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Hardball on Health Care?


This morning, the New York Times reported that the American Medical Association had sent the Senate Finance Committee a firm, detailed rejection of the public plan. “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs," their comment read. "The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”

Well, looks like something happened between this morning and this afternoon, because the AMA is backtracking, and quick. It just released a clarifying statement:

"Today's New York Times story creates a false impression about the AMA's position on a public plan option in health care reform legislation. The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates, but the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress. This includes a federally chartered co-op health plan or a level playing field option for all plans."

In other words, it opposes the "strong" plan I outlined here and is open to the "weak" plan. The co-op thing is a red herring. So why the quick turnaround? Hard to say. But that's not a clarification. It's a backtrack. The original statement was not unclear. And it comes amid mounting indications that the key players are beginning to play hardball with the industry. Take this article from Roll Call:

Top aides to Senate Finance Chairman Max Baucus (D-Mont.) called a last-minute, pre-emptive strike on Wednesday with a group of prominent Democratic lobbyists, warning them to advise their clients not to attend a meeting with Senate Republicans set for Thursday.

Russell Sullivan, the top staffer on Finance, and Jon Selib, Baucus’ chief of staff, met with a bloc of more than 20 contract lobbyists, including several former Baucus aides.

“They said, ‘Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,’” said a Democratic lobbyist who attended the meeting.

“Going to the Republican meeting will say, ‘I’m interested in working with Republicans to stop health care reform,’” the lobbyist added.

They're saying that you're either with health reform, or you're against it. And if you're against it, you can't expect to be taken care of in the final legislation. They're not going to save your seat at the table while you're trying to burn down the room. And the AMA, it seems, got the message.

(Photo credit: Brendan Smialowski, Getty Images)

By Ezra Klein  |  June 11, 2009; 3:00 PM ET
Categories:  Health Reform  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: The Left Wakes Up to Financial Regulation
Next: The Difficulties of Bipartisanship



Posted by: jefft1225 | June 11, 2009 3:14 PM | Report abuse

I wonder just how many doctors are actually in favor or against a strong public option.

It is one thing for an organization such as the AMA to follow thru with its stated mission of protecting the doctor's bottom line (vs the patient's) at any cost, but what about the individual practitioners? Are they for or against?

Posted by: JERiv | June 11, 2009 3:51 PM | Report abuse

I'm with you jefft1225. Can we get Harry Reid to drink some of that kool-aid..cause he's softer than wet tissue paper.

Posted by: mrmoogie | June 11, 2009 4:31 PM | Report abuse

Why is the co-op idea a red herring? Isn't Kent Conrad's idea gaining some ground? Did you mean that the AMA wouldn't really support a co-op, they're just plain backtracking?

Posted by: LindaB1 | June 11, 2009 4:37 PM | Report abuse


I have to wonder the same thing.

And the reason I wonder about it is because there are an awful lot of doctors who are having to take write offs of bad debt or refigure what they're charging for certain procedures because people can't pay. That's got to kick their bottom line in the teeth.

And this is actually something I wonder about based on personal experience. I'm a cancer survivor who is filing bankruptcy because of medical bills. My doctors (and the hospitals) have had to either write off the debt or be willing to get paid $10 a month for the rest of my life just to get a portion of their money back.

I can't fathom these doctors/hospitals NOT wanting a public option where they would at least be guaranteed a better payment than what I can make.

Posted by: doxytoo | June 11, 2009 4:42 PM | Report abuse

Anecdotal, but I and a fair number of the physicians I work with took the time today to e-mail or call the AMA to strenuously object to their anti-public-option stance. I both e-mailed and called. It was hard to get through on the phone - lots of tied up lines.

Posted by: pheski | June 11, 2009 4:57 PM | Report abuse

Woohoo! Great news.

This proves the good old AMA ain't what it used to be. There are other competing organizations that represent doctors that are for public option and/or single payor. The AMA doesn't have the big stick it used to (though it is still formidable).

Not to mention the fact that their statement made no sense whatsoever.

LindaB1...the coop is weak because the idea has multiple coops being set up around the country. Sounds good (choice, right?) but it fractures bargaining power. The plan would not be near as competitive as a national option.

Posted by: scott1959 | June 11, 2009 5:21 PM | Report abuse

And that's acceptable conduct? That doesn't sound like the kind of behavior I would expect from our great wise, selfless, benevolent public servants. This is why the number of problems solved in the political sphere should be strictly limited. Politics corrupts and poisons everything it touches. It should not be allowed to touch healthcare. This is a gross abuse of power.

Posted by: fallsmeadjc | June 11, 2009 10:56 PM | Report abuse

@lindab1 Why is the co-op idea a red herring?

Any public plan that does not use the massive economies of scale to bargain for health care discounts in drugs, treatments, and hospitalization will NOT even limit the rising cost of healthcare, let alone drive prices down. Regional coops would not have the size to do this. Small regional coops will also not save on the administrative savings of one national plan with one administrative structure. National public healh insurance now!

Posted by: srw3 | June 12, 2009 12:32 PM | Report abuse

I am a family physician, and a member of the American Medical Association. They do not speak for me. I strongly disagree with their original stance in opposition to the public health insurance option. I am frustrated by their backpedaling in an attempt to be present at the bargaining table when the public insurance plan is shaped, in what presumably will be attempts to water it down to protect physician payments.
Every single primary care physician I know supports the public health insurance plan. Note that I said EVERY SINGLE PRIMARY CARE physician.
The AMA voting structure gives every specialty one vote. Specialists and subspecialists far outnumber the five primary care specialties--family medicine, internal medicine, psychiatry, obstetrics and gynecology and pediatrics. Their financial interest is to get full inflated price for patient care from private insurance companies, while simply refusing to see the uninsured or those on the public programs which pay physicians less.
As a family doctor working in a community health center, I take care of many uninsured or underinsured patients who NEED specialty care. Currently, it is a struggle to access the care they need.
I see the public health insurance option as a way for ALL Americans to have the choice of available, affordable health care. I wholeheartedly support a strong public health insurance option.

Posted by: doctorjones | June 12, 2009 2:26 PM | Report abuse

thank you drjones, for reminding us what doctors actually care about.

It makes sense that at the heart of our health care system are a vast number of highly trained working professionals who are simply decent people, wanting to take care of others. It shouldn't be so hard for us to enable this to happen.

Posted by: wapomadness | June 12, 2009 5:57 PM | Report abuse

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