The AMA has come out against the “public option” in the healthcare reform bill making its way through Congress:
WASHINGTON — As the health care debate heats up, the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.
The opposition, which comes as Mr. Obama prepares to address the powerful doctors’ group on Monday in Chicago, could be a major hurdle for advocates of a public insurance plan. The A.M.A., with about 250,000 members, is America’s largest physician organization.
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But in comments submitted to the Senate Finance Committee, the American Medical Association said: “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.â€
If private insurers are pushed out of the market, the group said, “the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.â€
For Congressional leaders the public option is the sine qua non of reform:
Speaker Nancy Pelosi of California said Wednesday that she supported that goal. “A bill will not come out of the House without a public option,†she said Wednesday on MSNBC.
Doctors of medicine are not stupid. They have benefited enormously under the system that emerged after the enactment of Medicare and Medicaid in the mid 1960’s. That system has also resulted in inflation in healthcare that has exceeded non-healthcare inflation systematically over the period of the last 40 years.
Healthcare costs have three primary components: insurance administrative costs, hospital costs of which salaries are a major component, and doctors’ bills. Getting insurance companies out of the way as described above will result in, at most, a reduction of 15%. That’s not nearly enough to pay for the universal coverage plans of reformers, indeed, it may result in the increased costs of which the AMA cautions. Doctor’s fees are all but certain to be the reformers’ next target.
Keep in mind that the AMA is far from representing all doctors – if I remember right, they tend to represent the oldest, wealthiest doctors, who usually have investments in the private insurance system.
That’s nothing to sneeze at, Dave, particularly if it helps to keep down future costs as well (and they will be there, with the increase in absolute size of the heavily aged population, as well as the overall increase in population in general for the US for the next 50 years).
One other thing – are you simply comparing the administrative costs under single-payer with that of the current system? The former might be able to save more money by using its monopsonistic capabilities to hold down wages for doctors. That’s why the Canadian system is so cheap compared the US, anyways.
The problem with that is that they are only telling one side of the story. Presumably, those people who join the public plan aren’t going to paying premiums for private health insurance, so you’ve got a situation where you’d have the amount of money paid in premiums being traded for the amount of money being paid in taxes. The difference is that the amount paid in taxes is just more visible than that being paid in premiums.
Hell, they didn’t think Medicare was a good idea back in the 1960s, and did all sorts of fun campaigns to attack it, like Operation Coffee Cup.
At the present rate of increase fifteen percent would be absorbed in about three years. Nobody with a lick of sense believes we can get where we need to go solely on the basis of cost savings by reducing insurance administrative costs.
Some things confound me. On so many topics discussed on this site I find myself in harmony with its proprietor. On health care, not so much. One wonders how this occurs.
Dave observes: “Doctors of medicine are not stupid. They have benefited enormously under the system that emerged after the enactment of Medicare and Medicaid in the mid 1960’s. That system has also resulted in inflation in healthcare that has exceeded non-healthcare inflation systematically over the period of the last 40 years.”
I come from a medical family. Father, grandfather, uncle. Mother (nurse). I currently have numerous friends in the profession. I know of not one (Not one! Not one!!!!!) who has a positive thing to say about Medicare or Medicaid. NOT ONE !!! They uniformly hate the government intervention into medicine. They do not view it as a price escalator. They have absolutely nothing good to say about these programs.
How can this diversion in opinion occur?
I can’t honestly say. It may a difference in their practices from the norm. Maybe some other factor.
At least half of all healthcare spending comes from the government. That’s just a fact—simple arithmetic. I think it’s more like sixty percent (that depends on how you calculated it). Physician incomes have increased about eight-fold since the enactment of Medicare and Medicaid while the incomes of other professionals with comparable levels of education have increased about five-fold. That’s a fact, too. That the difference in the increase is a consequence is an inference but a reasonable one, I think.
It may be sharp differences among regions or locations. I don’t honestly know.
Five fold vs eight fold is a hard statistic to ignore. Although disaggregating into, say, internests vs surgeons would be interesting.
Its axioamatic that govt subsidized areas will have price inflation. Can you say education?
Maybe doctors just don’t know they are being subsidized. They, uh, aren’t noted for their financial acumen.