That Didn't Take Long Part II: The AMA Takes Mere Hours to Reverse Themselves
Posted on June 11th, 2009 by Jason Rosenbaum in Profits Before People
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The big news today was the AMA is renewing their historical campaign against health care reform:
As the health care debate heats up, the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.
The opposition, which comes as Mr. Obama prepares to address the powerful doctors’ group on Monday in Chicago, could be a major hurdle for advocates of a public insurance plan. The A.M.A., with about 250,000 members, is America’s largest physician organization.
This isn't really news. The AMA has been opposing reform for almost 100 years now:
Despite a lofty reputation and purported commitment to universal coverage, AMA has fought almost every major effort at health care reform of the past 70 years. The group's reputation on this matter is so notorious that historians pinpoint it with creating the ominous sounding phrase "socialized medicine" in the early decades of the 1900s.
"The AMA used it to mean any kind of proposal that involved an increased role for the government in the health care system," Jonathan Oberlander, a professor of health policy at the University of North Carolina, told NPR in a 2007 interview. "They also used it to mean things in the private system that they didn't like. So, at one point, HMOs were a form of socialized medicine."
This time, however, the AMA seems a bit reluctant to go up against a popular President on reform. A mere few hours after the above article was published, the AMA reversed their position:
“Today's New York Times story creates a false impression about the AMA's position on a public plan option in health care reform legislation. The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates, but the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress. This includes a federally chartered co-op health plan or a level playing field option for all plans. The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians.”
Now, can we believe AMA's reversal? For my money, I say no. Look at their history. However, this reversal does prove two things. First, we've got a better chance at passing reform this year than we possibly every have. Second, the AMA clearly can't be trusted if they reverse their positions so quickly depending on how the political wins are blowing.
A couple other notes on the AMA. First, they hardly represent all doctors. Their membership has been dropping in recent years, partly over their opposition to reform. Second, a large minority of their members actually support a much more radical version of reform, single payer, so it's not unreasonable to assume a majority might support the reform we're talking about, which allows doctors and patients to preserve their relationships with their insurance companies if they want.
Either way, it took mere hours for the AMA to start twisting in the wind. They may be confused on whether they are openly against reform or not, but judging by their history, I have no questions about what they really believe.
I am a student at the medical school of which the dean is the president of the AMA. For the past year our dean has been talking about exciting changes in health care and expansion of coverage and primary care. The reassuring words of our dean made me feel as if the AMA had come around to a progressive position, but after reading the NYT article in the hospital this morning I felt punched in the stomach.
After reading the AMA's semi-retraction I feel a little less betrayed. I do feel that the AMA wants to be a part of what the president is doing but they must fight a deep mistrust of medicare by many physicians. The AMA president has been touring europe, learning about their healthcare systems and is actively engaged in the figuring out solutions.
I do not feel it is productive to simply blow off the AMA as a bunch of old-fashioned reagan-style idiots who don't represent anyone. Even if the AMA may have been wrong about many, many things in the past it are still a hugely influential group and one that is sensitive to public opinion.
We should be doing all we can to pressure the AMA to change it's position, rather than wasting energy on trashing what is in fact the largest group of doctors in the country.
Dear Daniel M-P,
I disagree with you. The AMA represents a small fraction of US physicians - around 20%. The majority of docs have abandoned this organization because it is entirely out of step with the needs of our patients or the values of our profession. They are beholden to the worst commercialism in medicine, and frankly, as a physician, a categorically state that the AMA does NOT speak for me. I was a member as a medical student, but there are so many other, better organizations that are more effective and more responsive that I feel it is a waste of time to remain in the AMA. I urge you to join your specialty society of choice or the National Physician's Alliance as better venues in organized medicine.
Flavio Casoy, MD