BRASS TACKS

AMA: II

(This article is the second on the political record of the American Medical Association. A third article will discuss the AMA's campaign against the President's health-insurance program.)

The AMA has been waging last-ditch battles against socialism for 30 years. From ditch to ditch they have retreated, but they drag their guns along, ever convinced that the hole they're in at the moment is "The American Way."

From 1924 to 1949 the "Voice of the AMA" was Dr. Morris Fishbein, who edited the all-powerful Journal of the Association. Last year the membership finally gagged him for sounding off too loudly and too carelessly, but the spirit of Fishbein lived on.

The negative program of the post-Fishbein Association--which has killed off nearly every recent piece of health legislation--is part of the whole tradition of organized medicine. Before the ad-men finish rewriting that history, here are some facts:

1. The AMA opposed inoculation against smallpox, diphtheria immunization, and venereal disease clinics, claiming they would hurt the economic interests of private physicians.

2. The AMA opposed workmen's compensation ("socialized medicine"), and social security ("communism").

3. The AMA fought federal aid to the states to reduce infant and maternal mortality ("Federal bureaucratic interference with the sacred rights of the American home").

4. The AMA opposed the requirement that all cases of tuberculosis be reported to a public authority--the foundation of tuberculosis control.

5. The AMA opposed--and still does--the creation of free diagnostic clinics for tuberculosis and cancer.

6. The AMA was against the Red Cross plan of 1947 for a nationwide reserve of civilian blood banks ("socialized medicine").

In 1932 the Report of the Committee on the Costs of Medical Care backed voluntary medical insurance as the best answer to the health problems of the average citizen and of "the unfortunate physician facing starvation" (about one out of three, at that time). Fishbein's reply to the suggestion: "Socialism and communism, inciting to revolution."

When group practices with hospital insurance sprang up anyway, they were "medical soviets." When whole state societies formed plans, the AMA gave ground, but went on giving the black spot to any doctor who joined programs outside the societies. In 1943 the Supreme Court unanimously convicted the Association of conspiracy to obstruct (by expelling members) medical care organizations other than those they sponsored.

Despite the AMA's resistance, Blue Cross hospitalization insurance took hold, and so did Blue Shield medical insurance, beginning in 1946. Meanwhile, many doctors had become convinced that voluntary plans were not enough; the AMA's resolute opposition to any plans at all left them no choice but to accept the principle of government insurance. At this late date, the lines of battle having moved beyond them, the AMA decided that it was time to back the voluntary plans.

What they were really against, they found, was government insurance. Whereupon they hired an advertising team and raised two and a half million dollars for a "National Education Campaign" to teach people that the voluntary was the AMA's way, and that "The AMA Way is the American Way."