If you think Obamacare is bad for consumers and patients think about this: how would you like to spend between twelve and sixteen years of your life in grueling and expensive academic training, only to have politicians and bureaucrats dictating to you years later how you will practice your craft and how much money you’ll be allowed to earn?
Let’s be clear about medical doctors. Any individual who can genuinely earn the title “M.D.” is worthy of significant respect, and one would hope that an entire association of M.D.’s would be equally as worthy. Unfortunately the American Medical Association – the professional group that has purported to represent physicians in the U.S. for over a century - managed to foolishly get itself caught in the crossfire of the “Obamacare” war over the past few years. Now, MD’s – both those few who remain members of the AMA and the majority of physicians who are not members – as well as the practice of medicine itself, are all set to be big losers in the coming months and years.
According to their website, the association’s stated mission is “to promote the art and science of medicine for the betterment of the public health; to advance the interests of physicians and their patients; to promote public health; to lobby for legislation favorable to physicians and patients; and to raise money for medical education.” It is also noteworthy that the group originally opposed Medicare, the U.S. federal government’s program that provides healthcare reimbursements for elderly and disabled persons, fearing that “undue government intrusion” in the medical profession would damage the doctor-patient relationship and be detrimental to the profession itself.
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But soon after Medicare’s beginnings in 1965, the A.M.A. changed their position. The association’s members and leadership both realized that government-funded health care through Medicare produced a steady stream of patients and more guaranteed reimbursements for services – in short Medicare in its early days guaranteed wages for MD’s. Thus for all of my lifetime, the A.M.A. has aggressively lobbied the U.S. Congress against cuts in Medicare funding as they have periodically been proposed.
Over the years the A.M.A. has also supported tight government limits on medical school entries – likely because doing so limited the “supply” of new M.D.’s, drove up the demand for existing MD’s, and thereby enhanced the wages of those who actually managed to get in to the profession. On this point the late Economist Milton Freidman once noted that the A.M.A. had become a “guild,” and was shielding its present-day members from the potential competition of future would-be Doctors.
Yet after decades of love and appreciation for the ways in which big government can shelter you from market competition and put money in your pocket, and with its membership dramatically in decline, the A.M.A. changed its public policy stance in mid-2009. After only a few months of President Obama in the White House, it was at that time that the association reverted back to being skeptical of government power, and publicly opposed President Obama’s healthcare “reforms”.
The federal government had at that point been exhibiting a years-long pattern of dictating to physicians how much they would be paid for specific procedures (rather than allowing doctors to set their own rates for services), and A.M.A. membership had begun to dwindle party as a result of this loss. The association thus surmised that Obamacare would give the government even more power to determine how much doctors could be paid, and told the President “no” regarding his early legislative efforts.
But months later the A.M.A. changed their minds again. Facing pressure from both the White House, and President Obama’s “Organizing for America” community organizer group, the A.M.A. hedged a bit back in 2010 and sheepishly agreed to Obama’s reforms “in principle.” This caused even more member physicians to leave the association, even as the President portrayed it as a “courageous” move.
But wait, there’s more! In June of 2012, less than four months before the presidential election, the A.M.A. changed its collective minds yet again, when the association’s President Dr. Peter Carmel announced their “official” renewed opposition to Obamacare. At the association’s annual summer convention, Carmel declared what many of us had been concerned about for quite some time; that placing more government bureaucrats and lawyers between a patient and a physician, Obamacare would make healthcare more expensive and less rewarding for all involved. Further, Carmel noted that President Obama’s law does not address the dwindling of Medicare reimbursements to M.D.’s, nor does it address the ever-escalating threat of medical malpractice lawsuits, a major source of healthcare cost increases.
And now here we are, a little more than a year after the A.M.A. “officially” decided that Obamcare was a bad deal, and we’re all experiencing the anguish of the federal take-over of the medical profession. The otherwise honorable and essential work of high educated physicians will be gradually replaced with less educated and less costly nurses and “P.A.’s” (physician’s assistants); existing physicians will have their reimbursement rates further reduced; veteran doctors are already leaving the profession or abandoning their small private practices to find a job at larger hospitals and corporately owned facilities; and some physicians are fighting to continue practicing their craft entirely apart from any involvement with insurance companies (check out the website Iwantdirectcare.com for evidence of healthcare without insurance).
President Thomas Jefferson once famously said that “a government big enough to give you everything you want, is a government big enough to take away everything that you have." The A.M.A.’s flirtation with the guarantee of patients via Medicare, and the present-day derailing of the medical profession via Obamacare, illustrates Jefferson’s wisdom quite vividly.
The A.M.A.’s foolishness demonstrates the destructive combination of being high trained in one’s profession, yet not comprehending the most basic facets of government, economics, and public policy.
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