The AMA’s Health Care “Rx” – No Good For What Ails You

This New York Times story tells us the following…

WASHINGTON — 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.

While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be “provided through private markets, as they are currently.” It is now reacting, for the first time, to specific legislative proposals being drafted by Congress.

Anybody remember that old saying about “déjà vu all over again”?

Because, as noted here…

Health care would pop up from time to time throughout FDR’s administration, and as recently as 1944 he expressed confidence that it was inevitable, but it never seemed the right time. Moreover, any talk of reform drew furious political pressure from the American Medical Association. Recent improvements in medicine had also made the practice of it very profitable. Despite constant ameliorating language from the White House about the primacy of doctors in making medical decisions, the AMA was dead-set against any comprehensive national health care program. In short, they helped make it never be the right time for health care reform.

…

Although (President Harry) Truman’s plan is still considered a “universal” health care plan, it was explicitly optional. By this time, some private insurance options, like the not-for-profit Blue Cross Blue Shield, were widely in use and popular. Similarly, the employer benefit system that we rely so heavily on today had sprouted up during World War II when price controls kept salaries below a certain cap and employers needed other goodies – health benefits – to competitively attract employees. So Truman’s proposal was the first historical precursor of the Obama line, “If you like your coverage, you can keep it.” But whoever wanted to could make a monthly payment into a national pool. The government would pay for medical care for each participant out of the pool and, in the event of lost waged due to illness or injury, would even give a cash payout to the individual.

The AMA, which had started to throw its weight around in the 1930s, savaged Truman’s plan. In a wide-open fee-for-service market, doctors and specialists could charge what the market would bear. But if 1/3 or 1/2 or more were in the National Health Insurance plan, the program would be able to set standard costs and payments, and the private market would undoubtedly follow. The AMA’s campaign brought up, for the first time, the charge of “socialized medicine,” even though no Communist country had a system like this, and went so far as to declare that the White House was staffed with “followers of the Moscow party line.” Soon, the combination of the Korean War and fierce opposition pushed national health care to the back burner. Truman tried again when he won reelection, but facing an oppositional Congress and continued resistance from the AMA, the plan went nowhere.

…

(President John F.) Kennedy’s push (for Medicare) from the bully pulpit of the White House gained momentum from sky high public opinion polls (as high as 69% in favor of Medicare in one Gallup poll) and grand public events like a massive rally and presidential address in May 1962, in front of 20,000 people in Madison Square Garden which was simultaneously broadcast to 20 million TV viewers.

But private insurers, understandably, resisted the plan. A national benefit for all citizens above 65 meant no customers for them over 65, not to mention a competing model for their business practices. The AMA again rushed to the ramparts, bringing back their taunts of socialized medicine. Two days after JFK’s speech in Madison Square Garden, the president of the AMA also delivered an address rebutting the president’s proposal – and this one was watched by 30 million viewers. Although there was support in the House, there was insufficient support in the Senate, where the cloture vote to cut off debate failed, 52-48.

The great article from Tim Foley tells us that Medicare and Medicaid eventually passed under LBJ (fought once more by the AMA and the conservative movement, led by their young, dashing matinee idol spokesman, Ronald Reagan). Also, universal coverage came up under Nixon, though his market-driven scheme died under the justifiable protests of labor unions and the emerging Watergate scandal (with nary an outcry from the AMA…surprised?). And the effort by the Clintons is covered as well.

Basically, despite what the AMA says about single-payer, universal coverage, you can rest assured that they will never support it (too much of an insurance burden, doctors obligated for charges and patient selection, whatever other “boogeyman” you want to concoct – and oh yeah, let’s not forget “socialized medicine,” boys and girls).

And as far as the supposed $2 trillion in cost savings proposed by the AMA and other industry groups (here)…

Their vague, pie-in-the sky promise amounts to just a 1.5 percent reduction in the growth rate of health care spending.

…

The groups did not spell out yesterday how they plan to reach such a target, and…they offer only a broad pledge, not an outright commitment….In addition, White House officials said, there is no mechanism to ensure that the groups live up to their offer, only the implicit threat of public embarrassment.

“Public embarrassment” from some of the most shameless people on earth? It is to laugh, my fellow prisoners.

And as Nate Silver tells us here that…

You might think that the American Medical Association, which today came out in opposition to a "public option" on comprehensive health care reform, is just a bunch of doctors trying to do what's best for their patients, and that their opposition to the public option is a mere disagreement over details.

And you'd be wrong. The AMA is not just a bunch of doctors, but among other things an extremely lucrative lobbying organization that has given more than $12 million in campaign contributions to federal candidates since 1998. And since 1998, according to the nonpartisan OpenSecrets.org, some 64 percent of the AMA's donations to federal candidates have been to Republicans -- although 2008, in which the AMA gave 56 percent of its contributions to Democrats, was a notable exception.

Yes, the AMA donations definitely trend towards the Democrats as of last year, but don’t kid yourself here…

These aren't particularly moderate Republicans the AMA is donating to either. The leading Senate-side recipient of its campaign contributions since 1998 has been John Ensign of Nevada, to whom the AMA has given $30,000. Ensign is the chairman of the Senate Republican Policy Committee. And Minority Leader Mitch McConnell, with $20,000 in donations, is in a tie with six other Republicans for second place. By contrast, the AMA has given just $3,000 to Ted Kennedy over this period, $4,000 to former Senator Hillary Clinton, and nothing to Majority Leader Harry Reid. Nor did President Obama or Vice President Biden receive any contributions from the AMA before departing for the White House. The AMA has, however, has given more generously to some other Democrats who are key players in health care reform, like Ron Wyden of Oregon ($12,800) and Max Baucus of Montana ($15,000; Baucus is the leading Senate Democratic recipient of AMA funds).

But Nick Kristof of the New York Times reminds us here to “keep our eye on the ball,” telling us the story of a lady named Diane Tucker, an American lawyer who moved to Vancouver, British Columbia and ended up suffering a stroke (her only symptom was numbness in her right hand)…

Scaremongers emphasize the waits for specialists in Canada, and there’s some truth to the stories. After the stroke, Ms. Tucker needed to make a routine appointment with a neurologist and an ophthalmologist to see if she should drive again.

Initially, those appointments would have meant a two- or three-month wait, although in the end she managed to arrange them more quickly.

Ms. Tucker underwent three months of rehabilitation, including physical therapy several times a week. Again there was no charge, no co-payment.

Then, last year, Ms. Tucker fainted while on a visit to San Francisco, and an ambulance rushed her to the nearest hospital. But this was in the United States, so the person meeting her at the emergency room door wasn’t a doctor.

“The first person I saw was a lady with a computer,” she said, “asking me how I intended to pay the bill.” Ms. Tucker did, in fact, have insurance, but she was told she would have to pay herself and seek reimbursement.

Nothing was seriously wrong, and the hospital discharged her after five hours. The bill came to $8,789.29.

Ms. Tucker has since lost her job in the recession, but she says she’s stuck in Canada — because if she goes back to the United States, she will pay a fortune for private health insurance because of her history of a stroke. “I’m trying to find another job here,” she said. “I want to stay here because of medical insurance.”

I cannot imagine a more urgent time than right now to pursue government health insurance including a public plan (and fortunately, by all accounts, President Obama does also). Though I’m sure it won’t work perfectly, it will force insurance companies to contain costs more than ever before (probably impacting doctor charges, but I don’t know how that tradeoff is avoidable given so many in need of coverage).

And when, God willing, the day comes when Obama signs it into law, the AMA will, at long last, be forced to retire some of the arguments in opposition they have used since 1944.

Update: Think Progress has more here.

Update 6/12/09: Didn't see this at The Daily Kos from yesterday...