Editore"s Note
Tilting at Windmills

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July 16, 2009

THE AMA COMES AROUND.... About a month ago, the American Medical Association announced that it would oppose any health care reform effort that included a public option. This was not unexpected -- the AMA has a lengthy record of opposing reform, and has resisted major effort for generations. Sam Stein recently noted, "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."

With that in mind, this was not at all what I expected to see this week.

The American Medical Association just sent a letter to House Ways and Means Chairman Charles Rangel, endorsing the health reform proposal put forward by three House committees. [...]

Recent signals from the AMA suggested they were reluctant to embrace reform, in no small part because they believed a public insurance option would underpay them. But the AMA letter contains no caveats. It is a straightforward endorsement.

And that makes it a pretty big deal. No, the AMA is not as powerful, nor as representative of the medical community, as it once was. But an unqualified endorsement for the most liberal plan out there has large symbolic value, given the role AMA played in killing health care reform for most of the 20th Century.

In his letter to Rangel, Dr. Michael D. Maves, executive vice president and chief executive officer of the AMA, concludes, "This year, the AMA wants the debate in Washington to conclude with real, long overdue results that will improve the health of America's patients."

Jonathan Cohn has more on the details, specifically on the AMA's hopes to change the Sustainable Growth Rate formula in Medicare, but in terms of political salience, it's bound to help proponents of reform note that in successive days, the Democratic plan has been endorsed by the American Nurses Association and the American Medical Association. That the AMA was expected to be an opponent -- and has always resisted reform efforts -- makes this all the more significant.

Steve Benen 1:45 PM Permalink | Trackbacks | Comments (31)
 
Comments

The AMA got everything they wanted.Of course, they support it.

Posted by: impartial on July 16, 2009 at 1:50 PM | PERMALINK

Note to Republicans - This is what governing looks like.

Posted by: Scott F. on July 16, 2009 at 1:51 PM | PERMALINK

Let's see, Rush Limbaugh should be denouncing the AMA as a Socialist, Marxist, Communist, Nazi organization in...three...two...one...

Posted by: Capt Kirk on July 16, 2009 at 1:57 PM | PERMALINK

Highly recommended reading / listening:

Amy Goodman's interview with Wendell Potter, formerly head of corporate communications at CIGNA, one of the nation's largest for-profit health insurance companies, on the Pacifica Radio program Democracy Now this morning. There is a transcript and streaming audio & video at the link.

As the debate over healthcare reform intensifies on Capitol Hill, we spend the hour with a former top insurance executive who’s now exposing the industry’s dirty secrets. Wendell Potter once served as the head of corporate communications at CIGNA, one of the nation’s largest health insurance companies. We speak to Potter about his own transformation from industry mouthpiece to whistleblower, the healthcare industry’s extensive PR and lobbying machine, the campaign to discredit Michael Moore’s film Sicko, and the insurance industry’s most pressing task: the fight against a public option, let alone a single-payer system.

Not only goes into detail about how the insurance corporations profit by denying care -- and directly causing the death of customers thereby -- but also about the relationship between the insurance corporations, the corporate media, corporate lobbyists, and the politicians who get to declare that single-payer is "off the table".

Posted by: SecularAnimist on July 16, 2009 at 2:05 PM | PERMALINK

Regarding the AMA's position -- perhaps their members are finally as fed up with the for-profit medical insurance corporations as anybody?

Posted by: SecularAnimist on July 16, 2009 at 2:07 PM | PERMALINK

...or, they could grasp that the writing is on the wall on this, and want to be on the 'winning' side of history.

Posted by: terraformer on July 16, 2009 at 2:09 PM | PERMALINK

I think that the rank and file is putting pressure on the AMA to better represent their beliefs. The AMA is at least sensitive to its declining membership and aware that this is an issue for the non-surgical docs who have been leaving the AMA at a pretty rapid clip in the last decade.

Posted by: J Bean on July 16, 2009 at 2:15 PM | PERMALINK

And what did the letter they sent to Sen. Baucus say??
Sorry for the cynicism but I don't think this is going to turn out well -- I think it will be muck by the time the lobbyists get through influencing the outcome.

Posted by: VaLiberal on July 16, 2009 at 2:19 PM | PERMALINK

Wow!

I'm with terraformer. I'd bet the AMA knows health care reform isn't getting derailed this time (memo to Blue Dog Dems!) and so wants to be inside the tent.

Incidentally, this development proves how bipartisan the reform effort is. The AMA opposed health care reform last time, but has come on board. Congressional Democrats should point out that it's Republican obstructionism that's nothing but partisan.

It should give Broder fits!

Posted by: Gregory on July 16, 2009 at 2:22 PM | PERMALINK

uh-oh

this makes me queasy...

you think the assoc. of quack-duffers is just surrendering, or do they have a coup comin'?

Posted by: neill on July 16, 2009 at 2:23 PM | PERMALINK

Like the government, the AMA has been taken over by liberal extremists bent on destroying American freedom.

Posted by: Al on July 16, 2009 at 2:29 PM | PERMALINK

I'm with J Bean. Doctors hate the current system, and the AMA has finally come around to reflecting that.

Posted by: inkadu on July 16, 2009 at 2:30 PM | PERMALINK

The AMA is not stupid. Eventually they will wring some $$ from the system but for now they are willing to have a seat at the table.

On another note, Kathleen Sebelius was on the Daily Show and I think she stated that only unemployed and small business people would be allowed to go on the public option. Does anyone know if this is true?

Posted by: coral on July 16, 2009 at 2:34 PM | PERMALINK

It's also obvious that with a national health plan there will be a lot more work for doctors since more people will have access.

Posted by: inkadu on July 16, 2009 at 2:53 PM | PERMALINK

I find it more suspicious than significant. O_o

Posted by: PattyP on July 16, 2009 at 2:53 PM | PERMALINK

neill is right - this stinks. The AMA has absolutely no reason or incentive to come down off a mountain they've been building for 70 years, but huge incentive to take desperate measures to stop a public option at all costs.

It's a trap. The AMA is a bunch of recalcitrant, irredeemable fuckers who never, ever listen and never, ever change.

I don't know how they're going to work it, but somehow this apparent concession is a booby trap to destroy reform for good.

Posted by: Yellow Dog on July 16, 2009 at 2:54 PM | PERMALINK

First off, I'd like to say Al, take a prozac or valium! You're going to need it, as we like to have informed readers here. Not your typical BS or brainwashing crap your side tends to do.

Now Back to my normal blogging.

We do need some type of intervention here. For the past few years, I have watched the news in horror of the mistakes, if you want to call it that. Hospitals were informing patients that had tests of their colons to come in for Aids/Hepatitus testing because of contaminated equipment.

Here in Cali, they arrested some 40+ people for impersonating nurses, yet, billing Medicaid & Medicare for millions, if not, billions of dollars.

And yes, I believe through willful neglect (for monetary gain) medical personnel was responsible and/or assisted in the deaths of Anna Nicole Smith and Michael Jackson.

Posted by: annjell on July 16, 2009 at 2:57 PM | PERMALINK

OK, I'm starting to believe we may actually get a semi-decent UHC bill this year.

Posted by: low-tech cyclist on July 16, 2009 at 3:10 PM | PERMALINK

Isn't Regina Benjamin, Obama's recent pick for Surgeon General, a high muckety-muck in AMA?

Posted by: exlibra on July 16, 2009 at 5:22 PM | PERMALINK

I have 2 doctors, 1 nurse and 1 PA in my immediate family-- ALL of them think the current system is completely and totally fucked and needs radical reform. I think you'd be hard pressed to find anyone in healthcare who cares first and foremost about patient care who won't say the same.

That being said, I think the AMA decided it made more sense to be sitting at the table than standing outside of the room.

Posted by: zoe kentucky on July 16, 2009 at 6:22 PM | PERMALINK

I guess this means that the doctors "booing" Obama at last month's AMA convention are all on board with this change of heart.

Posted by: Neo on July 16, 2009 at 6:48 PM | PERMALINK

The AMA and Howard Dean are now both inside the same tent.

How long ago 2003 seems.

Posted by: Davis X. Machina on July 16, 2009 at 6:52 PM | PERMALINK

So will the public option be self-funded or subsidized?

Posted by: Surg on July 16, 2009 at 8:01 PM | PERMALINK

This just makes me really anxious, too hard to believe the AMA is going along. What kind of backroom deals were they promised on the "final" bill? I don't trust anyone in DC, least of all groups like the AMA. I don't believe they are caving; something must have been promised and it won't be anything good for consumers.

Posted by: klara on July 16, 2009 at 8:18 PM | PERMALINK

AMA is merely looking at their own numbers. Their membership is decreasing THANKS to a separate organization that started about a decade ago to get behind Health care reform. Sure AMA is still the largest, but not for that much longer.

They are starting to realize that they either join the 21st Century, and see their membership decrease even more.

Sorry don't remember the exact name of the new organization, but the President of that organization was in Washington DC last month to testify for Congress. He lives and practices in Madras, Oregon.

Posted by: bruno on July 16, 2009 at 10:29 PM | PERMALINK

Is this really a big deal? My wife's ex is a surgeon. My stepson is a doctor. I know lots of doctors through them and every single one of them ridicules the AMA. There's a reason why only 15% of practicing physicians belong to the organization.

Posted by: Paul Camp on July 17, 2009 at 12:57 AM | PERMALINK

I'm with klara. If the AMA is on board, then the package is going to be better for their agenda than for consumers. I was almost optimistic about health care reform until now.

Posted by: Gwen on July 17, 2009 at 2:13 AM | PERMALINK

You shallow progs are such effing dupes. What the AMA has come around to is the realization that Public Option isn't worth crap and is no threat to their high salaries. They finally called off the Kabuki.

But an unqualified endorsement for the most liberal plan out there

That anyone can write that referring to Public Option, in total ignorance of HR676 (Single Payer), is a sign of how tilted to the wingnut sphere of logic this entire debate is.

Posted by: Disputo on July 17, 2009 at 7:34 AM | PERMALINK

THIS IS IT!

The healthcare reform bill released by the House Of Representatives is an excellent bill as I understand it. It's a bill with a strong, robust, government-run public option, and an intelligent, reasonable initial funding plan to cover almost all of the American people. It is carefully written, and thoughtfully constructed, informed, prudent and wise. This bill will save trillions of dollars, and millions of your lives. It is also now supported by the AMA.

This is the type of bill that all Americans can feel good about. And this is the type of bill that has the potential to dramatically improve the quality of healthcare for all Americans. Rich, middle class and poor a like. Democrats, Republicans, Independents, and all other party affiliations. This bill has the potential to dramatically improve the quality of life of every American.

The house healthcare bill should be viewed as the minimum GOLD STANDARD by which all other proposed healthcare legislation should be judged. All supporters of true high quality healthcare reform should now place all your support behind this healthcare reform bill released by the United States House Of Representatives, as the minimum Gold standard for healthcare reform in America.

You should all now support this bill with all your might, and all of your unrelenting tenacity. This healthcare bill is a VERY, VERY GOOD! bill for all of the American people. Fight tooth, and nail for every bit of this bill if you have too. Be aggressive, creative, and relentless for this bill.

From this time forward, go BIGGER and DEEPER with the American people every day until passage of healthcare reform with a robust, government-run public option.

FIGHT!! like your life and the lives of your loved ones depends on it. BECAUSE IT DOES!

SPREAD THE WORD

(http://www.youtube.com/watch?v=RSM8t_cLZgk&feature=player_embedded)

God Bless You

Jack Smith Working Class

Posted by: jacksmith on July 17, 2009 at 11:44 AM | PERMALINK

The bill is good and that's why the AMA supports it. The AMA has never said they would not support anything with a "public option" in it (as vague as that is), but has expressed concern over limiting patient freedom of choice and a free market in healthcare. It's not the same thing.

Sure it's all the rage to vilify the AMA and minimize their sincerity and influence among physicians, but it's really hooey. It's a great group of doctors who care, show up to participate (unlike the sideline whiners).

I'm excited at the prospect of our country finally getting something accomplished for our patients.

Posted by: Doc Bonsai on July 17, 2009 at 4:05 PM | PERMALINK

@ neo
The AMA docs "booing" Obama followed the boo with a light-hearted laugh. Obama received a dozen or more standing ovations during the talk. I was sitting in the 6th row.

Interesting to see the snarling critics, the nail-biting cynics who insist there must be backroom deals, etc., when I know from first-hand experience that there are a range of doctors who participate in the AMA from the self-serving and business oriented to the public health and patient advocates. Caricatures are so conveniently concise and nasty, but are ultimately. Just thank the AMA for supporting great legislation and leave it at that.

Posted by: Doc Bonsai on July 17, 2009 at 4:23 PM | PERMALINK
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