AMA Doesn't Speak for Most DoctorsPublished: 2010-01-06 10:51:06Author: Dr. Lee Hieb | Human Events | January 5, 2009The American Medical Association officially endorsed the Democrats’
health reform bill. An eager Barack Obama, of course, used this
endorsement to claim that “doctors” support his healthcare takeover.
This misleading statement plays on the common misperception that the
AMA represents some huge block of American physicians. Not true. In
fact, excepting membership given to students and residents in training,
the AMA represents only 17-19% of physicians
actually in practice.
During
the last twenty plus years, the AMA has progressively lost members, and
this slide continues. Like many doctors, as a medical student I
belonged to the AMA. But once in practice, I recognized the disconnect
between the highly paid AMA directors, the AMA policy makers, and me.
Rather than stand on principle, the AMA has sold out for short term
financial benefits for its members and, most egregiously, for its own
organizational self-preservation.
In the 1960s, the AMA
protested appropriately against the institution of government run
Medicare. But, sadly, when the politicians assured AMA leadership that
physicians reimbursement would continue as “usual and customary” fees
-- in other words that the doctors could continue to charge their usual
rates and this would be paid by the Medicare budgeteers, the AMA rolled
over like a salivating puppy. This proved to be a bad bargain since
the government -- surprise surprise -- did not keep its financial word.
The AMA, if we can say nothing else about it, fails to learn. History
repeated itself recently as the AMA traded its endorsement for a
promise by the politicians to improve physician pay scales. To know
the truth, the AMA needed only to look around. Car dealers are even now
discovering government perfidy by expecting to be promptly paid in the
“cash for clunkers” scam. It seems no one can avoid the lure of money
-- even when promised by politicians.
Worse yet, the AMA has
become an arm -- sometimes a strongarm -- of the government. Under
the balanced budget act, there is a fixed pot of money for physician
reimbursement -- in 2008 approximately $76 billion. So, in this fixed
pot scenario, if internists, for example, are to be paid more for their
patient care, someone else -- general surgeons for example -- must be
paid less.
Needless to say, everyone wants a seat at the table
when the money is doled out, and the AMA is in charge. Theoretically,
all specialty areas of medicine have representation in this process,
however that is not always the reality. According to the AMA rules, if
a specialty society doesn’t maintain a certain level of AMA membership
among its members it loses its seat on the bargaining committee. In
other words, the AMA says, “Belong to us or you won’t get paid.” The
Gambino family union bosses must be consultants for AMA contracting.
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