Along the way, the AMA wants to rid the market of state-mandated benefits, also high on the insurers’ wish list. “Appropriate regulations and fewer benefit mandates would permit market experimentation to find the most attractive combinations of plan benefits,” the docs say. No self-respecting insurance carrier would disagree. It opposes letting people between age fifty-five and sixty-four buy into Medicare, even temporarily. The AMA has a proposal for the youngsters, too. It suggests that the government offer tax credits or vouchers to parents of kids enrolled in SCHIP, the State Children’s Health Insurance Program, to make it easier to buy health coverage in the private market. In other words, it wants to begin eroding government coverage for poor kids.
The AMA doesn’t care for a public insurance option, either. Here’s what the doctors say:
The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans. A crowd-out of private insurers and the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.
There you have it—is this the same old AMA opposing anything that even remotely looks, smells, or quacks like an entrée to national health insurance? Is it 1948 all over again? Health care journalists should make it their business to find out.
Thanks to Trudy Lieberman for a perceptive article. The record will show that I’ve written many pieces over the years criticizing the drug industry, AMA, and hospital lobby, as well as the insurance companies, for resisting systemic health reform that might reduce industry profits. But Trudy is right that critics like me, in short columns, tend to default to characterizing the insurance companies as leaders of this pack (or PAC). I do think that the insurance lobby is first among evils, as it were, but in future critiques I will be sure to pay more attention to the precise roles of the whole unsavory team and not just the quarterback.
#1 Posted by Robert Kuttner, CJR on Tue 9 Jun 2009 at 11:04 AM
The information you've revealed, and the intricacies of the hospital, AMA, insurance, and drug company interests brings most of us to the brink of despair. Added to this is the lack of leadership by our elected representatives, especially in the Senate. Each vested interest group is asking for concessions from the others that they know are unacceptable, and on we go.
#2 Posted by dpjbro, CJR on Tue 9 Jun 2009 at 12:07 PM
Ms. Lieberman and Mr. Kuttner
Speaking as a physician, yes The AMA is as you say it is but keep in mind it no longer speaks for the whole "doctor' public. Indeed only 13 % of the physicians in the country belong to the AMA.
You would find more pay dirt if your were to sub divide the physicians into Generalists, lower reimbursement specialities ( they support single payer Universal plans in a majority, PNHP is amongst these) and then specialists, surgeons etc. Then, add to the fray specialist owned hospitals, non-profit hospitals acting like for-profit hospitals and doctor owned insurance companies. These are the true players you are looking for.
Finally, the biggest players will still remain the insurance compnaies, Big PHRmA, device manufacturers and physicians who are in bed with them.
Hope this helps.
#3 Posted by wilbur larch, CJR on Tue 9 Jun 2009 at 02:44 PM
We've got a "top-down" problem. Nobody can be happy with any solution imposed on everybody by the Senate, Obama, the "government", the AMA, etc ...
There's too much lumping of diverse entities with special needs and priorities into phony categories.
If the people want a public option, enough people, they have the right to expect their elected officials to allow them to provide it to themselves, through the instrument of their government, notwithstanding the bribes and "leg-breaking" by special interests (who are often not human entities but legal fictions.)
#4 Posted by public takeover, CJR on Tue 9 Jun 2009 at 04:52 PM
Several people have noted that the AMA no longer represents the opinions of a majority of doctors. It is helpful to remember that the AMA still has enormous lobbying clout in Congress as my post pointed out.
#5 Posted by Trudy Lieberman, CJR on Wed 10 Jun 2009 at 08:19 AM
the ama opposed medicare too
#6 Posted by jamzo, CJR on Wed 10 Jun 2009 at 03:08 PM
AMA and some other medical associations must be in deep fear of losing funds from pharmas, insurance and instrument companies that they depend on to run their organizations, foundations, grants, annual meetings, CME programs, fellowships, patient literacy programs, clinical trials, lobbying efforts and publications. In essence, their organizations could be reduced to small non-profits with a staff of six, or however many can be supported through membership dues. But health care shouldn't be about job retention or society maintenance.
BTW, watch for a flurry of emails this week from Dodd et al inviting you to "Take part in health care reform!" They want our thoughts(now that deals have been struck) but only by email, an afterthought.
Never mind that doctors and nurses have been arrested for attempting to have the majority of we "mighty citizens'" voices heard in Baucus's committee meetings.
As Rep. Louise Slaughter (D-NY) reflected in a 2006 editorial published in the New England Journal of Medicine: “The current problems with Medicare Part D are largely the direct result of the undemocratic way in which the plan was authored and passed. The final legislation, heavily influenced by drug-company and health insurance lobbyists, focused mainly on the needs of those industries instead of those of the seniors it should serve.”
If anything, the process is even more undemocratic now in 2009.
#7 Posted by Kathlyn Stone, CJR on Fri 12 Jun 2009 at 10:10 AM
I think it is important to identify what the problems are but only insofar as this information will be used for stratigic organizing. There is little time left to get the bill that we need.
All of us need to be relentless in our grassroots efforts: call your representatives, your senators, and the president. We need to go door to door. We need to discuss this with friends, family, and neighbors. We need to write letters to the editor in our local districts and to the papers of record. And we need to write to the major broadcasting networks to give this issue it's proper exposure. Money does talk and we have the numbers and are relentless in our pursuit.
This will require a herculean effort but 2 years ago, I didn't think that a community organzier from Chicago had a chance to be president.
We are in the battle of and for our lives. It is good to analyze but better to organize.
#8 Posted by Sarrar, CJR on Fri 12 Jun 2009 at 10:39 AM
The Leaders in the U.S.Senate and their Spouses are in the Pocket of the Insurance Company's and Mega. Medical establishments as per an article in the AP yesterday By LARRY MARGASAK and SHARON THEIMER, Associated Press Writers Larry Margasak And Sharon Theimer, Associated Press Writers . I incourage you to look it up, because you won't find it in any of your News Papers or TY news outlets. It names names and quotes the amounts of money recieved by these Senators and their Wives.
#9 Posted by Curtis Mulkey, CJR on Sat 13 Jun 2009 at 10:16 AM