"You entered this profession to be healers," Obama said, "and that’s what our health care system should let you be."
They were stirring words. And yet the audience remain decidedly unstirred. They reacted not as high-minded champions of health and the public interest, but like any other interest group, focused entirely on their narrow economic interests. Fixing malpractice. Ending the annually scheduled reduction in Medicare payments. And even then, the approval was qualified. Once Obama made clear he didn't want to cap malpractice awards, as the AMA has long desired and Republicans usually promise, the clapping stopped. A few people actually booed.
I suppose this isn't surprising. Among other things, the AMA represents an ever-shrinking portion of the physician population. And, by all appearances, it represents the profession at both its most craven and conservative. Remember, this is the organization that funded pro-tobacco candidates even as its top public health priority was to reduce smoking. And, remember, this is the orgnaization that in 1995 endorsed Newt Gingrich's plan to savage Medicare by, among other things, forcing beneficiaries to pay more for their care. What convinced the AMA to make this deal? Chiefly, it was Gingrich's agreement to strike a provision that would have cut physician fees.
Of course, not all physicians agreed with the AMA back then. The American College of Physicians, a more liberal group, protested the cuts because of what it would mean for the elderly. And the same is true today. Smaller, more liberal physician groups are lining up behind reform. They want malpractice relief and a Medicare fix, too. But they also want what's best for their patients--and their country. They want to help construct a deal, one that works for everybody.
[...]Physicians say they have a higher obligation than other professions, that they are healers and not just tradesmen looking to make a buck. And many really believe that, I know. Now is the time to show it.
It sure is. Doctors are key to this, both because their patients will be asking about them about it and because they are one of the few popular players who can wield some real clout in the political debate.
It was good for Obama to fully lay out his principles and outline for reform in detail in front of the AMA. I just hope he isn't expecting anything from them and is looking for allies among doctors elsewhere. The AMA has stood in the way of every health care reform ever contemplated and they aren't likely to change now.
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