I'm a joiner.
For years I was a member of two synogogues.
I can't count the pieces of mail I get reminding me pay my dues for any number of environmental and civic organizations.
I never pay museum dues. I just become a member.
Public radio deducts from my checkbook monthly.
And so it's really no surprise that for over twenty years I have been a member of the American Medical Association.
I've never really paid much attention to what they do. I've had a vague sense that they are more focused on the well-being of physicians rather than the well-being of the health care system, but I'm a joiner.
It seemed to make sense, being part of the community of physicians. And it was part of joining our local medical association.
But now I'm gone.
The New York Times today reported that the AMA will oppose creation of a government-sponsored insurance plan, a "public option" to compete with the private insurance industry. The AMA position, conveyed to Congress in a letter to Senator Baucus' Finance Committee argues:
"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. 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."
If private insurers are pushed out of the market, the group said, "the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers."
Which brave new world does the AMA come from where adding a new choice restricts choice?
If Americans vote with their feet and choose a new option, wouldn't that be a demonstration of choice?
If inefficient, poorly competitive insurers were driven from the market by the exercise of patient choice, wouldn't that lower health care costs?
I think, as Don Schlitz wrote and Kenny Rogers sang, "you've got to know when to hold them and know when to fold them." So I am folding.
From here on out I will put my medical affiliations to work where they might do some good:
I'll certainly stick with the Physicians for a National Health Program, 15,000+ (yes, only a fraction of AMA's membership) doctors committed to achieving single payer health finance reform.
I'll stick, for now, with my own specialty group, theAmerican Academy of Family Physicians more than a third the size of the AMA and, if not actively campaigning for single payer reform, at least not (yet) expressing opposition to a public option and fighting for the central role of primary care in any health care reform process.
And I will applaud from the sidelines (as a family physician, I can't join) the work of the American College of Physicians, the organization of internal medicine specialists, nearly half the size of the AMA, whose leadership on universal access has included support of single payer health finance reform.
Goodbye AMA. And good riddance.
I am embarrassed to admit, particularly from the vantage point of the recommended list, that when I called to cancel my membership, I learned I was already no longer a member!! It seems that some time ago, when I renewed my membership in the California Medical Association (a requirement of joining my county Medical Association and a dubious membership in its own regard) I failed to renew as an AMA member. So no dramatic "quitting".....
The point is the same, however. This "professional" organization deserves no support, only our opprobium.
By the way, follow me on Twitter @doctoraaron