American Medical Association Backs House Healthcare Bill

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17 July 2009 :: J.E. Robertson

The American Medical Association (AMA), long a leading opponent of major national healthcare reforms, has now backed the House of Representatives’ HR 3200, known as America’s Affordable Health Choices Act of 2009. The AMA president J. James Rohack, MD, affirmed the group’s support for the House measure, writing “This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform”.

He added: “We urge the House committees of jurisdiction to pass the bill for consideration by the full House.” Rohack even adopted the president’s customary language regarding comprehensive healthcare reform, saying “The status quo is unacceptable”. The AMA president noted that HR 3200 is just one step in a long process and said the AMA would be committed to working with Congress to achieve reform this year.

The AMA also listed a number of key points of reform it supports as necessary to achieving the goal of “quality, affordable health care” for all Americans:

• Coverage to all Americans through health insurance market reforms
• A choice of plans through a health insurance exchange
• An end to coverage denials based on pre-existing conditions
• Fundamental Medicare reform, including repeal of the flawed sustainable growth rate (SGR) formula
• Additional funding for primary care services, without reductions on specialty care
• Individual responsibility for health insurance, including premium assistance to those who need it
• Prevention and wellness initiatives to help keep Americans healthy
• Initiatives to address physician workforce concerns

The “quality, affordable” is more language the AMA is borrowing directly from Pres. Obama’s rhetoric on healthcare, suggesting interests are beginning to line up. Rohack also said of the AMA: “We are committed to passing health reform this year consistent with principles of pluralism, freedom of choice, freedom of practice, and universal access for patients.”

Just a month ago, the Huffington Post ran an article with the headline “American Medical Association Trying to Torpedo Health Care Reform Again“. The article noted the AMA’s declared opposition to any “public option” for health insurance. Representing doctors, the AMA has always been wary of “socialized medicine”, national systems in which doctors and patients alike have less freedom of choice, but no such program has been proposed.

The AMA’s new support for the House measure, which includes a “public option” for insurance, suggests a reversal on that pledge, perhaps after Obama and top Democrats explained that the public option is simply a low-cost high-coverage insurance option, to compete with standard private-sector options in an effort to improve the focus on consumers, in the marketplace.

According to that Huffington Post report:

“The AMA used [the phrase "socialized medicine"] to mean any kind of proposal that involved an increased role for the government in the health care system,” Jonathan Oberlander, a professor of health policy at the University of North Carolina, told NPR in a 2007 interview. “They also used it to mean things in the private system that they didn’t like. So, at one point, HMOs were a form of socialized medicine.”

The Obama administration has been persistent in explaining that the “public option” is just consumer-financed health insurance and would not involve government making choices about care for patients. That may have gone a long way to persuading the leading doctors’ organization to support the Democratic bill in the House.

Dr. Michael Maves, executive VP and CEO of the AMA, wrote in a letter to Rep. Charles Rangel (D-NY), Chairman of the House Ways and Means committee:

We pledge to work with the House committees and leadership to build support for passage of health reform legislation to expand access to high quality, affordable health care for all Americans.

Again, the echo of language used by Obama is clear, and the AMA’s support for the House measure appears solid. Whether there will be an effort by AMA lobbyists to “water down” or eliminate the public insurance option is not clear, but the White House has been firm in stating its determination that no such major provisions integral to “comprehensive reform” be removed or diluted.

The DailyKos blog has compiled a number of press quotes it says shows the AMA endorsement had bolstered the case for Pres. Obama getting the kind of healthcare reform legislation he’s been asking for. The AP, for instance, suggested Obama’s speech to the AMA in June changed hearts and minds:

A personal appeal from Obama at the Chicago meeting won over some doctors and the group’s policy-making delegates ended up adopting a measure signaling openness to reform that includes a public option. Obama said in a Thursday statement he was “grateful that the doctors of the AMA have chosen to support” the health insurance reform.

The American Spectator writes:

The AMA has just thrown its weight behind the most liberal health care legislation that could conceivably pass into law, and so Democrats will now be able to say that it has the backing of the nation’s largest group of physicians, and argue that it can’t really be that radical.

While the House plan is not actually the “most liberal” healthcare plan conceivable, it may be the most liberal “that could conceivably pass into law”. Either way, the AMA does lend a significant amount of support to Pres. Obama’s persistent claims that he is seeking a pragmatic solution to an unacceptable situation.