Doctors cautiously signal they'll work with Obama

The American Medical Association voted yesterday to support "health reform alternatives that are consistent with AMA principles," although the group fell short of specifically supporting a public plan, the Associated Press reports.

"While the Obama administration would have preferred a strong endorsement, the vote by American Medical Association doctors is a victory of sorts for the White House and the group will continue to be a player in the health care reform efforts." The AMA, considered a "conservative bunch," represents "about one-fourth of the nation's physicians."

"The group acted Wednesday in its typically cautious fashion on the health care reform effort, heeding concerns of its most conservative members while indicating it wants to be a team player and work with Obama. But critics say it missed a chance to go bolder and signal clear support for the public plan concept." Dr. Nancy Neilsen, immediate past president of the AMA, "said the new language could include a public plan, but that it doesn't commit the AMA to endorsing any or all public options." Some AMA members "likened the (public plan) concept to communism, putting government in charge of health care and forcing doctors and patients into plans. Some said it would only lead to a single-payer system that the AMA has long opposed. And others who think doctors aren't paid enough under two existing public programs, Medicare and Medicaid, worried a new public plan would be no better"  (Tanner, 6/17).

Reuters adds that "The AMA said it will weigh in on proposals for a public, government-run insurance option, government-subsidized insurance cooperatives or insurance exchanges, in an attempt to ferret out and foil 'unintended consequences,'" according to Dr. Nielsen (Stern, 6/17).

The Chicago Tribune reports that "The AMA's 543-member policymaking body stripped 'public option' from an earlier resolution, but doctors endorsed a plan to cover the uninsured by supporting 'health system reform alternatives'" (Japsen, 6/18).

BusinessWeek writes that Obama's attempt to win over the AMA is part of a "divide-and-conquer strategy" designed to "take advantage of the expanding economic rift between primary-care physicians - a group generally open to reform - and highly paid specialists who thrive in the current fee-for-service culture of U.S. medicine." The AMA is dominated by highly-paid specialists including surgeons and cardiologists, rather than lower-paid primary-care doctors, who tend to be more supportive of national health insurance. Doctors "just might" find it in their "best economic interest to work with the Obama Administration rather than to go into attack mode" because of "a rare division of interests within the medical profession and a popular president relentlessly pursuing an overhaul of health care" (Arnst, 6/17).