-
The Grand Old Poseurs
May 13, 2013 | 72 comments
-
Obamacare Pimps Smear Lipstick on Another Pig
May 6, 2013 | 58 comments
-
Can One Iraq Vet Stop Obamacare?
April 29, 2013 | 88 comments
-
GOP at Fault for Obamacare Train Wreck?
April 22, 2013 | 106 comments
-
The Wheels Come Off Obamacare
April 15, 2013 | 159 comments
The Right Prescription
The Wages of Collaboration
The Democrats fail to respect the AMA in the morning.
During the health care reform debate, while ignoring the throngs of angry Americans who took to the streets all across the country to protest the looming passage of ObamaCare, the White House and its congressional allies were very attentive to the constituents they valued. Mindful of the mistakes that had doomed Hillarycare in 1993, they worked assiduously to co-opt health care industry “stakeholders.” The American Medical Association was by far the most important target of this strategy. Its shrinking membership notwithstanding, the AMA was still seen as a force to be reckoned with inside the Beltway and continued to enjoy considerable public esteem. Thus, Obama and the Democrats badly wanted their flagship social program to benefit from the political and PR advantages that come with the AMA’s stamp of approval.
This was fortuitous for the AMA. It had a big problem called the “sustainable growth rate formula” (SGR). Created by the “Balanced Budget Act of 1997,” SGR was meant to slow the growth of Medicare spending by tying physician payment increases to the expansion of Gross Domestic Product. And, because the cost of providing medical care grows faster than GDP, this formula guaranteed annual payment cuts for doctors who treat Medicare patients. The AMA has pressured Congress to repeal SGR and replace it with a system that tracks medical cost inflation, but this “permanent fix” has never materialized. Congress has instead opted for a series of last-minute, short-term fixes. Meanwhile, the cumulative payment cuts mandated by SGR hang over the medical community like the Sword of Damocles.
Thus, the AMA saw the push for ObamaCare as an opportunity to get SGR deep-sixed once and for all. Instead of fighting them, as it did during the 1990s, the venerable physician association decided to climb into bed with the Democrats. In exchange for an implicit promise to finally enact the long-sought permanent fix, the President of the AMA became a high-profile cheerleader for “reform.” J. James Rohack, who has since been succeeded by Dr. Cecil Wilson, began promoting ObamaCare at press conferences and in effusive opinion pieces. Failing to notice the countless broken promises that lay strewn in Obama’s path to the Presidency, Rohack wrote: “I saw firsthand at the White House this week that the physicians’ perspective and commitment is valued as lawmakers work on reform.”
In the end, however, “the physicians’ perspective” wasn’t valued quite as highly as Dr. Rohack was led to believe. The permanent fix was conspicuously absent from the final health care bill signed by the President in March, and the ObamaCare cost estimates promulgated by the Democrats assumed that SGR will stay in place. Nonetheless, still clinging to sweet memories of White House tête-à-têtes, the credulous medico continued throughout April to rhapsodize about ObamaCare. Implausibly claiming that “reform” would improve competition, provide more choice in the insurance marketplace, and reduce administrative burdens, Rohack was determined to keep his smile in place as he stood waiting at the altar.
He was still waiting at the end of May. The House had passed a temporary fix, which the AMA pronounced inadequate, but the Senate refused to go along even with that half-measure. By June 1, when a 21 percent cut in the Medicare payment rate was due to take effect, Rohack finally understood that he and the AMA had been …ah … had. And Hell hath no fury like a surgeon scorned. On June 3, the seething sawbones denounced the Senate’s irresponsibility, accusing Reid & Co. of going on vacation while the nation’s seniors and their physicians waited for relief. He went on to unsheathe what he evidently thought would be a deadly weapon: “Today, the AMA is unveiling a new multi-million dollar ad campaign encouraging the public to contact their Senators and tell them to get back to work and fix Medicare now.”
The Democrats of “the world’s greatest deliberative body” were, however, not impressed. When the Senate finally returned to work, it passed a temporary measure even less satisfactory to the AMA than the House bill — a “doc fix” that put off the Medicare payment cuts for a mere six months. Then, adding insult to injury, Nancy Pelosi refused to allow a House vote on that measure until the Republicans agreed to support a “jobs bill” they had absolutely no interest in passing. The GOP gleefully pleaded with Pelosi not to throw them in that briar patch while the AMA’s new President, Cecil Wilson, cried foul and began to rend his clothing. Meanwhile, calculating that Congress would eventually grant yet another of its last-minute reprieves, the bureaucrats at Medicare halted payments to all physicians.
At length, as Congress prepared to head home for recess, the Democrats tossed a pittance in the direction of the weeping Dr. Wilson and thanked the AMA for its trouble. The country’s largest physician association had completely compromised its integrity and received virtually nothing in return. Rohack and his fellow quislings delivered their patients and colleagues into the hands of Washington’s health care bureaucrats in exchange for yet another temporary reprieve from Medicare payment cuts. They whined about Beltway perfidy, but had little choice but to accept a short-term fix set to expire immediately following the midterm elections, when neither the Democrats nor the Republicans will have any incentive to cough up the $240 billion required for a permanent solution to the SGR mess.
Even worse, the once-feared physician lobby has revealed itself to be far weaker than most, including the organization’s membership, realized. The people that matter inside the Beltway now openly wonder how much clout the AMA actually wields. Sadly, it didn’t have to be this way. Dr. Rohack could have used his organization’s influence to encourage genuine free market reform. Instead, he decided to climb into bed with people whose only interest in the health care system involves how much power and money they can squeeze from it. And, now that the White House and its congressional allies have gotten what they wanted, they will treat the AMA like the cheap date it has become. Such are the wages of collaboration.
About the Author
David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.
Letter to the Editor View all comments (48) | Leave a comment
More Articles by David Catron
More Articles From The Right Prescription
http://spectator.org/archives/2010/07/15/the-wages-of-collaboration
Follow us:
ADVERTISEMENT
Current Issue
- Public Nuisances
- Self-Righteous Republic
- A President Loses His Power
SPONSORED LINKS
FLASHBACK TO: 1995
-
Pope Culture
A man of faith in a godless age is hitting Americans where it hurts.
-
Why the GOP Does Not, Like, Totally Suck
Mr. and Mrs. American Spectator Reader, let P.J. O’Rourke talk sense to your kids.
-
Dames at Sea
-
In the Absence of Guns
In Britain, defending your property can get you life.
-
The Metaphysical Martini
-
Counting the Costs of Clintonism
The debacle of this president’s administration is both a cause and a symptom of the decline of American values. Unless Congress impeaches him, that decline will go on unchecked. An eminent jurist surveys the damage and assesses the chances for the recovery of our culture.
-
Chuck McHagel
It won’t take long for conservatives to scratch this presidential wannabe off their 2008 scorecard.
-
The Legacy of Old John and Mother Fresh-Roasted
-
It’s the Best Time of the Year
The American Christmas, like the songs that celebrate it, makes room for everybody under the rainbow. Is that why so many people seem to be hostile to it?
-
The Bush Crack-Up
Was the President done in by the economy, or by the politics of the economy?
Clip of the Day
ADVERTISEMENT
nobar| 7.15.10 @ 7:08AM
Medicare will only last as long as it takes for Obama/Pelosi "healthcare" to go into effect. The seniors who were so unconcerned about universal health care because they had Medicare coverage are about to learn a very sad lesson about politics in general and about Democrats in particular.
Appleby| 7.15.10 @ 7:17AM
Seniors vote. This could get interesting.
AMENBRO| 7.16.10 @ 3:05AM
So do no tax payer funded free Abortion on demand demanding Independents vote. More so than ever before to elect this abhorrence of a President
Question IS, who have theses people not lied to.
Course all yawl were told this shipe when the American Public elected this should have been aborted soul.
coal carrier| 7.15.10 @ 7:27AM
Once again, crony capitalism. When the Don does a favor for you, someday you have to return the favor.
Dan Hirsch| 7.15.10 @ 9:29AM
Yes, but...
At least the Don actually delivers the favor before expecting your repayment favor...
Don't blame private ownership of capital for the craven behavior of corruptocrats!!
Maddox| 7.15.10 @ 7:52AM
Trusting anything Obama's band of merry thieves say they will do is as intelligent as walking into freeway traffic blindfolded.
hurtzmuch| 7.15.10 @ 8:03AM
Given the history of the current Administration and the Democrats how could the AMA ever go along with this....never trust a liar. A carrot dangled by this group never seems to get to the donkey. The Obama/Reid/Pelosy agenda is clear, take the money, take the freedom, take the hope.... get everybody on bent knee to beg for some scarps of what is left of the American Dream. It is well past time to go out and take a stand.... we must all do things now to earn back our freedom!
Dan Hirsch| 7.15.10 @ 9:31AM
It's sorta like when "Free beer tomorrow" turns into "Free beer yesterday!"
gypsy| 7.15.10 @ 9:00AM
wow, the AMA got out its kneepads, and now they're bitching because Ol' Massah won't pay up. This is a perfect example of how fascism works: Big Business colludes with Big Government, and the little guy gets crushed. Then Big Government uses police state power to crush Big Business. Next stop: total bankruptcy, and a second American Revolution
Alan Brooks| 7.15.10 @ 9:11PM
No revolution; America would dissolve, not devolve; this isn't Russia-- they are used to misery.
You are overly optimistic.
Alan Brooks| 7.15.10 @ 9:13PM
...gyp,
the American Revolution was more violent than you think it was, and the Civil War was worse, so...
what sort of "Revolution" did you have in mind?
Galen| 7.15.10 @ 9:22AM
So much for schadenfreude, I'm a senior who is in fear and tremblilng because soon I'll have sickness to the soul (as will all Americans as Obamacare produces third world medicine)
The very rich will fly to Belize where all ready spas are being built but even they can suffer a medical emergency. Well even the trial lawyers
will join in the democracy of death.
dw| 7.15.10 @ 9:35AM
Lay down with dogs, wake up with flees. The AMA sold us all into slavery and didn't even recieve full payment. The democrats go to sleep lying and wake up forming their lies for the upcoming day. The outcome of obama policies has always been obvious to anyone still able to independently anylaze and think, but the indoctrination of higher educations group think propaganda has created a few generations of intellectual vapidness. Doctors are not immune.
PolishKnight| 7.15.10 @ 9:47AM
The fundamental problem with the AMA is that they do not possess the characteristics of a valued Democrat special interest group. If anything, they are similar to the most reviled Democrat demographic group: Middle and working class white males!
Doctors are not a significant voting bloc compared to, say, illegal immigrants. It's questionable if many of them even vote Democrat to begin with (considering their upper middle class status and race/gender). The have services and skills that the Democrat electorate wants, but doesn't want to pay for.
Indeed, Doctors made the same deal with the devil that working class white males made with the Democrat party back in the 1960's. Now the only working class/private sector white males that still buy into leftism are in the useful idiots category much like soccer hooligans living in dives to watch their beloved club players. "I'm important!" they like to yell.
Regarding medical costs growing faster than GDP. That is NOT a healthy condition in a free market. If any commodity or service, whether it's health care, education, or, say, housing grows faster than GDP, it becomes a bubble since no economy can survive when too much spending goes into one sector. "Rationing" has to occur OR something in the market has to change. This needn't be too painful overall. Perhaps the AMA should follow the lead of law schools and allow more doctors to graduate and immigrate? Oh, wait, that would be a FREE MARKET. Can't have that. They're the GM union auto workers all over again. Indeed, it won't just be the RICH going off to Belize for heart surgery!!!
loulou| 7.15.10 @ 10:21AM
None of the doctors I know are members of the AMA.
Occam's Tool| 7.15.10 @ 6:33PM
There ARE new medical schools opening up. But, given the rate at which the baby boomers are aging and the length of time it takes to train an MD (let's ignore undergrad's 4 years, OK? GP---7 years, pediatrician---7 years, surgeon--- 10 years, psychiatrist---8 years. Specialists in these fields even longer. Then add in the 4 years of undergrad and you have quite a piece.
For example, I did an intenship in Peds before doing my psych residency of 4 years, for a total of 5 years. But let's discount that year, OK. From the time I graduated high school until I graduated residency, it would not have been until age 30 that I started my professional career as a fully trained MD.
In addition, as someone who HAS trained physicians overseas (in New Zealand), let me tell you our standards are HIGHER. So, it will take a while to fix this crisis, which is growing worse by the day. The AMA gets the majority of its income from selling coding books, not membership dues. Therefore, its financial interests are not aligned with its members. Therefore, it is worthless and I don't waste my money on a membership. I belong to the AAPS.
Occam's Tool| 7.15.10 @ 6:34PM
Sorry, forgot to close parenthesis in first para.
Hershl| 7.15.10 @ 9:49AM
Since when does Obama do anything thought out?
Consider the fact that he is mum on the reality of Muslims gang raping US female volunteers.
http://jewishdailyreport.wordp.....o-shut-up/
GUDOC| 7.15.10 @ 10:07AM
As a physician, the action of the AMA only reinforces why and the great majority of physicians in this country never joined this out of step organization.
John W.| 7.15.10 @ 10:13AM
Mr. catron,
The subheading for your story is "The Democrats fail to respect the AMA in the morning. "
It would be more accurate to have written "The Democrats didn't kiss the AMA when they were finished." Of course, I doubt prostitutes ever get kissed after their services arte rendered.
Pete| 7.15.10 @ 10:31AM
Your first instinct is to laugh but then you realize the joke is on us all. This story has direct parallels to the story of the last presidential election.
squalis| 7.15.10 @ 11:23AM
The AMA is an organization that decades ago lost the best chance for true healthcare reform. When it had real clout, it could have worked to established firewalls between medical specialties. In my view, among the reasons for healthcare inflation (I don't want to minimize the impact of trial lawyers) are the absence of regulatory limits of a physician's practice to that of their training. (Today, we have cardiologists performing vascular and nuclear medicine procedures, urologists owning radiation oncology facilities, and far too many clinicians own imaging equipment, all under the false moniker of enhanced patient care. How many MD's have ownership in cherry-picking outpatient surgery centers?) This simple "fix", I believe, would have significantly reduced incentives for over utilization without creating incentives for under utilization, that is to say rationing, today's political quick fix. I might be wrong, but it is my recollection that many years ago there were some discussions in AMA publications about this, but the AMA chose not to pursue. The AMA instead bowed to its special interests (medical subspecialty groups). Money, in any morally corrupt organization, talks. The piece by Mr. Catron demonstrates that nicely. As a practicing physician, my only regret about not being a member of the AMA is that I could not resign in protest over the AMA's betrayal of the American people by helping Obamacare to pass. In the words of dear Rev. Wright, the AMA's chickens have finally come home to roost!
Stephanie| 7.15.10 @ 11:28AM
How does anyone believe anything these awful people say anymore? I've never seen such lying in my life!
Mac-101| 7.15.10 @ 11:53AM
Charlie Daniels is the only one who ever won dealing with the Devil! Ain't sure how good a golden fiddle sounds though.
Gill O’Teen ✝✡$| 7.15.10 @ 1:20PM
Actually, fiddler extraordinaire, Charlie Daniels, never won a deal with the Devil. He only sang the story of a young Georgia lad who accepted a bet with Lucifer. The first part of that great song is worth blatant plagiarism on my part:
“The devil went down to Georgia, he was looking for a soul to steal.
“He was in a bind 'cos he was way behind: he was willin' to make a deal.
“When he came across this young man sawin' on a fiddle and playin' it hot.
“And the devil jumped upon a hickory stump and said: "Boy let me tell you what:
“"I bet you didn't know it, but I'm a fiddle player too.
“"And if you'd care to take a dare, I'll make a bet with you.
“"Now you play a pretty good fiddle, boy, but give the devil his due:
“"I bet a fiddle of gold against your soul, 'cos I think I'm better than you."
“The boy said: "My name's Johnny and it might be a sin,
“"But I'll take your bet, your gonna regret, 'cos I'm the best that's ever been."
“Johnny you rosin up your bow and play your fiddle hard.
“'Cos hells broke loose in Georgia and the devil deals the cards.
“And if you win you get this shiny fiddle made of gold.
“But if you lose, the devil gets your soul.” http://en.wikipedia.org/wiki/i.....id=1649061
The AMA lost its hellish bet and will now pay the Devil’s price.
However, I believe that Kris Kristofferson did come out ahead in a Beelzebubean deal as he recounted in a great ballad on his very first album, Kristofferson (1970) about meeting an old man in a Music City Row Tavern:
“You see, the devil haunts a hungry man,
“If you don't wanna join him, you got to beat him.
“I ain't sayin' I beat the devil, but I drank his beer for nothing.
“Then I stole his song. (To Beat The Devil http://www.cowboylyrics.com/ly.....13009.html
Gill O’Teen ✝✡$
gill.Oteen07041776@gmail.com
“And the devil, taking Him up into an high mountain, shewed unto Him all the kingdoms of the world in a moment of time. And the devil said unto Him, All this power will I give Thee, and the glory of them: for that is delivered unto me; and to whomsoever I will I give it. If Thou therefore wilt worship me, all shall be Thine. And Jesus answered and said unto him, Get thee behind me, Satan: for it is written, Thou shalt worship the Lord thy God, and Him only shalt thou serve.” The Gospel according to a physician named Luke (4:5-8).
Only 920 days to go.
dandy dale| 7.15.10 @ 12:05PM
Didn't the AMA make a sharp left turn 10-15 years ago? Similar to AARP, they have lost membership do to there political left turn.
2 Gunz| 7.15.10 @ 12:23PM
Hey AMA, HA HA HA HA HA HA HA HA HA .
You're like rev wright, tossed under the bus.
David Thomas | 7.15.10 @ 1:11PM
When the AMA sold to chainsaw Al of Sunbeam the right to use the AMA logo on Sunbeam products as a "seal of approval" without any testing or analysis of them, just for money, they took a major loss of respect in my judgment.
Nancy in NC| 7.15.10 @ 3:03PM
Did anyone hear that the health care plan requires insurance companies to pay for extensive screening tests? More than likely that will be the straw that breaks the camel's back...or in this case, the insurance companies. In five years, there will no insurance except the government. And our liberties will be a distant memory.
Oregonian| 7.15.10 @ 3:09PM
To paraphrase the late Flip Wilson: "Do the name Neville Chamberlain strike a familiar chord?"
martin j smith| 7.15.10 @ 3:17PM
The AMA is learning the hardway. They were fools to begin with but crony capitalism does have it pitfalls.
And, BTW: Those going on medicare now just turning 65 are in for a rude awakening of a 21% cut in benefits. and how many voted for Obama ?
Clinton nee Publius | 7.15.10 @ 3:36PM
In China they tell the proverb about the dragon who came to eat the village. Many ran about wanting for action and only fear of the dragon's appetite was set upon their minds. One villager decided to treat with the dragon even though the dragon was pure corruption and the wages of the dragon's war were death and destruction.
"If only we would feed the dragon those who are not worthy of continuing life, we may yet be spared his rending teeth and corruption," a villager opined. Fearing for their own safety and abandoning their courage, they decided they should do this thing and forget the service the old villagers had rendered in their prime, and they forgot the potential service their children would render in their own old age and they ignored the pleas of the poorest villagers who worked the hardest for the least. One by one, they fed them all to the dragon as the dragon came upon them again and again. Each time the dragon left, it laughed at them but said it would probably not come back.
But it came back.
In the end, the last villagers were swallowed by the dragon and the dragon starved and the village was gone. All the weapons were still stacked where the soldiers had left them when they were told that fighting was useless and giving up would save them.
In the end, the AMA made the deal with the dragon even after the dragon ate GM, ate Chrysler, ate AIG, ate Lehman Brothers, ate Merrill Lynch, ate the seniors and ate DME manufacturers. The AMA knew full well that they were making a deal with corruption and that corruption knows no promise it cannot make, but keeps no bargain in its wake.
Ms Jones| 7.15.10 @ 4:04PM
Another Obama water-carrier thrown under the bus. Is anyone really surprised?
PolyAnndoc| 7.15.10 @ 5:08PM
I always thought that doctors are smart, but are they really?
Occam's Tool| 7.15.10 @ 6:36PM
Yes, we are smart---in science. But many scientists, like Albert Einstein and Robert Oppenheimer, are political naifs.
squalis| 7.15.10 @ 8:10PM
We are smart. That's why the majority of docs don't belong to the AMA.
Gill O’Teen ✝✡$| 7.15.10 @ 10:18PM
Intelligence has nothing to do with this. As a general rule 2% of the population has a genius level IQ, which is the sole membership requirement of the high IQ society MENSA. According to the National Debt Clock, that means there are 6,194,861 Americans smart enough based on today’s population of 309,743,068 (10,202 who lost jobs) to apply for that membership. Over the years, I have known many people qualified to join that elite organization. However, I quit attending those meetings when I discovered that if I wanted to know how to do something, I was better served inquiring of somebody actually involved in that thing. If I wished to learn blues guitar, then I sought out blues guitarists. If I wanted to learn how to play chess, I sought out chess players. If I wanted to learn computers, I sought out computer programmers or technicians. Most Americans are kept quite busy first learning their craft, then keeping current on all the changes and improvements which constantly demand attention. When I go to my doctor, more frequently of late, I never inquire of her politics. I am more interested in whether or not she has the necessary medical skills to help me keep my old bag of bones together. The lord of flies took advantage of us. Busy with our daily tasks we did not have the time needed to perceive the lurking demon in the details. We were all naive in that most of us never dreamed that any person seeking to lead the greatest country ever, would turn out to be its greatest enemy ever. He abused and continues to abuse our trust. The question is not whether doctor’s are really smart, it’s what the hell do we do now to extricate ourselves from this pit before it catches fire.
Gill O’Teen ✝✡$
gill.Oteen07041776@gmail.com
"To avoid being mistaken for a sellout, I chose my friends carefully. The more politically active black students. The foreign students. The Chicanos. The Marxist professors and structural feminists." bury obummer in his memoir, "Dreams From My Father."
Only 920 days to go.
Gill O’Teen ✝✡$| 7.15.10 @ 10:40PM
Oops! MENSA also requires that a person submit proof of IQ based on test results and good ol’ cash.
Gill O’Teen ✝✡$
gill.Oteen07041776@gmail.com
“Membership of Mensa is open to persons who have attained a score within the upper two percent of the general population on an approved intelligence test that has been properly administered and supervised.” http://www.mensa.org/
Only 920 days to go.
MarkJ| 7.15.10 @ 6:03PM
Looks like Obama and his Democrat good-time buddies gave Dr. Rohack an unlubricated colonscopy he'll never forget.
I'm sure Dr. Rohack now knows how a cell-block bitch feels.....
Chris| 7.15.10 @ 6:24PM
The pharmaceutical industry also made a deal with the devil. It's only a matter of time before bOzo imposes price controls and thus destroys any chance that any new drugs will come out of the US. Everything BHO touches turns to $h*t
supra skytop | 7.15.10 @ 10:43PM
I wanted to thank you for this excellent read!! I definitely enjoyed every little bit of it. I have you bookmarked your site to check out the new stuff you post.
CJ| 7.16.10 @ 4:01AM
AMA is run by academic elitists. I'm a physician and cancelled my membership several years ago. They no longer represent practicing physicians. Unfortunately, no other large organization does and different specialties are more likely to attack one another than to unite and oppose Obamacare.
Anthony| 7.16.10 @ 6:23PM
The reality is that the AMA's clout is in fact limited. Most people don't seem to understand that many MDs, retired or active (another complicating factor) do not belong to the AMA or state associations, perhaps because these associations portray themselves as speaking for all physicians.
jstwndring| 7.17.10 @ 4:21PM
Everyone's for sale. As long as they (AMA) were getting taken care of, they were happy with this beaurocratic nightmare known as Obamacare. And that's the problem with this country. No-one really cares a whit about what's happening, as long as they themselves aren't getting screwed financially. The only reason the Democrat Party's numbers are down is because the economy is down, otherwise, they'd probably get re-elected. We are a collection of ignorant, self-absorbed, greedy, bastards, who's only concern is: What's in it for me? The Republic is dead.
jstwndring| 7.17.10 @ 4:24PM
By the way, TAS is getting spammed big-time. You guys should put some posting controls on here so you don't get these attacks.
JeffT| 7.18.10 @ 2:35PM
When I worked in the dental field, dentists would always rail against the ADA as a toothless organization not concerned with its members. As a result, few dentists belong to the ADA. The same is true with the AMA. It is a political entity, not really representing physicians. This is why about 15% of docs belong to it. The rest know it's not working in their best interest. These PACs, like AARP, are self-aggrandizing groups not working for their members interests, not unlike union thugs.