgeon General warned about the dangers of smoking, most major medical groups got on board to fight this modern plague. One exception: the AMA. The AMA instead accepted millions of dollars for a cover for the Tobacco Institute that for over a decade enabled the industry to say the issue was unsettled and being researched.
The AMA blew it many other times on tobacco. In 1981, the AMA was on the hot seat when it was disclosed that its Physician Retirement Fund owned tobacco shares. Anti-tobacco docs in 1985 revealed that the incoming AMA president owned a farm, with another AMA board member, on which tobacco was grown in 1985.
We're still waiting for an apology on tobacco.
- Masters of status quo.
The AMA is already on record as opposing your plan for government-sponsored health insurance for the tens of millions without health insurance.
You've been attacked for "socializing" banks and the auto industry. Get ready to be slammed for selling socialized medicine.
The AMA invented and popularized the term.
Morris Fishbein, voice of medicine as editor of the Journal of American Medical Association through the 1920s and the 1940s, was a wordsmith and sloganeer. He successfully tarred discussion of national health insurance with scare tactics, including calling any change in financing health care as "socialized medicine."
In 1962, in an effort to defeat the Medicare plan for the elderly, the AMA had its then President Ed Annis broadcast from an empty Madison Square Garden, soon after President Kennedy made a pitch there for Medicare. Great stagecraft and propaganda. The AMA opposed Medicare, but it ultimately lost the battle. Old people got much-deserved health coverage -- and, ironically, the plan made doctors rich.
Your proposal is hardly the most radical out there. You should present your plan. Listen politely. Don't yield. The health of the nation is at stake and shouldn't be left in the hands of medical politicians. Keep in mind that time is passing the AMA by.
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