3 Things Wrong With the AMA's Support of the President's Healthcare Reform Plan

The president has aggressively marketed the support of certain industry groups such as the pharmaceutical industry, the AMA and the AHA to help sell healthcare reform. He has used their pledges of support, which came in exchange for price protection principally in the Medicare program, in Washington, D.C., and nationally. The AMA, for example, in exchange for possible reimbursement help on the Medicare side, has lent its endorsement to President Obama. Here are three things which are horribly wrong with this support and the marketing of that support.

First, physicians on average receive 20-30 percent or better pay from commercial payors than from Medicare. The AMA has traded its support for reform in exchange for some stability in Medicare rates. However, with healthcare reform will come migration away from commercial patients to Medicare patients. The net loss to physicians has been estimated at 11 billion dollars. The deal at first glance — better Medicare payment for support — looks good. However, when you look at this over a several year period and in its entire likely impact to physicians, it is horrible for physicians.

To add insult to injury, it is widely believed that the president won't be able to deliver to the AMA the reimbursement protections he promised.

Second, the AMA doesn't represent the physician community. At one time, AMA membership and the AMA really was the heart and soul of doctor representation. Today, the AMA represents just 15-17 percent of physicians. Despite the fact that it only represents a small percentage of overall physicians, the AMA has provided the president with an endorsement which he can use over and over again. He in effect says, "hey if the doctors support it, it cannot be bad, can it?"

Third, there is nothing worse for a physician to be in a market where there is Medicare and just one other dominant payor. It means physicians have almost no contract leverage. Between a growing public option and Medicare, physicians will have very little negotiating power if any.

Ultimately, the lack of physician strength and the lack of a thriving healthcare sector will lead to the dumbing down of the American healthcare system. It is mind boggling and shortsighted to watch the AMA lend its support to the demise of the American healthcare system.

The AMA unfortunately has simple-minded and weak leadership at a time when it needs great leadership most.

See Tuesday's Becker's ASC Review E-weekly for more perspectives on healthcare reform.

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