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The American Medicalcareisforrichpeople Association Secret Magic Decoder Ring

The AMA has come out in favor of voucherizing Medicare.

AMA's Council on Medical Sacrifice Service:

The Council recommends that the AMA support transitioning Medicare to a defined contribution program that would enable beneficiaries to purchase coverage of their choice through a Medicare exchange of competing health insurance plans.

Don McCanne, of PNHP:

I hate to say it, but there does seem to be a more nefarious agenda than that dictated by their political ideology. This may sound like an oversimplification, but I don't think it is: they want patients to pay their full fees in cash. They do not want an intermediary to control fees or to establish any other rules on how their services are to be reimbursed.

The Council on Medical Sacrifice Service goes on to say:

In addition to supporting transitioning Medicare to a defined contribution program, the AMA should continue to strongly advocate for related Medicare reforms. Policies related to balance billing, private contracting, and the repeal of the Medicare Independent Payment Advisory Board remain particularly relevant and should be reaffirmed. Similarly, the AMA should continue to support incentives to encourage people to contribute to health savings accounts, and to promote their use as a means to ensure access to high quality medical care. It is also critical that the AMA continue to advocate for the other Medicare reforms articulated in Policy H-330.896, particularly restructuring beneficiary cost-sharing in order to provide incentives for appropriate utilization while discouraging unnecessary or inappropriate care, and increasing the Medicare eligibility age to reflect increases in the average life expectancy in the United States.

With the Secret Magic Decoder Ring:

Defined contribution shifts more of the responsibility for health care spending to the patients' pockets. Balance billing allows physicians to collect directly from the patient the balance of their full fees regardless of what any intermediary authorizes. Private contracting allows the physician to contract directly with the patient for full fees, again with no third party intervention. Health savings accounts are cash accounts which the physicians can tap directly. "Restructuring beneficiary cost-sharing in order to provide incentives for appropriate utilization" is code language for requiring patients to pay more in cash for any care they receive. Increasing Medicare eligibility age is a scheme to postpone the day that their patients become eligible for a public program that limits cash payments from patients. And there is much to be said about the Medicare Independent Payment Advisory Board (IPAB), good and bad, but the AMA fears this most of all since it would place control of their fees in the hands of an independent government board. (Much more needs to be said about IPAB, but not here.)

The good news is that nowadays only 15% of doctors hate you:

In the early 1950s, about 75% of US physicians were AMA members. That percentage has steadily decreased over the years. In June, at the annual meeting of its policy-making body, the House of Delegates, the AMA announced that it lost another 12 000 members last year.

That brings total membership below 216 000. Up to a third of those members don’t pay the full $420 annual dues, including medical students and residents. Not counting those members, somewhere in the neighbourhood of 15% of practising US doctors now belong to the AMA.

The bad news is that that 15% really does hate you:

The AMA congratulates President Obama on winning re-election as the President of the United States... As the nation's largest and most influential physician organization, the AMA is eager to continue working with elected leaders on both sides of the aisle to accelerate bold innovation....

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Rangoon78's picture
Submitted by Rangoon78 on

“Resolved, That the American Medical Association declares its opposition to the Institution of any scheme embodying a system of compulsory contributory insurance against illness, or any other scheme, which provides for medical service to be rendered contributors or others, provided, controlled or regulated by any State or the Federal Government.” (HOD Proceedings, April 26-30, 1920: 37)

Indeed, the position of the AMA House of Delegates reflected the prevailing national sentiment; by 1920, the American Association for Labor Legislation had admitted defeat. The AMA maintained its position on compulsory government-sponsored health insurance for decades to come, weighing in against such proposals as the President Truman-backed Wagner-Murray-Dingell bill* (S. 1606), which would have established a compulsory national health insurance program financed under Social Security (the bill was defeated in Congress on numerous occasions).

Source: http://www.ama-assn.org/resources/doc/et...

*Wagner-Murray-Dingell Bill | Cry Wolf Project

This bill would have instituted a national medical and hospitalization fund, which both workers and their employers would contribute to (much the same as Social Security). Almost everything was covered except dental care and drugs.

'Would socialized medicine lead to socialization of other phases of American life? Lenin thought so. He declared: 'Socialized medicine is the keystone to the arch of the Socialist state.'

-AMA pamphlet (Your Medical Program…Compulsory-or Voluntary?) from the AMA’s public relations campaign against health care reform. 1949.
01/01/1949 | Full Details | Law(s): Wagner-Murray-Dingell Bill
'A Government agency proposes to: Collect the tax. Control the money. Set the rules. Determine the services. Direct doctor and patient participation. Dominate every citizen’s medical affairs.'

-AMA pamphlet (Your Medical Program…Compulsory-or Voluntary?) from the AMA’s public relations campaign against health care reform. 1949.
01/01/1949 | Full Details | Law(s): Wagner-Murray-Dingell Bill
http://crywolfproject.org/taxonomy/term/300

Submitted by hipparchia on

but i do like the sound of this: 'Would socialized medicine lead to socialization of other phases of American life? Lenin thought so. He declared: 'Socialized medicine is the keystone to the arch of the Socialist state.' (up to a point)

hard to argue with success: free health care (uk, sweden, spain, etc, socialized medicine!), free education through college (france, california until the right wing took over), free childcare, ...

i did not know about the cry wolf project. thanks for that!

Submitted by hipparchia on

well, it does seem to be "in progress", sorta, since it has been steadily shrinking in size for years and years (that's a good thing), but it still has an outsize influence in healthcarepolicyworld (that's a bad thing). gotta wonder, if it keeps on shrinking, would the last person standing still be regarded as The Voice of all physicians?

i'm all for applying a little marginalization from the outside too. :)

NWLuna's picture
Submitted by NWLuna on

is that the MSM still think it represents most of physicians, instead of that small minority of 15%. It is a good bellwether -- if the AMA is for something, it's probably a bad idea.

The AMA should stick to concierge medicine for the 1%.

Submitted by hipparchia on

The AMA should stick to concierge medicine for the 1%.

15% of the doctors caring for 1% of the population, i can see a recipe for disaster in that. otoh, it would be nice if instituting socialized medicine or medicare for all encouraged a lot of these particular doctors to retire early.

Submitted by chadwick newsome on

...to the poorest and sickest...

This mirrors the rich person's (and their employee, Obama's) perspective on social security. Turn Social Security into a stump of its former self by harshly means testing it so only the poorest of households will be eligible. That'll save social security. By destroying it. (The tag end of the tag end of the program can always be elininated later, as poor people have no power and no advocates who do have power.)

athena1's picture
Submitted by athena1 on

And you have to basically be unemployed to get on Medicaid.

Submitted by hipparchia on

where is charles dickens when we need him? yep, the plutocracy is busily trying to turn the world [not just the u.s.] into a rerun of dickens' england.

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