This morning's big health care news could make President Obama's Monday address to the AMA interesting:
As the health care debate heats up, the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.
The opposition, which comes as Mr. Obama prepares to address the powerful doctors’ group on Monday in Chicago, could be a major hurdle for advocates of a public insurance plan. The A.M.A., with about 250,000 members, is America’s largest physician organization.
While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be "provided through private markets, as they are currently." It is now reacting, for the first time, to specific legislative proposals being drafted by Congress.
Or will it? Possibly because of that looming appearance by the very popular president before their ranks, they're stepping back from the Times story with this 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. The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians."
Is this a real reversal on their part? I'm not holding my breath that they'll do anything but obstruct. The AMA has fought every public health plan since FDR tried to get it as part of Social Security in 1935 and again when Truman tried to enact it beginning in 1945. They've been fighting against Medicare and any expansion of it since it's inception.
Which has all been rather short-sighted of them. At Think Progress's Wonk Room, Igor Volsky makes the case for why the AMA should support a public option: a public option is not only going to have to compete for subscribers, but for physicians, too.
Indeed, if public plans institute rock bottom rates that aren’t accepted by health care providers, "Americans having a choice of private plans alongside the public plan would not opt for the latter, which would then either whither away or have to raise fees until it is competitive in the market for enrollees."
To attract medical providers, the public plan would have to deliver timely, adequate, and efficient payments. As CAPAF Senior Fellow Peter Harbage recently pointed out, "if providers were sure that the public health insurance plan would make timely adequate payments absent the paperwork gimmicks (such as pre-authorization) used by insurers today," they would likely participate in the program.
Currently, "physician practices report that overall the costs of interacting with insurance plans is $31 billion annually and 6.9 percent of all U.S. expenditures for physician and clinical services." Approximately "one-third of the average primary care physician’s compensation is spent on physician practice-health plan interaction":
A robust public option would very likely make life much easier for physicians, who should spending their time in practice actually, you know, taking care of patients, instead of filling out insurance forms. Office overhead could be reduced significantly. But somehow, in the AMA's mind, this is all a threat to their professional autonomy.
Thankfully, not all physicians are on board with the AMA, either individually (as doctoraaron testifies) or in their trade associations. The American Academy of Pediatrics, the American Academy of Family Physicians, Physicians for Reproductive Choice and Health, the National Physician Alliance, and the Community of Interns and Residents/SEIU Healthcare are all part of the HCAN coalition.