Some Docs Upset at AMA's Public Plan Stance

Cheryl Clark, for HealthLeaders Media , June 16, 2009

When David Priver, MD, once an American Medical Association delegate, read last week that the group opposed President Barack Obama's public insurance plan option for adults under age 65, he blasted an angry e-mail to his colleagues:

". . . If nothing is done to reverse this ill-advised AMA policy, we can expect (AMA) membership to drop like a stone," wrote the San Diego obstetrician-gynecologist.

Even when learning the AMA backed off from that stance the next day, clarifying that it merely opposed any plan that forces physicians to participate or which pays Medicare rates which are too low, Priver was not appeased.

"Why make a statement like that and backtrack a day later?" Priver rhetorically asked in an interview Monday, saying he thought the move was disingenuous. "I think they really shot themselves in the foot this time."

For many physicians across the country, the AMA's initial stance severed any allegiance doctors have for the nation's largest and most powerful physicians group.

"The AMA has badly misread the sentiments of not only its members, but of physicians across the country," says Priver, former president of the San Diego County Medical Society and delegate to the California Medical Association. "Most of us don't want to be seen as obstructionists for reform. And the AMA, if they did a better job of keeping in touch with the grassroots, would have known that," Priver says.

Priver joins an increasingly vocal group of doctors who say they are defecting from the AMA.

In an article last week entitled "Dear AMA, I Quit!" in the Huffington Post, a Maryland physician said he was "disgusted" that the organization seems pre-occupied with physician reimbursement at the expense of patient care. Instead of working for patients, it seems to be "supporting the private insurance industry, which has been a driving force in creating the dysfunction(al) health care system we have today," wrote Chris McCoy, MD.

McCoy said he was reacting not just to the Thursday article in the New York Times, but also to the AMA's 12 pages of comments on health reform submitted May 11 to the Senate Finance Committee. Such a plan "threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70% of Americans," the AMA wrote.

"A crowd-out of private insurers and the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers," according to the AMA.

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