Young v. Old Views of Medicine…

June 17, 2009

AMA: Delegates Still Mulling Position on Obama Healthcare Reform Plan

A day after President Barack Obama made his case for support of healthcare reform that would include a public plan option to the American Medical Association, it’s still not clear if the AMA is buying his message.

At issue is a resolution from the Kansas State Medical Society that asked the AMA to “express its opposition to ‘public option’ proposals which could result in the elimination of the private health insurance system.”

Obama would like the government to run a Medicare-like insurance option alongside private plans, all of which would be purchased through an insurance clearinghouse called the “exchange.”

But Republicans in Congress are sharply opposed to the idea, calling it a “government takeover,” that would drive private insurance companies out of business.

Last week, the AMA began to signal its opposition to a public plan and immediately found itself enmeshed in controversy as other organized medicine groups criticized the position.

A day after voicing its objections to a public option, the AMA was forced to issue a second statement — this time rebuking The New York Times for its reporting of the AMA stance.

AMA outgoing president Nancy Nielsen, M.D., Ph.D., said the AMA wouldn’t support a public plan option that requires physician involvement and pays Medicare rates.

As the public plan option was debated in a reference committee on Sunday, AMA members streamed to the “pro,” and “con” microphones in equal numbers.

There was a notable age gap, with the youngest members speaking against the resolution that would place the AMA squarely against Obama’s public plan option, while the AMA’s old guard took the contrarian’s role.

Those who opposed the Kansas resolution said it would send a message of resistance at a time when the AMA should be working with the president.

“It does give the appearance of drawing a line in the sand,” said Jacob Ryan, a member the medical student section.

“We can’t let anyone claim we weren’t part of the solution,” he said.

But another AMA member took a different stance.

“This sends the message that we’re opposed to it, and gives [us] a stronger stand to negotiate,” said Peter Lund, M.D., a urologist from Erie, Pa., who is a member of that state’s delegation.

On both sides, the AMA members said they support a system in which there are multiple insurance options — so much so that the reference committee report characterized the debate this way: “Both sides are vehemently agreeing.”

The delegates will vote on the reference committee report later today or tomorrow.

Although it is always difficult to predict which way the AMA’s diverse house will vote, in general the delegates take their lead from the reference committee, which has recommended a substitute resolution stating that the AMA supports ” ‘public option’ alternatives that are consistent with AMA principles of pluralism, freedom of choice, freedom of practice, and universal access for patients.”

But, in matters of healthcare reform the delegates have often balked at following reference committee resolutions, and another likely scenario would be a return to the original Kansas resolution.

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