The New York Times is
reporting that the American Medical Association will be lobbying Congress to oppose a public health insurance program, an integral part of health reform. In an attempt at damage control, the AMA has responded with a statement declaring it would support a public option if it operates like a
for-profit insurance agency. In effect, the AMA still opposes reform. As Igor Volsky
details the various reasons why the member physicians of the AMA should support a public health insurance program, it is important to consider that the AMA as an institution is not a neutral player simply representing doctors. Started in the mid 19th century as an accrediting organization, the AMA has morphed into a behemoth lobbying and member services entity that is deeply entwined with the for-profit health industry.
In the past century, the growth of AMA has been not only funded by health industry lobbies such as drug makers, but this relationship has tailored AMA’s anti-reform policy agenda. In reading the
Huffington Post and the
New America Foundation articles revealing AMA’s opposition to health reform during the New Deal, its efforts to block the passage of Medicare, and the AMA’s critical role in defeating health reform in 1993, questions arise over why the AMA has historically opposed any initiative to take health care out of the hands of the for-profit health industry.
In the first 50 years after its
inception, the AMA struggled to fill its coffers. Because member dues were deemed insufficient to fund its various activities, the AMA eventually decided to sell advertising space for its medical journal JAMA to drug companies. Expanding on this business model, AMA President George Simmons decided to create the “
AMA seal-of-approval” for favored drugs in 1899, resulting in a five-fold increase in advertising revenue by 1909. Simmons, it turned out, had no credible medical credentials and the AMA did no drug testing for the products given the seal-of-approval.
Simmons was later driven out of the AMA, but his model for extracting fees for branding medical practices and products persisted. Simmons’ focus on molding public opinion also became one of the greatest weapons of the AMA - his “
Propaganda Department” would soon expand to communicate the AMA’s views through a column syndicated published in over 200 newspapers, a weekly radio program, and various books about how homeopathic practices and non-AMA approved drugs were “
quackery.”
Through the 1930s to 1950s during the tenure of AMA President Morris Fishbein, the tobacco industry leaned on the AMA to substantiate its dubious health claims. Beginning in 1933, JAMA published tobacco advertisements, stating that it had done so only “after careful consideration of the extent to which cigarettes were used by
physicians in practice.” The tobacco industry became the AMA’s largest advertiser, and its implicit endorsement of tobacco products allowed companies like Camel to proclaim slogans such as, “More doctors smoke Camels than any other cigarette.”
moreSam Stein
Just days before President Barack Obama is set to address the American Medical Association to pitch its members on his vision for health care reform, the 250,000-member physician group announced it would oppose a major component of that effort.
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Politically, the revelation could be a potentially significant blow to progressive health care reform advocates, who contend that a public option is the best way to reduce costs and increase insurance coverage. AMA has the institutional resources and the prestige to impact debates in the halls of Congress.
Historically and philosophically, however, AMA's opposition is hardly newsworthy. Despite a lofty reputation and purported commitment to universal coverage, AMA has fought almost every major effort at health care reform of the past 70 years. The group's reputation on this matter is so notorious that historians pinpoint it with creating the ominous sounding phrase "socialized medicine" in the early decades of the 1900s.
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Indeed, the role played by AMA throughout health care reform battles past has often been primarily as the defender of the status quo. In 1935, fears of an AMA backlash
helped persuade Franklin Roosevelt's advisers to drop a health care article from the Social Security package -- fearful that the opposition would sink the legislation altogether.
Concerned about government restriction on and oversight over surgical activities -- not to mention the loss of physician income -- the group deployed the "socialized medicine" argument to undermine Harry Truman's effort at a national health care system years later.
In 1961, AMA organized a campaign to block Medicare. Titled "Operation Coffeecup," the effort insisted that the government-sponsored system would lead to a varying form of totalitarianism. For a spokesman, the group turned to Ronald Reagan, who lent his famous actor's voice to a 10-minute plus recording.
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