While it seemed like a new President of the United States was going to have the biggest impact on health care reform, the new president of the American Medical Association (AMA) seems to be getting similar attention as well. Last week, Dr. J. James Rohack told CNN that the AMA supports an "American model" that includes both "a private system and a public system, working together." Essentially, he acknowledged the groups openness to a government-funded health insurance option for people without coverage, even though the AMA told a Senate committee in May 2009 that it did not support a government-sponsored public health insurance option:
"The AMA does not believe that creating a public health insurance option … is the best way to expand health insurance coverage and lower costs across the health care system," because a public insurance plan could lead to "an explosion of costs that would need to be absorbed by taxpayers."
The new AMA president mentioned that the Federal Employee Health Benefit Program—available to Congress and other federal employees—could be expanded as a public option. He believed that in doing so, Congress could avoid creating a new program. But how does Dr. Rohack plan to staff this existing program for 45 million more people when America is already in a severe shortage of doctors, nurses and health care providers? How are we going to pay for all of this staff and training?
Even more perplexing, Rohack noted the AMA’s opposition to expanding Medicare coverage into a broader general public plan. In fact, he noted that the plan is "going broke" and fails to cover the costs of participating doctors. Yet what does he expect will happen when 45 million people are added to the existing program? Does he think the government will be able to manage the program better with 45 million people then they could with over 40 years of Medicare experience?
With the backdrop of President Obama reaching out to town hall meetings to push his own health care agenda, Rohack said 2009 is "the year we need to have affordable health insurance coverage for all Americans." Furthermore, he advocated for a reformed system that must include “access for everyone, the freedom to choose your doctor, and the freedom for doctors to provide the best possible care.” In addition, he also stressed efficiency measures such as electronic record-keeping to reduce administrative costs, as well as protection for doctors from excessive malpractice lawsuits.
Consequently, this drastic shift in AMA the public option can only mean a few things: either Congress is cutting a deal with doctors on including certain carrots in health care reform, or they are threatening specific sticks to scare them. Whatever the backdoor scenario is doctors need to get a more concentrated and collected voice, instead of just a newly ambitious president. Before doctors can start worrying about treating more patients under an existing program, they need to prioritize.