ARMSTRONG: Our dead American Medical Association

OPINION:

So, what’s up with the AMA? You know, the American Medical Association, venerated representative of the American physician, right? Wrong.

This long-lived and generally respected organization, one that represented more than 70 percent of American doctors in the 1960s, has become a shell of its former respectable self, now representing less that 15 percent of America’s practicing physicians. But, you say, wait - how can that be? Didn’t the AMA support President Obama’s Affordable Care Act?

Yes, it did, and as a result of that very public support and the incorrect notion that the organization still had the support of most American doctors, the act passed. The majority of American doctors were not pleased. That is an understatement.

You see, the once-proud AMA of the 1960s, the organization that fought a battle against Medicare in its current form, the one whose president, Dr. Edward Annis, famously predicted the problems we face today, sold its soul to the government in 1983.

Dr. Annis spoke to an empty Madison Square Garden in May 1962 because the media would not televise his direct response to President Kennedy’s speech pushing for the creation of Medicare, then called the King-Anderson Bill.

Dr. Annis predicted the top-down government controls; the rules and regulations; the giant bureaucracy, and even the fiscal insolvency that looms large today. But the train left the station in 1965 with the passage of Medicare, and in 1983, the AMA jumped on board - for money and the promise of control.

The government was looking for a way to standardize medical billing for Medicare, and the AMA had just the thing. We call it Current Procedural Terminology. The AMA owns it, and the organization signed an exclusive agreement with the government in 1983 that made it the coding system for all Medicare billing.

Gradually, the terminology became the standard for all medical billing - private insurance and government plans. The AMA has a government-granted monopoly, and it enjoys a lucrative stream of income as a result.

It is estimated that the AMA takes in between $50 million and $80 million per year from licensing fees and the sale of coding books, materials and other related products. This income dwarfs the amount generated from dues-paying physician members. See the problem? The AMA is a corporation in the business of selling and protecting its Current Procedural Terminology income stream, not its doctor members. The emperor truly has no clothes, and America’s working physicians have no effective representation to counter the massive power of the federal government and the new Affordable Care Law, which will control the entire health care economy by 2014.

Few Americans understood this before passage of the health care law. Unfortunately for American doctors, even fewer members of Congress were aware of this before their March 2010 vote, which ushered in this massive law.

In return for supporting the bill, the AMA was “promised” a fix to the flawed Medicare payment formula known as the “sustainable growth rate” or the “Doc Fix.” But that hasn’t happened, and there is not an extra $300 billion in the budget for the next decade to accomplish this fix.

So, what’s up with the American Medical Association? It doesn’t represent American doctors and never should have made that claim or allowed the American public to presume it did in 2009 and 2010. The AMA represents only itself.

Dr. Richard A. Armstrong is the chief operating officer of Docs4PatientCare (docs4patientcare.org).