The death of the American Medical Association
To illustrate the point, one need only examine the organization’s complete and utter ineptitude at handling the most important issue facing American physicians – the ever present axe that hangs over their heads as they attempt to fight off the 21% reduction in Medicare payments payable to doctors willing to treat the nation’s elderly.
It’s not like they haven’t had their chances.
The first misstep came with the AMA’s willingness to accept and support the Obama healthcare plan without gaining anything in return. Surely, a promise to deliver on a repeal of the law that is producing the threatened cuts – or at least a commitment to table the cuts for a meaningful period of time – could have been accomplished in exchange for AMA support of the health care reform bill.
But then, when it comes to politics, one must ask before one can expect to receive. And when asking politely doesn’t work, one must be prepared to threaten with the checkbook.
But not so the AMA.
The AMA says it endorsed reform because the law would help doctors and patients by expanding coverage, adding it never took part in a quid pro quo to support the bill.
“We make no apologies for our strong, principled advocacy on behalf of patients and physicians,” Cecil B. Wilson, president of the AMA, said in a statement to POLITICO. “We have been vocal advocates for covering the uninsured since before the last presidential election — before the issue became divisive and politicized.”
I suppose I can respect such a noble and principled approach. But then, I’m not a physician struggling to keep my office open while accepting elderly patients on what little Medicare already pays, let alone trying to do it with a further 21% cut in pay.
Having let the moment pass them by at the outset of reform, the AMA determined not to make the same mistake twice. Last month, they went full force for a complete repeal of the threatened cuts – a repeal that would cost the national treasury some $240 billion. Once again, a noble objective. But in an election year where Democrats are already getting their heads handed to them for ballooning deficits, it doesn’t take a strategic genius to understand that such an approach is not going to succeed and that an unwillingness to compromise is just plain stupid – especially when Congress offers a reasonable compromise.
And that is precisely what Congress did.
Unable to push through an expensive repeal of the law, for all the obvious reasons, Congress suggested a five-year fix that would have given the docs a little breathing room while we see how reform develops. But the AMA refused. Instead, they launched a multimillion – dollar television campaign attacking the U.S. Senate for walking away from the problem.
What did the AMA win for their efforts? Rather than the five- year deal they had within their grasp, they achieved only a one-month reprieve. That’s right – having turned down a five-year deal, they spent millions of dollars only to end up with just 30 days until the ugly problem raises its head once again. Does it get any more embarrassing for a political lobbying group? Is it any wonder that membership in the AMA has dwindled to a mere fraction of what it once was?
For those physicians who continue to belong, I can only hope that they show better judgment when cutting us open than they do when it comes to political decision making. While taking a principled, all-or-nothing approach may be admirable – it is usually the province of interest groups who seek only to be heard in the press and on cable TV rather than those who actually mean to accomplish something in Congress. Our collective health demands much more. Medicine in America is very much about politics. And if the physicians can’t handle it, you and I will pay the price.
It is worth keeping in mind that the AMA is the very same organization that has managed to get its way on healthcare policy since first taking on Teddy Roosevelt to defeat a national health insurance program. Indeed, they have defeated every single president they’ve taken on when it comes to healthcare proposals that did not meet with their approval.
But those days are over. The time has come to pronounce the AMA dead and hope that the nation’s physicians will respond by creating an organization with the requisite skill and courage required to represent their interests.
Why do we care? Because while you may have gripes about how much money physicians earn (and I hear them all the time), I assure you that the interests of America’s physicians are very much tied to our own. You simply cannot have a health care system without the doctors who diagnose the illnesses, dispense the treatments, work the cures and alleviate our pain. This is not an abstract proposition. Should you or a member of your family become ill, it won’t be politics or disgust over how much the other guy earns that is on your mind. You’re going to want a doctor and you’d better hope there is a competent one available to provide what you need.
The AMA has given a whole meaning to the adage, “Physician, heal thyself.” The nation’s doctors would be wise to take the advice and get themselves properly organized before it’s too late- if it isn’t too late already.