The AMA's Unhealthy Obsession
by Joe Conason
www.truthdig.com/, June 17, 2009
Campaigning to build the widest possible
consensus for reform of the nation's health care system, Barack
Obama told the delegates of the American Medical Association that
he wants their support, too. Persuasive and always polite, the
president did not mention the embarrassing truth about his hosts-namely,
that the AMA has undermined universal care with mindless zeal
for more than 70 years.
The real question is not what the AMA
will support or whether the attitudes of the AMA have changed,
but why anyone would still heed its policy prescriptions. Very
few national organizations have been so wrong for so long about
the matters most salient to their own members.
The AMA's sad history dates back to the
Depression of the 1930s, when progressive doctors sought to organize
themselves into the first health cooperatives, or health maintenance
organizations, so that they could provide care to working families
under a group plan. Seeing a threat to its own power, the AMA,
in a blatant antitrust violation, prohibited members from working
for those early health maintenance organizations.
During the decades that followed, the
AMA dedicated millions of dollars to stopping universal health
care in the United States, even as other developed nations were
establishing a variety of successful systems that covered every
citizen while holding down costs. This was an obsession that the
organization shared with political forces on the far right. When
President Harry Truman proposed a national health plan in 1948,
the AMA unleashed a Red-baiting fury.
In the book "The Culture of the Cold
War," Stephen J. Whitfield recalls how the AMA vowed to "resist
the enslavement of the medical profession," warning that
Truman was attempting to impose "a monstrosity of Bolshevik
bureaucracy" on America. In pamphlets issued to fight the
Truman plan, AMA publicists included a phony quote from Lenin
proclaiming "socialized medicine is the keystone to the arch
of the Socialist State." The same pamphlets smeared supporters
of Truman's "compulsory health insurance" plan by connecting
them to the Communist Party.
Having killed Truman's bill, the AMA continued
to amass enormous amounts of money for what historians say was
the most massive special-interest campaign in American history
up to that time. Among the darkest episodes was its opposition
to free government-sponsored distribution of the Salk polio vaccine,
which the AMA and its extremist allies regarded as yet another
step toward socialism. That plan, too, was killed, depriving millions
of children and adults of critical care during a national epidemic,
in an act that amounted to a lobbying violation of the Hippocratic
When John F. Kennedy began to work toward
a national health system in 1962, the AMA again mounted a costly
and clever opposition campaign, whose estimated cost reached $50
million-a lot of money in those days.
It was a stealth effort, known as Operation
Coffee Cup, that relied on doctors' wives to spread a propaganda
message, taped by Ronald Reagan, among their friends and neighbors.
As always, the rhetoric was hot. National health insurance would
destroy "the sacred relationship between doctor and patient,"
and even "the sanctity of human personality." Doctors
would be "regimented and made subordinate to the bureaucrat,
and the people forced by law to accept such medical care as could
be provided by a politically appointed bureaucrat."
The AMA finally met defeat in 1965, when
President Lyndon Johnson and a bipartisan coalition in Congress
succeeded in passing Medicare. By then, public support for national
health insurance had swelled, leading to a massive repudiation
of right-wing ideology and the Republican Party in the 1964 election.
Indeed, many Republicans realized that their party's adherence
to the AMA's rigid opposition had led to their catastrophic electoral
That lesson was lost on the AMA, whose
delegates soon elected a daffy far-right doctor employed by oil
billionaire H. L. Hunt as their president, with a mandate to wage
total war against Medicare. The organization has continued to
fight reform, helping to kill plans proposed by every Democratic
The AMA is like a company union that pretends
to represent employees while always protecting the interest of
the boss. The result is that American doctors find themselves
at the mercy of corporate insurance bureaucrats-and that most
of them no longer belong to the once-venerable organization that
purports to speak for them. If the AMA truly supports reform this
time, as its leaders have announced, then it must abandon its
historical subservience to corporate medicine. These physicians
are long overdue to heal themselves.
Joe Conason writes for The New York Observer.