Home Blog Business as usual: the AMA’s opposition

Business as usual: the AMA’s opposition

June 2009

I wasn’t surprised when I read yesterday’s news that the American Medical Association “strongly opposes” any government-backed health plan, as well as being against increasing enrollment in Medicare to those under the age of 65. (Despite some backtracking after those initial reports, it appears the AMA is still against mandatory physician participation in any public program or an extension of the Medicare program.)

I’m not surprised because the AMA has a long-standing opposition to any government-sponsored insurance solution. But what really bothers me is the fact that the AMA seems to consider itself the representative organization for physicians in the U.S.

The AMA, founded in 1847 and incorporated in 1897, is the largest association of doctors and medical students in the country. But its ranks are shrinking and for good reason. About 30% of its reported 250,000 members are students, residents or fellows for whom membership is paid for either by medical schools and training programs or offered at a significantly discounted rate compared to full membership for “practicing” physicians.

Membership in the AMA has shrunk to less than 19% of practicing physicians–and some organizations estimate that the actual number is lower than that. Doctors have instead chosen to join the ranks of more representative specialty organizations, such as SHM or AAP.

The reasons are obvious. The AMA has chosen over the years to focus its mission not on representing the interests of physicians and their patients, but on staying alive. At the same time, when doctors’ representation is urgently needed at the national level, the AMA strangely remains on the sidelines, unless it’s an issue that could affect its existence, as shown by its stand against some of the proposals being bandied about to fix the current state of health care.

The AMA’s objection to these proposals seems to be purely economic and doesn’t take into account whether a public program would finally guarantee health care coverage for everyone. It also seems as if the organization is siding with private insurance companies who stand to lose business (or at least face a lot of competition) from a government-sponsored plan.

Just look at its history: The AMA stood against the inclusion of a health-care article in FDR’s Social Security proposal; against the creation of Medicare in the 60s; against the Clinton administration’s efforts to reform health care. And now, once again, the AMA is against any government—sponsored solution to the health care morass that we have all been complicit in creating and maintaining.

The AMA has decided is doesn’t stand for the issues but against them. Instead of offering policy proposals or solutions, the AMA has become an obstructionist organization that just says “no.” Instead of offering alternatives, it voices objections. And now, in the face of policy proposals to fix this country’s ailing health care system, the AMA again just has “no” to offer.

I’m not a member of the AMA and have not been since I left medical school. The organization doesn’t represent me or the majority of doctors. I would hope that specialty organizations–which truly advocate for doctors, other health providers and patients–look at the various proposals, participate vigorously in the debate and be courageous enough to endorse some of the painful changes we will all have to make to provide everyone with the health care system we all deserve.

I also have a message to members of Congress: Do not be afraid of the AMA lobbyists knocking on your door. When you shake their hand, it will be sweaty, not from the heat, but from fear that you’ll discover their irrelevance. They’re sheep in wolves’ clothing: While they want to appear to be speaking for a powerful group, they instead represent an ailing organization that is losing members and is refusing to engage in the debate on the future of health care