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A Look Inside What the Hell Happened with the AMA Today

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Joanne98 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jun-12-09 09:28 AM
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A Look Inside What the Hell Happened with the AMA Today

An article appearing in this mornings NY Times by health politics uber-scribe Robert Pear declared Doctors Group Opposes Public Insurance Plan. It went on to describe the objections of the American Medical Association (AMA) to the public health insurance option, the centerpiece of the health care plans being pushed by the relevant committees in Congress, in no uncertain terms. But by the early afternoon, the AMA was releasing a clarifying statement along the lines of Oh, of course wed be OK with certain types of public plans, silly! So what the hell happened?

Lets get this out of the way first. That wasnt a clarifying statement. That was a walk back. Yes, the article by Pear focused predominately on forcing physicians to participate in a public plan more than anything else, and forcing physicians in is a detail thats only in one of the many variants of the public plan. But the Pear article also uses this dead-to-rights quote as to why the AMA wont support it: 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. I happen to believe this is a loco argument why are we bailing out yet another industry specifically because it cant compete? But this is the argument no matter what variety of public plan youre talking about. So "clarifying hours later that you meant to say the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress?

Not. Credible.

Three theories as to what prompted this about-face. (Keep in mind I don't know for sure -- but these hypotheses are intriguing to think about).

1.) Dear God, what did we just do?

The AMA as an organization has been both low-key and reserved about its stance on President Obamas push to make quality, affordable health care for all a reality. Theyve been at the table, but theyve been quiet about it. And even though many doubted that theyd be good citizens throughout the process, reformers generally left them alone.
But were not idiots. The AMA has been the sworn enemy of health care reform since the days of FDR, Harry Truman, and JFK, particularly any time physician reimbursement rates are involved. They opposed Medicare the most popular health care system operating in the country to the death back in the 1960s. It was reasonable to watch them with a wary eye.

Therefore, when the AMA seemed to step up to oppose a critical element of the Presidents health care plan, everyone was ready to pounce and pummel them.

Heres Media Matter suggesting a curious confluence between the AMA and private insurances lobbying efforts.

Heres Igor Volsky on Think Progress pointing out, But the AMA, which has a long history of opposing the enactment of Medicare and other health reform legislation, does not speak for all doctors. (Igors right, by the way. The AMA represents maybe 20% of physicians in this country).

Heres Jon Cohn pointing out the inconsistencies of their argument.

Heres Matt Holt on The Health Care Blog saying, Its a pity that as a policy wonk I cant take them seriously.

Heres Merrill Goozer summarizing, When push came to shove, the doctors stood with the companies that absorb an inordinate amount of their time filling out forms.

And finally, the coup de grace, Maggie Mahars killer post, The AMA Would Make Health Care Unaffordable to Many Americans.

And there are many, many more. By the way, theres no question some AMA members read the newspaper and health care policy blogs. They were probably not thrilled that their organization had just become a national punching bag. The end result: Holy Cow! What did we just do?

(This is starting to be a pattern. Ben Nelson hated the public plan, now hes open to it. The Blue Dogs were for the trigger, but then had to let everyone know that was a negotiating strategy. Max Baucus says the public plan is on the side of the table, then last week after meeting the President, had to say its definitely in. Ill be curious to see how many more legislators and organizations have these Wile E. Coyote running off a cliff moments.)
2.) So help me, I will strike you down

The most intriguing theory comes from Ezra Klein: as we get closer to a bill, Congressional reformers and the White House are playing hardball. They're saying that you're either with health reform, or you're against it. And if you're against it, you can't expect to be taken care of in the final legislation. They're not going to save your seat at the table while you're trying to burn down the room. And the AMA, it seems, got the message.

I havent seen this suggested by anyone but Ezra but its an interesting theory.

3.) Dude, I did not come all the way to Chicago for nothing

Thats right, the AMA convention begins this Saturday in Chicago. On the agenda includes the usual annual business of the organization, which, judging by their agenda, will doubtlessly include a number of votes on what policies to support or not support on health care reform. I dont know how your annual conventions go, but if Im attending one, I generally dont like it when the organization published a position in the freakin New York Times before I even get a chance to vote on it. To say the timing of the article suggests the leadership is nor respecting the opinions of the members is an understatement.

All of this sets up a fascinating moment on Monday when President Obama addresses the AMA Convention. It was already highly anticipated we know Obamas new stump speech on health care specifically includes numerous mentions of the public plan and now has been dialed up to eleven.
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xchrom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jun-12-09 09:35 AM
Response to Original message
1. recommend -- the AMA needs to be front and center
for progressives to talk about.

they are not on the side of the average american citizen and health care reform.

it's bothersome in the extreme that insurance, the AMA and others are being allowed so much input on crafting this reform.

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Tuesday Afternoon Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jun-12-09 10:01 AM
Response to Original message
2. K&R
thanks for posting this....
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Demoiselle Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jun-12-09 10:08 AM
Response to Original message
3. Most important thing to remember...AMA only reps 20% of our doctors!
..I didn't know that...Thanks for this post.
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DKRC Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jun-13-09 06:14 PM
Response to Original message
4. Too late to R, but I can still K!

I also think the AMA heard from more than just Dr. McCoy.
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