Obama's visit to AMA paying dividends

[andym]

http://www.chicagotribune.com/business/chi-ama-obama-jun16,0,3566595.story

AMA offers its take on health-care reform

A day after President Barack Obama sought doctor support for his health-reform plan, the American Medical Association is preparing to meet him at the bargaining table in support of some form of publicly funded option.

Exactly what the publicly funded option will be is expected to be ironed out in the weeks and months to come by members of Congress and the White House. But a key sticking point had been whether the politically powerful AMA would agree to support an option to cover the more than 46 million uninsured Americans funded by the government.

The AMA's policy-making House of Delegates will vote later Tuesday or Wednesday morning on a resolution that supports "public option alternatives." The resolution is in sharp contrast to an earlier resolution floated by some delegates that opposed a public option such as an expansion of the Medicare health insurance program for the elderly, saying it "could result in the elimination of the private insurance system."

The new resolution, disclosed by the AMA this morning, indicates a public option "could take many forms and would not necessarily have to be designed in a way that would undermine coverage." AMA leaders have voiced support for a system run by private insurance companies funded by the government such as the health insurance provided for U.S. government workers and members of Congress.....
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Don't underestimate the importance of this. AMA opposition was significant in defeating the Clinton universal health care. More importantly, very early attempts (such as that by President Truman) at universal health care were defeated more because of AMA concerns than insurance industry concerns (thre health insurance industry was much weaker before 1970)


BTW, the idea of private insurers funded by the government could be the basis for a good system, IF it it set up in a way, for example, similar to the French system (WHO #1 rated, but a kind of multipayer system) which prevents the 30% overhead of the insurance companies.

[FrenchieCat]

1. His speech was excellent,

and thoughtful.

[high density]

2. Great, sounds like an even more direct way to rip people off

Instead of ripping off fellow corporations and the employees of the corporations, why not just suckle onto the teat of the Feds? Wonderful idea!! This worked out great for funding mortgages.

[andym]

4. Not necessarily, it depends on the regulations that govern the payments.

Here's how the French set up their system which is considered superior (by the WHO) to Canada's single payer system-- with far fewer problems (long waits etc) and very cost effective too.

From http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/11/frances_model_healthcare_system/

National health insurance in France stands upon two grand historical bargains -- the first with doctors and a second with insurers.

Doctors only agreed to participate in compulsory health insurance if the law protected a patient's choice of practitioner and guaranteed physicians' control over medical decision-making. Given their current frustrations, America's doctors might finally be convinced to throw their support behind universal health insurance if it protected their professional judgment and created a sane system of billing and reimbursement.

French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new healthcare funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

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But note that everyone in France gets good basic care.

[high density]

5. But does that solve the core problem?

My problem with AMA's idea is that it sounds like we get more money and throw it into the current system, while ignoring the fact that this system is broken and too costly. Was France dealing with such widespread inefficiency when it set up their program? The entire private US health insurance/care system seems to be so wasteful and dishonest that I am leery of these ideas that seek to have Freddie Mac-like corporations dependent on government payments. I don't see how companies like United Healthcare will become model corporate citizens and insurers simply because the cash flow begins coming directly from the government. If anything it seems like a recipe for getting ripped off even more.

[andym]

7. The French system uses govtnegotiated rates (like Medicare)-- something like that would be necessary

The French system creates negotiated rates (like Medicare) with providers -- something like that would be necessary here too. By creating negotiated rates, costs can be held down and by mandating everyone must be included, everyone is included.

Private insurers would have to make profits by providing extras (as they do there).

Here is an depth critique of the French system and its relevance to the US.
http://www.ajph.org/cgi/reprint/93/1/31.pdf

[invictus]

6. The lobbyists will make sure those regulations are ineffective. Just like Wall Street lobbyists did.

nt

[andym]

8. That's what we are here: to oppose corporate lobbyists by actively lobbying Congress ourselves! nt.

[avaistheone1]

3. I understand the AMA has been overwhelmed with calls from the public

expressing their disappointment with AMA initial pronouncements that the AMA is against a public plan.
Within 24 hours of their initial statement, the AMA has somewhat softened their position on a public health plan.

Some progress, but hardly enough.

[andym]

9. Perhaps more calls are needed then. nt.

[grantcart]

10. creating a wedge between the AMA and the insurance industry is the key

He played it very well.


If the AMA gets on board the insurance industry will be very isolated.

[andym]

11. Yes, good strategy. If the AMA is even remotely on board=increased chances for significant reform

The AMA has been one of the strongest opponents of universal healthcare.

From The civil rights legacy of Harry S. Truman By Raymond H. Geselbracht
http://books.google.com/books?id=rQbwPWTu4QMC&pg=PA132&dq=truman+universal+health+care+ama

Socialized medicine means that all doctors work as employees of government. The American people want no such system. No
such system is here proposed.“ And so began President Truman’s fight to accomplish something that continues to elude America and its political, medical, and business leadership—the enactment of a plan for comprehensive health insurance for all Americans. Truman was a stubborn and tenacious man. The election of a Republican Congress in 1946 was a setback for much of his agenda, and particularly for universal health care. Senator Robert Taft in particular became a strong opponent of Truman’s proposal. But in typical Truman fashion, he did not give up. He kept coming at the Congress and he made universal health
insurance a key issue in the 1948 presidential campaign. That election returned him to office, and also returned Congress to Democratic control.

It was not just congressional Republicans who fought Truman`s health care program. The nation’s physicians, represented by the
AMA, opposed Truman and made his health plan the focus of one of the most skillful and well-financed lobbying and public relations efforts that has ever been launched against a presidential initiative. The word went out to doctors across the nation that “the final showdown on collectivist issue" had begun. “Do not underestimate the crisis. If you are willing to fight for personal freedom and professional independence, send us emergency contribution...to make possible maximum nationwide efforts.”“ The AMA said that President Truman’s legislation was more socialistic than any medical program in any country, except maybe the Soviet Union, and would turn doctors into clock-watchers and slaves. I remember the AMA-sponsored pamphlets in my father’s office on Huntington Avenue in Boston with titles such as Showdown on Political Medicine. Such alarmist literature was in offices like his all across the country, and doctors were urged to give them out to every single one of their patients. Along the way, unfortunately, the AMA picked up a lot of allies. The American Hospital Association, the American Bar Association, the Protestant and Catholic Hospital Associations, editorial writers for the nation’s newspapers, and scores of others weighed in against the plan. Even after Truman’s stunning victory in 1948, the assault continued.