It’s a “there you go again” moment for the American Medical Association.
We learn from CNN’s Elizabeth Cohen’s twitter page that the biggest standing ovation given to Obama by the AMA House of Delegates was in response to this line:
“You did not enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers – and that’s what our health care system should let you be.” (Here is the entire text of the president's speech.)
It is ironic that this sentiment in particular moved the AMA so, considering that the organization’s actions at the meeting so far indicate that bean counting—that is, counting their hard-earned money—is exactly why these doctors entered the profession.
First, they announced that they would not support an optional public insurance plan, because it might mean less money for doctors (though they appear now to be trying to recant that statement). They are basing their opposition on figures showing that Medicare pays doctors 20% less than private health plans, and therefore an expanded Medicare-like public insurance program might mean less money in their bank accounts.
A pay cut? Outrageous!
Here’s a news flash: all the players in the health care industry—doctors, hospitals, and insurance companies—are going to have to accept pay cuts if we want to bring health care spending under control. The AMA’s posture of knee-jerk opposition to anything that smacks of financial sacrifice gives it the look and feel of a reactionary organization, which is how they looked when they hired Ronald Reagan for "operation coffee cup" in its ill-fated effort to defeat Medicare in 1965.
Second, the AMA, yet again, has decided that its own ethics committee just doesn't understand medical ethics, at least when it comes to the topic of industry funding of continuing medical education. This is an issue I have covered here and here. One year ago, the first time the AMA read CEJA's report on CME (CEJA being the Council on Ethical and Judicial Affairs), the delegates rejected it because it announced the bad financial news that industry funding of education for doctors represents an unresolvable conflict of interest and therefore has to go.
Now, a year later, a new CEJA, under a new chair, introduced a new report, this time saying that industry funding of CME can continue, but it is still “ethically preferable” for doctors to pay for their own education. Apparently even this watered down version of medical ethics is unacceptable to the AMA, because defining industry-free CME as "preferable" might slow down the flow of industry cash, so they rejected it, referring it back to CEJA for more extreme dilutions. You can read the particulars on the Policy and Medicine blog.
Presumably, the next report will not dare to even mention ethics and industry funding in the same breath. I predict that the entire report will be brief and to the point: “Industry funding of CME is necessary for the public health.” Now that’s the kind of sentiment any bean-counting doctor can get behind!