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AMA-zing Misrepresentation

By Joshua M. Sharfstein

SO you want to be a doctor. Is it for the prestige of being an acknowledged professional? The thrill of saving people from the jaws of death?

Or is it the money?

If this third consideration is drawing you into medicine, fear not. The American Medical Association is already working to protect your income.

The AMA, representing more than 250,000 doctors and medical students, has a well-earned reputation of placing its members' economic interests ahead of, well, everything else in the world. In the 1960s, the AMA opposed the creation of Medicaid and Medicare, for fear that government help to the poor and elderly might slice into physician profits. In the early 1970s, one president of the AMA declared that "health care is a privilege and not a right."

Today, the AMA is more subtle in its methods, but no less ruthless in its intent. Its recent actions on the issues of Medicare reform and abortion reveal the organization's continued emphasis on the bottom line.

OVER the last ten years, costs under the Medicare program have risen at more than four times the rate of inflation. Thousands of senior citizens are grappling with increasing health care costs that outpace their income growth by more than 50 percent.

Over this same period, payments to doctors under Medicare have risen at a rate of almost 20 percent a year. The average doctor now makes $130,000, more than ten times more than the income for the average senior citizen household.

It is not surprising that the AMA sees no problem with wealth aggregating in the hands of doctors while the elderly bear the financial costs. Yet the AMA maintains the charade that it is only acting in the best interests of patients.

In a controversial pamphlet picturing a pitiful old woman, the AMA called Congressional efforts to set targets for Medicare spending "rationing." But every acknowledged senior citizen group in the country, legislators from both parties and President Bush say that the proposal is needed to keep health care affordable.

"There is nothing in this policy that would prevent a physician from providing a benficial service to a patient," writes the Physician Payment Review Commission, a bipartisan group which designed the medicare reform. In other words, the only thing rationed under the proposal are outrageously high doctor fees.

Perhaps the AMA's made its most original argument against limiting costs to senior citizens before the House Ways and Means Committee this March. "Controls on physican fees should not be imposed while the rest of the economy is unregulated," said the AMA representative. In other words, leave us alone until this becomes a communist country.

WHILE the AMA can at least try (and fail) to defend its positions on Medicare reform, its hypocrisy is undeniable on the issue of abortion. Amidst much pomp and circumstance, the AMA filed a pro-choice legal brief with the Supreme Court before the Webster case.

"The individual's fundamental privacy and liberty right to be free of government extends to medical treatment decisions," the legal brief nobly argued. But when this "fundamental right" clashed with the income of doctors, the AMA chose the low road.

In legislative elections across the country, the AMA has supported anti-abortion candidates over those who favor limitations on Medicare physician fees. This past August, the AMA contributed $5,000 to the campaign of Republican Ileana Ros-Lehtinen, who is a notorious anti-abortion extremist. Among other things, this legislator defended a criminal who had attacked an abortion clinic and sponsored a Florida bill to guarantee humane treatment of fetal remains.

Her opponent, strongly pro-choice, had done nothing to alienate the AMA except call for expanded health care in the tradition of the late Claude Pepper.

NOT all doctors agree with all of the AMA's actions. Many support Medicare reform, and most are adamantly pro-choice. Physicians across the country devote thousands of hours to free service, and the vast majority do not overcharge Medicare patients.

It should also be mentioned that not all that the AMA does is wrong. The organization offers a forum for scholarly research that furthers the advancement of medicine. Local branches of the AMA have cooperated with local government to improve the health of thousands of Americans.

Perhaps the real tragedy of the AMA is how it overshadows and, at times, opposes the efforts of thousands of valiant professionals struggling to increase the health of America.

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