American Physician's versus American Medicine

It is a common misconception that when the American Medical Association speaks it is the voice of America’s doctors. While this may have been true a few decades ago, today fewer than 20% of America’s physicians are actually members of the AMA. Over the years many practicing doctors have left the ranks of the AMA over a variety of political and social stances taken by its leadership. As has been widely reported, there was a significant increase in this gradual exodus following the AMA’s support of the highly controversial Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare.http://blog.heritage.org/2011/06/23/doctors-medical-students-abando...

A major element of the healthcare reform act is a government mandate that all citizens must purchase health insurance, which meets or exceeds specific standards set by the Secretary of Health and Human Services. This feature of the law has been widely criticized by various advocacy groups nationally and it was the subject of intense debate during the latest AMA House of Delegates meeting in Chicago. The majority of the House voted to continue AMA’s policy supporting this insurance purchase requirement. It must be pointed out that the House currently has a disproportionate representation of liberal academic physicians and medical students since most conservatives abandoned the AMA long ago.

Proponents of the policy argue that without a mandate with significant penalties, many people will simply not purchase insurance until they are actually facing a major healthcare expense. Since another feature of the reform law is the highly popular “guaranteed issue” provision, insurers would be compelled to issue their policies even to those facing imminent surgery, costly chemotherapy or any new diagnosis. These so-called “free-riders” would drive the cost of health insurance through the roof for everyone and force more and more people into a single payer system controlled by the government.

A second reason used for supporting the mandate is the idea that when people don’t have health insurance they tend to delay seeking healthcare for treatable problems until late in their course and will avoid routine screening for potentially preventable diseases. Proponents use various studies and statistics in an attempt to demonstrate that people with insurance get better care and are healthier than those who don’t. What they don’t say is many poor “uninsured” Americans qualify for the Medicaid program but fail to avail themselves of this existing benefit. These same people certainly cannot afford to buy private insurance, but under the mandate would be forced to do so or enroll in Medicaid. Essentially, this amounts to forcing such individuals to accept a government handout or face a fine.

Opponents of the mandate, which includes the majority of practicing physicians in America, believe this is a very slippery slope. They argue that if the government can force its citizens to buy health insurance that they don’t want or can’t afford, then there is nothing beyond the scope of their control. It is also pointed out that having health insurance is no guarantee of access to quality healthcare services. It is also clear that many people with insurance don’t get routine check-ups or screening for things like colon cancer, breast cancer, hypertension, etc. What’s next? Is the government going to force everyone to get a colonoscopy according to its guidelines? That would give a whole new meaning to “up yours.”

Perhaps the most important reason why many physicians oppose the mandate is that it is simply un-American. The word mandate is defined as an “authoritative command.” Who is it that has given our government the authority to issue such a command? This country was founded on the principle of individual freedom and personal responsibility with government playing the limited role of defender of those freedoms, not forcing responsibility. As a physician I took an oath to put my patient’s interests above my own; a system that has served society well for 2,500 years. But under the mandated system that the AMA endorses, the government will soon require physicians provide only those treatments that a panel of “government experts” has deemed appropriate. Your physician will have become a government functionary, an employee of the state. Is that what you want, even if it appears to be free?