American Medical Association Policy and Advocacy

H-165.960 Health Access America Refinements


(11) The AMA should achieve the right to negotiate for physicians program payment and the other conditions in government health entitlement programs, where legislative and/or administrative restrictions are unilaterally applied to physicians' freedom to set their own fees. Any such fee restrictions should be limited to those patients who cannot reasonably afford to pay the difference between the physician fees and government reimbursement levels. In the private sector, where insurance arrangements for thousands of patients are increasingly controlled by single third party payers, physicians should have the ability to negotiate collectively on behalf of their patients and themselves.

(12) Single-payer systems are not in the best interests of the public, physicians or the health care of this nation and should be strenuously resisted. (Check "House of Delegates" and enter "H-165.960")

Comment: It is unfortunate that the leadership of the American Medical Association continues to endorse official AMA policies that protect physicians' income while essentially neglecting the great, unmet, health care needs of the nation. As long as they continue to support grossly deficient policies such as tax credits and medical savings accounts, the AMA will have very limited legitimacy in the process of reforming health care in America.

Should the AMA ever take a strong advocacy role on behalf of physicians? The answer may be, "Yes." I'll explain.

Most of us engaged in compassionate reform activities firmly believe that our abundant health care resources can be allocated much more effectively, resulting in comprehensive, high quality care for everyone. But under our current sick structure, efforts to remove cost restraints for the purpose of embellishing physician wealth can only place additional stresses on our deficient mechanisms of delivering resources for care of the medically underserved. Physicians must advocate for structural reform that will improve resource allocation before they can legitimately advocate for their own financial interests.

Once we have in place an effective system that will assure comprehensive care for everyone, mechanisms of cost containment will be essential. At that time, physicians will need a strong and effective voice in negotiating rates and practice environment. Otherwise, those in control will divert physician resources into other sectors of the budget. Very soon medicine as an occupation would be appealing only to the Mother Teresas of this nation, and, frankly, there simply are not enough individuals that are so dedicated. So it is in the best interests of patients to be certain that physicians are rewarded at a level that will assure that prime candidates will continue to be attracted to the medical work force.

The AMA's position that it should "achieve the right to negotiate (collectively) for physicians" is a proper stance, but not within our current sick system. If the AMA actively participates in bringing about the ethical reforms that will cure the ills of our system, than it will have earned its position as negotiator on behalf of the medical profession.

Don McCanne