AMA to Lobby Against Public Plan– Again

By Michael Ricciardelli
In The Uninsured
June 11, 2009
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The New York Times reports that the AMA has announced that it will lobby against the inclusion of a Public Plan in health care reform legislation.  Merril Goozner over at GoozNews has posted an interesting Real Politik analysis worth a view, and at least one physician, Dr. Chris McCoy, Policy Chair for the National Physicians Alliance, has publicly quit the AMA in response. In his post over at the Huffington Post, “Dear AMA: I Quit!,” Dr. McCoy points out the inconsistencies in the AMA’s position in regard to its own research, and the group’s less than progressive history when it comes to health reform. The piece is well worth quoting at length:

But this should not have surprised me: when health care reform has been necessary, the AMA has always stood on the wrong side of history. The AMA opposed the creation of Medicare in the 1930s, when it was first proposed as part of Social Security. The AMA opposed Medicare again in the 1960s, going as far as to hire an actor named Ronald Reagan to read a script to the AMA Auxiliary declaring Medicare as the first step toward socialism, and concluding with the statement that if Medicare were to become law, “One day, we will awake to find that we have socialism…. One of these days, you and I will to spend our sunset years telling our children, and our children’s children, what it was once like in America when men were free.”

That was 50 years ago … and none of that has come to pass. And yet this year, the AMA argues that a public health insurance plan will destroy the private insurance market. I challenge the AMA leadership to cite a single example of an industry where involvement by the government has lead to the elimination of private enterprise. This has not been the case with the creation of public police forces in the second half of the 1800’s (private security companies still exist), we have a robust system of public and private colleges existing the same market, and bookstores still sell books despite the presence of public libraries. A mix of public and private enterprises in the market is a truly American solution to ensuring equal access, as well as competition to drive quality improvement. In fact, the creation of the public health insurance option will *increase* competition, as demonstrated by the AMA’s own studies showing that 94% of health insurance markets only have 1 or 2 providers in the market.

It would appear that the AMA’s position against the public health insurance market is driven by out-dated political ideology that blindly supports private industry rather than a careful examination of the facts of the current situation.

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3 Responses to “AMA to Lobby Against Public Plan– Again”

  1. […] we posted back on June 11, 2009 the AMA had announced the day prior that it […]

  2. I sit on the board with Utah association of Health underwriters and http://www.BenefitsManager.net for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year that seems all too familiar on the federal level. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a “no loss” or “no gain” over competing carriers in the insurance exchange portal which is http://www.UtahInsuranceExchange.info. On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.
    In http://www.UtahInsuranceExchange.info which is the beginning of a state sponsored program addresses issues on a local state level that the federal level might look at. Coming from an underwriting background I know where the dime falls. I am of the opinion that large waste occurs from providers billing for procedures that developed “no outcome”. Insurance carriers are not the only bad guys on the block. In most of our purchasing decisions….don’t we pay ONLY when we know that we will get a desired outcome? Why is it if you ask the doctor how much this test or procedure is he doesn’t know? Shouldn’t providers be held to a transparent cost standard?
    You must be in the health care business from some touch point to make statements of fact in face of historical proposed changes. When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get it because of real time experience.
    I often quote the Switzerland health care system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies there are not resuscitate upon birth if they cannot draw breath? Did you also know that is the same with senior care with system failure? They don’t extend life of a senior with multiple failures like intubation as example. Anyone in the business of paying claims knows that single most expensive bill in NICU for newborns and seniors in acute intensive care / hospital.
    These decisions were made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or definition of when to incubate a newborn or a senior? To define the conditions? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
    I don’t think we are hearing about tort reform because most of the house and senate are lawyers. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance.

  3. AMA to Lobby Against Public Plan– Again : HEALTH REFORM WATCH…

    That snake looks a little more predatory today.Hard to believe they actually opposed Medicare and Medicaid too….

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