The American Medical Association has been nothing short of controversial throughout its history. The group has long taken conservative stances on policy issues in American health care. Michael Moore’s Sicko portrays the AMA as a clear opponent to past universal health insurance movements in this country. Wikipedia notes “Profession and monopoly, a book published in 1975 is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States.”
Nonetheless the group has been the representative of physician interests over the years. Its recent work to repeal a large reduction in physician Medicare reimbursements has been successful in the House and Senate. The AMA has also been an active voice on public health issues as well as an advocate for reducing disparities in health care delivery.
However, AMA membership numbers are relatively low for a group that represents the interests of all physicians. Surely the rise of specialty societies may be partly to blame. According to a MedPage Today article only 244,005 of more than 900,000 physicians were members of the AMA in 2005. The article estimates that only 135,300 of those members were actively practicing medicine.
Another reason may be, as Michael Ostrovsky points out in a question to AMA President-elect Dr. J. James Rohack, “discontent among doctors” with the organization. Are low membership numbers an indication of the AMA losing its relevance in American medicine?
That’s a difficult indictment to make.
But it is worth noting recent activity by the AMA that could be construed as efforts to regain some of the relevance it may have lost over the previous decade.
The AMA has long been an opponent of publicly-funded health care. In this election year it seems the group has reversed course a bit. As the estimated number of uninsured Americans nears 50 million, the organization has launched its Voice for the Uninsured campaign. Their proposal is to give all Americans the ability to purchase health insurance individually made available through market reforms. While still not completly publicly-funded, the propospal does provide some public assistance through tax credits. Here is the complete proposal.
Last week the AMA released on its website an apology to black physicians. “The American Medical Association today apologizes for its past history of racial inequality toward African-American physicians, and shares its current efforts to increase the ranks of minority physicians and their participation in the AMA.” An Associated Press article states that fewer than 2 percent of AMA members are black. No wonder:
It wasn’t until the 1960s that AMA delegates took a strong stance against policies dating to the 1800s that barred blacks from some state and local medical societies.
Until then, AMA delegates had resisted pleas to speak out forcefully against discrimination or to condemn the smaller medical groups, which historically have had a big role in shaping AMA policy.
Better late than never.
These efforts may be the AMA trying to regain its relevance with physicians—especially with young doctors. Then again these moves could also be political shuffling. Traditionally conservative viewpoints are not the most popular political positions at the moment. Is it a coincidence that the AMA has proposed a politically feasible (on both sides) health insurance policy as an election approaches that very well could end with Democrats ruling the House, Senate, and Oval Office? Is it a coincidence that they apologized to black physicians for more than a century of exclusive policies (in 2008!!) as this country is in the midst of a very real opportunity to elect its first ever black President?
I hope so.