What Is The AMA Thinking?
I gave up my membership to the American Medical Association years ago. And if I hadn’t, I would have done so this week.
For those that don’t know, I am a physician; a radiologist, to be specific. And like the majority of physicians, I don’t belong to the AMA. Actually, only about one-third of physicians now belong to the organization. The AMA has long been viewed by most physicians as simply an inside the beltway organization that really has little or no connection to the daily routines of physicians in practices across the country.
I will predict that this week’s endorsement of the House plan for healthcare will move many people to resign from the AMA. I have personally heard of many people doing just that. This woman, a Dr. Elizabeth Vliet, posted an editorial on why she quit the organization. Specialists have leaving in droves for decades, and that is why the AMA has an ever decreasing voice in the medical community.
Even with the current issue, state medical chapters are dissenting. At current count, at least 25 state chapters are opposing the House bill, or at least divided on whether the House bill will be good for the country, or damage the health system irrevocably.
This was simply the usual inside the beltway politics for the AMA. There members are largely against the House bill, though they are strongly in favor of reform. But doctors are not willing to make sacrifices simply in the name of reform…they want actual results. The leaders of the AMA, on the other hand, are bartering with Congress on what to give up, and what to get in return. The first item was a recalculation of the way Medicare reimburses doctors. Barack Obama had suggested major cuts to doctors in these payments, costing physicians up to $250 billion over 10 years. Democrats in the House, however, reneged on that pledge, and reinstated those payments. The problem is, there is absolutely no way that the Reform bill can be budget neutral without that provision. And now that the President has drawn a line in the sand on being budget neutral, I and others would not be surprised if the one item the AMA gained from selling themselves to House Democrats on this bill were removed in later discussions…leaving the AMA (and physicians at large) holding the bag.
Additionally, the AMA has not pushed the White House to bargain on tort reform, a major sticking point for most physicians. Physicians, as a whole, are willing to sacrifice a lot including decreasing incomes. However, they are not willing to do that without some compromise on the other side. So far, there has been littte to no leeway given by Democrats to physicians on this issue.
Unfortunately, the AMA is acting like most lobby groups in Washington…give and take in back rooms, without listening to its members. Whether this portends future problems for the AMA will take time to be ssen. However, certainly many, if not most, physicians feel that there supposed representatives in this debate have left them out in the cold.
UPDATE: Excellent interview between Howard Dean and Daniel Palestrant, CEO of SERMO in CNBC…Dean supports socialized medicine, and that is all he supports.
AMA opposed social security, medicare, and just about any public health initiative. Instead of focusing on medicine and treatment, AMA has become a protector of economic interests of one side over another. Damn the Hippocratic oath. But now by trying to work on new bills, all it has done is ensured a place at the table lest they end up on the menu.
Was the AMA even around in 1935 for Social Security? They supported Medicare Part D. They also, like most physicians, should support health care reform. Just not the House version.
There are few people more important than a good physician. When we need one to oversee our health and well being it is one of the most important decisions we make in attempting to find a good one. One of my biggest fears is that the best people will choose fields other than medicine if our half witted leadership manages to ruin health care for the sake of expediency.
Of the things I am most grateful for is the quality of doctors I have known over the years. With few exceptions I have been fortunate to have the services of some of the most dedicated and professional people that one could come across.
There needs to be incentives for people to pursue medicine as a career. Our system needs reform but this should be done with deliberate care. This should not be a rush job to pass a bad bill. We will all suffer if our best talent decides to pursue careers other than medicine if it just doesn’t pay to do so.
The AMA represents a shrinking minority of physicians, and it would be even smaller if many states did not require membership in the AMA in order to belong to the state medical association. For the AMA, as for the Democrats in Congress and the White House, this is not about health care but about power and money. Reforming health care reimbursement in the United States is not as complicated as all that. All that is required, really, is for government to get out of the way by removing all the distortions that have been introduced over the years through tax policies, insurance mandates, etc. Give decision making power back to the patient. Simple minded stuff. But it has never happened because actual reform is not what the Dems want. Or some Republicans, either.
This bill absolutely cannot pass. “General practitioners,” will be out of business if further cuts are imposed. Being an internist myself (in the state of RI no less), I gross about 18% of what I bring in (~$20/hr). After paying student loans, this number is lower (~15%). They are not even discussing tort reform in any significant way. If this passes I will go to law school and defend the physicians that are dumb enough to continue practicing.