American Medical Association Reconsiders Obamacare Mandate
June 16, 2011
RUSH: The AMA: "AMA to Reconsider Support of Health Insurance Requirement -- Faction contends key tenet of overhaul legislation is 'a matter of individual responsibility to be encouraged by the use of tax incentives and other noncompulsory measures.' A divided American Medical Association will consider withdrawing its support of a key tenet of the health overhaul law that requires Americans to purchase an insurance plan. The Chicago-based national doctors group, which represents nearly a quarter-million physicians, is being asked by several medical societies within the organization to change its stance in favor of the 'individual mandate.'" I don't know if they're running for office or not. It's amazing how things change whatever you do approach an election, inside and outside politics.
"A formal vote comes up at the AMA's annual policymaking House of Delegates meeting Saturday through Wednesday at the Hyatt Regency Chicago. The AMA's support of the health care legislation, which was passed by Congress and then signed into [blah, blah] was seen as critical at the time the controversial legislation was being debated. The delegates' debate comes following the filing of federal lawsuits by several attorneys" blah, blah, blah, we all know this. "A resolution that will be introduced by three national surgery groups, including the American Society of General Surgeons and six largely southern state delegations of physicians, says the federal mandate 'regulating the individual purchase of health insurance will likely undermine the innovations and improvements in health care financing that can evolve in a free market.'
"The AMA should 'regard the purchase of health insurance to be a matter of individual responsibility to be encouraged by the use of tax incentives and other noncompulsory measures,' those opposed to the mandate said in their resolution." Well, now, this is fine and dandy. Now, look, there are 20 other groups. It's not the entire AMA, folks -- and, by the way, the AMA is not what it used to be. Physician membership at the AMA has decreased now to less than 20% of practicing physicians. So you could say that the physicians that are members of the AMA are a fringe group, there are that few practicing physicians still in the AMA, but it doesn't matter because it carries a lot of weight based on reputation and just the name of the group: The AMA.
But I love these people that come along after the fact, realizing the damage has been done, and now to save a little face say, "Guess what? It's time to say we gotta rethink this." It's a small percentage of the entire AMA in the first place, but nevertheless it's happening. Speaking of doctors, listen to this. (sigh) This is from UPI: "A survey by Accenture indicates more U.S. physicians are selling their private practices to work at larger healthcare systems. By 2013, less than one-third of U.S. physicians are expected to remain in private practice and patients may increasingly find that being treated by physicians in private, small practice settings may be a thing of the past. 'Health reform is challenging the entire system to deliver improved care through insight driven health,' Kristin Ficery, a senior executive at Accenture Health, says in a statement.
"Physicians tell the survey [by Accenture] that they are increasingly attracted to the benefits offered by hospital-based employment opportunities, which include" a big one: "relief from administrative responsibilities." Doctors are notoriously horrible at that 'cause they hate it, which I totally can relate to. Many doctors consider themselves to be artists. As such, they think of themselves as creative, and administrative stuff? It's minutia. It's just a waste of time. They hate it; they despise it. I do. I despise having to do that stuff. Oh, my gosh! You know, I still pay all my own bills, and I hate it. Well, let's just put it this way: It's the one thing I've not farmed out to somebody. We still do it for a whole host of reasons, but I still hate it. From the time it takes on down, I hate just the whole concept of being involved in administrative duties.
So here's the point here. If you are the Obama regime, and you're trying to move everybody down the tracks toward full-fledged government-run health care, there are a number of things that you need to have happen -- and one is fewer and fewer and fewer options for patients, for coverage and for insurance. The regime has done a good job in writing this health care bill of, in five to ten years, removing practically every option but the government. If you can get doctors to willingly give up their private practices -- if you can somehow encourage doctors to give up the entrepreneurial aspects of the gig and force them into hospital employment or government employment -- and you use as the carrot, "Hey, come join us! We'll handle all the administrative for you," I'm telling you, it's gonna work.
It will be very attractive to a number of doctors; I don't know how many. I know this is a blanket indictment, and I don't mean it to be 'cause it's not true of every doctor, just like nothing is true of every single person in a line of work. But, well, we all know doctors. I go into the doctor's office and sometimes the desks I see are covered with undone administrative business piling up: Checks, forms to fill out, Medicare. They put it off and put it off. It's the last thing in the world these guys want to do. Women, too. Don't misunderstand that it's anything gender specific. So the farther doctors get from private practice, which is the entrepreneurial model... The fewer doctors who essentially "hang a shingle" as, you know, lawyers do when they get out of law school: Just open their own office.
The farther you can get doctors away from private practice, their own offices, the more amenable they will become to government and bureaucrat control of their profession because it's going to take over an aspect of it that they detest. Note here the first benefit: "Physicians tell the survey they are increasingly attracted to the benefits offered by hospital-based employment opportunities, which include relief from administrative responsibilities." That's the first benefit: Relief from all these administrative responsibilities. Now, in addition, it must be pointed out that today the bulk of these administrative responsibilities are due to all of the government's reporting requirements and all the paperwork required by government, and the boondoggle of Medicare.
So here comes an opportunity to get rid of all that and have bureaucrats do it and believe me: It's gonna be very attractive for a lot of these doctors to just say, "Okay, fine." So it's a slow, creeping progression here toward whittling away of health care -- both insurance coverage and treatment -- being provided in the private sector. Private physicians are gonna be as rare as mortgage brokers thanks to the government. Now, we talked yesterday about the damage that the government has done to the health care industry. Not just costs, but the degree of treatment. Every aspect of it, it's just a mess -- and they're doing the same thing now to the home industry. So it's popping up out there. Now, all these AMA guys say, "Hey, guess what? We think it was a mistake, the individual mandate."
It's too little too late, but at least they're on the right side of it.
This is Marty in Louisville.
CALLER: Hey, Rush, listen, I'm a physician. I've been listening since around 1992.
RUSH: Thank you, sir.
CALLER: And you were talking about getting physicians out of private practice. All the incentives in Obamacare are to go towards a single payer and they formed something called an accountable care organization where the money is given to the hospital for the diagnosis. And the hospital distributes it, redistributes it to the physician. And the hospitals are in the process right now of forming these accountable care organizations --
RUSH: Accountable care, you're calling it?
CALLER: Right. Right. It is gonna compel the physician to become an employee, basically, of the hospital and ultimately the government. You know, the dirty little secret here is they want to get rid of old school docs like me who are familiar with the private practice model --
CALLER: -- and replace them with the post office mentality position.
RUSH: Exactly. Exactly.
CALLER: And that's exactly what it's all about, and it's not even voluntary because the physician is gonna be forced into a relationship with the hospital where he is gonna basically have to give up the private practice.
RUSH: Well, the story alludes to the fact that some doctors might not mind that because one of the benefits is that the hospital or whoever is gonna take over all the nightmares and headaches of the administrative aspects of their job.
CALLER: Yeah, they're also gonna tell them what they can and can't do.
CALLER: And how to treat the patient.
RUSH: Already doing that.
CALLER: Yes. Well, the point is that that's exactly what they intend, and it's working. It's absolutely working.
RUSH: Okay, as a doctor in the system, why are these bureaucrats doing this? Do they really think that this is the ticket to better health care and cheaper health care, because anybody with common sense realizes this is a debacle.
CALLER: Listen, it's about control.
RUSH: Exactly right.
CALLER: They want control of the system. They want control of our lives.
RUSH: Exactly right.
CALLER: They want to change our whole relationship with the government.
RUSH: And they don't care whether it works or is efficient or not; they want the control.
CALLER: Listen, they are Democrats. There's no accountability. You know, it's ironically named an accountable care organization.
CALLER: It's anything but accountable.
RUSH: Just like it's not the Affordable Care Act. It's everything but affordable.
RUSH: Well, I appreciate the call, Marty. What are you gonna do?
CALLER: I happen to be a plastic surgeon. So far I have an out because a lot of the things I do don't involve third-party payers.
RUSH: Oh, yeah.
CALLER: But, you know, I hope no one's listening because they'll figure out a way to tax me to death pretty soon.
RUSH: Yeah, we all have that fear.
RUSH: If not tax you, just take it.
CALLER: Yeah. And I think one of the underlying plans here is to begin to confiscate. You know, there's a possibility here, and I know this sounds a little outlandish, that they're gonna change the 401(k) rules to try to pay for the deficit to generate income.
RUSH: Yeah. Yeah, we've talked about that. What they essentially are going to do is offer you an exchange. They're going to get you to give up your 401(k), give you what they think is market value for it today --
RUSH: -- so they can take the money and then they're gonna guarantee you like two to three percent every year on it. It's a lose-lose proposition. It's nothing more than an end around to get their hands on your money now in violation of the original promise when the whole 401(k) was set up.
CALLER: Well, listen, this is why we must defeat Obama.
RUSH: I'll tell you something, Newt made a point in the debate. He said, if you're really serious about overturning health care, you can't stop with just beating Obama. You gotta defeat the Democrats that run the Senate. If you're gonna repeal it, you're going to defund it, you have to have control of the Senate as well. Even if you're not able to beat Obama, take control of the Senate, but the best is take control of everything. It's gonna take this election and many more to effectively start the process of rolling all this back. And we'll find out if that's what people really want. We have hope here that it is. We'll find out. Appreciate the call, Marty.
RUSH: Here's Jody, Minneapolis, welcome to the EIB Network. Hello.
CALLER: Hello, Rush. It's an absolute honor to speak with you. I just wanted to point out that your point about the AMA numbers are actually quite correct. The AMA numbers are inflated. I'm proof positive that they're inflated. As a physician, I actually don't think I ever paid dues though I've been a member of the AMA for many, many years; they just keep giving me membership. When they came out in support of the Obama health care initiative, I called the membership office and very specifically asked to be taken off all of their mailing lists and have my membership dropped. Approximately six months later, I get a letter from the AMA stating, "We hope you've reconsidered your position, and here's your next membership." So even though I've been a member for many years, I've never paid dues; I've never sent my money.
RUSH: So the membership is not that large, not that many doctors are members anymore, right?
CALLER: No, and a large number of them, the membership numbers are people like me. They have never actually paid for a membership, and we're counted in those numbers.
RUSH: I appreciate that. Thanks very much, Jody. This is Jerry. We move to Battle Creek, Michigan. You're next on the Rush Limbaugh program.
CALLER: Hey, Rush.
CALLER: Great talking to you. It's great talking to you.
RUSH: Thank you, sir, very much.
CALLER: I'm like Jody. I left the AMA back in the early nineties when the Stark Amendment passed and the AMA clearly was not supportive of primary care physicians. I guess I didn't leave them, they left me. I keep getting their mailings and JAMA articles. It'd be fine with me if they quit sending me their stuff, but they really don't represent my interests, and clearly seem to be interested in another agenda.
RUSH: Well, they're a political organization, and that's why the left and the media are touting them as being big and important and so forth. It used to be. The AMA used to have lot more members than it has now. It was a huge organization. It did carry a lot of weight, had a great reputation, and they're still living off that. Of course, since they make the "right" political decisions, or have, the media still trumpets them as what they were -- big, powerful, influential -- when in fact they're not nearly as influential or big as they were. It's still significant, though, that whatever remaining membership numbers there are, are still saying, "You know, maybe this individual mandate's not the way to go." I still am struck by the timing: Why now? Where were you when it mattered? It might-a mattered if the AMA had come out against this from the get-go and stuck to its guns. You never know. You know, Obama was buying allegiance to his plan with health insurance executives, and he was doing it with the other health care providers and so forth. But you have to wonder.
Anyway, they've arrived at the right point of view on it, albeit late. We'll take it nevertheless.