AMA Support Can Secure The Public Option

It was quite a sight Monday afternoon: President Obama pitching his health care agenda before the American Medical Association, frequently eliciting applause and cheers and laughs, happily chatting with members after the event. You would almost get a sense of solidarity between the two parties.

Students of history, however, knew better.

The AMA has been the leading obstacle to progressive health care reform for nearly a century -- tracing all the way back to Theodore Roosevelt, the first American president to call for universal health coverage. The organization hasn't since missed an opportunity to eviscerate legislation aimed at extending coverage and bringing costs under control.

This is not to portray the AMA as a bunch of impish fiends, but there's more to this group of friendly doctors than meets the eye. Indeed, the AMA is one of the most powerful lobbying arms in the United States, and like all successful lobbyists, they're very skilled at getting Congress to do their bidding at the expense of regular people.

To be fair, the AMA's efforts to fortify the medical establishment's swagger have been reliably aided by the insurance and pharmaceutical industries. But as Harvard political scientist Theda Skocpol writes, the group has been "historically the bitterest of all enemies of governmentally-sponsored health reforms."

It was amusingly ironic to hear Obama reprimand cynical idioms like "socialized medicine," a cautionary tale received by applause. I had to wonder how many clappers in the audience knew that it was their own organization that coined the term in the 1940s, exhaustively touting it in a successful bid to slay Harry Truman's all-inclusive health program.

Fortunately for the economically besieged, these types of McCarthyite scare tactics don't resonate as well as they once did.

Why, then, has the AMA been so opposed to progressive reforms? Conceivably, it's because a public program would be subject to cost controls and consumer-friendly regulations, which are bad for medical-industrial profits.

Let's give this group of doctors the benefit of the doubt: it's very unlikely they're all driven by greed. But the AMA's most salient and tenacious battles have involved advancing the financial interests of its members -- no matter that most have long surpassed the six figure mark.

President Obama disarmed this impulse by appealing to the nobility of the medical profession, certainly the high point of his speech: "You did not enter this profession to be bean-counters..." he exclaimed, "you entered this profession to be healers," to which he received thunderous applause.

We'll soon find out if Obama was right.

As healers, these physicians should appreciate the need for an affordable alternative to private insurance, considering that 47 million prospective patients are uninsured and that medically-induced bankruptcies are rising by the minute. The public option, which is the only realistic hope of overcoming these challenges, remains the most controversial part of the legislation.

After the speech, senior AMA representatives told the press that Obama was "warmly received," before proclaiming their commitment to affordable, quality health coverage for all Americans. Now, let's see if they're willing to do what's necessary to achieve it.

The AMA has softened its stance against the public alternative, perhaps realizing that Americans are increasingly supportive of a government-sponsored health program. This is a commendable development, but it's not enough for a group that carries in the palm of its hand tremendous influence over the nation's physical and economic health (in more ways than one).

It's time for AMA physicians to take back the compassion and honor that led them into their profession and throw their support behind the public alternative. Considering the vast political clout they carry, it could well make the difference between failure and success.

Comments

[Chaimirija]

In some of these countries, the govt pays for medical school, and in none of those countries do physicians live less than upper middle class lives.

Frankly, I do not want to have to kiss an organizationsAss. Especially an organiztion that is a lobby for its members best interests. Yes, it is true about the Medicare and Medicaid reimbursements, but those should not be their only patients.

Also, those other systems you speak of? There is no compromise of care. Germany, France, Britain, Canada...which systems are you speaking about?

[klmdiego]

Strangely enough, the physicians in the AMA during Theodore Roosevelt's days aren't all that active in the organization any more. The AMA did not specifically mention the words "public option" in it's policy because no one knows what public option actually means. Many physicians are no longer taking Medicare and Medicaid patients because the cost of caring for the patients is greater than the reimbursement by the government; this is not physicians being greedy, but rather a real genuine fear that having a public plan forced on them, as is in many of the other nations with strong public plans, may compromise their ability to care for patients.

The AMA has a lot of power in the government when it comes to health care reform, but rightly so. In his speech Monday, the President also said, "To most Americans, you[doctors] are the health care system." Physicians may have concerns about current health systems reform, but they need to be involved at every stage of the process to ensure any changes achieve both the AMA's number one priority (covering the uninsured) and preserve the sanctity of the physician-patient relationship. Patients and their doctors must be able to decide together their course of treatment. To do that, we need physicians and the AMA to be involved.

Unlike previous failed attempts at health care reform, our President has shown that he realizes the importance of physician input by speaking to the AMA. We'll soon find out if he means it.

-KLM

[CodeWorrier]

Can't force 'em to do the right thing, but we can let 'em know we're paying attention...

http://webapps.ama-assn.org/contactus/contactusMain.do