By Alex Ruoff
Bloomberg, June 28, 2019
About a decade ago Phillip Verhoef left the American Medical Association because it wouldn’t back efforts to replace the nation’s private health insurance system with a public one. He was frustrated the group focused more on doctors’ pay than what saw as a flawed health system.
Verhoef, assistant professor of medicine and an intensivist at the University of Chicago, has spent the years since selling the idea of “Medicare for All” to medical students, fellow doctors, elected officials and anyone who will listen. He’s met with medical student organizations to explain how it might work and their role in changing people’s minds about the subject.
Now, he’s hoping to convince the AMA it’s time to join him.
“We won’t get single payer until we get a demand for it from a large body of physicians,” Verhoef said. “I believe we can do that.”
Verhoef, who serves on the Illinois board for Physicians for a National Health Program, an organization of about 20,000 doctors who advocate for a single-payer health system, is part of a collection of groups hoping to persuade the AMA to reverse its long-standing opposition to ending private health insurance in the U.S. They see the medical group as crucial to their goal of getting lawmakers—and the nation—to support Medicare for All because the AMA is the single largest organization representing doctors and has a long-standing presence on Capitol Hill.
“They’re on the wrong side of history and we want them to get on the right side,” Lori Clark, executive director of the Jane Addams Senior Caucus, said.
These groups are organizing rallies outside the AMA’s headquarters in Chicago and held a protest inside the group’s annual meeting early in June demanding the country’s largest doctors lobby support some type of Medicare for All legislation.
Their first demand is that the AMA end its association with the Partnership for American’s Health Care Future, a collection of hospital, doctors and insurance groups that works through a D.C.-based lobbying shop to oppose single-payer legislation.
Doctor groups have fought the growth of public insurance largely because it typically pays much less for their services than private insurance. Medicare can pay half or even a third as much for some common doctors services than private insurers.
Making Progress
The organizations pushing for single payer, including the National Nurses United, People’s Action, Democratic Socialists of America, and others, say they’re seeing progress.
AMA members voted down a measure to support a single-payer health system by 53% to 47% in June, the closest the group has ever come on such a vote.
Pramila Jayapal (D-Wash.), the lead sponsor of the House’s Medicare for All bill (H.R. 1384), celebrated the vote as a sign more doctors favor her idea.
“Doctors and the AMA are influencers in this debate and we want them lining up behind us,” she said. “It’s slower than we want, but it’s happening.”
The AMA vote came from the group’s Medical Student Section. “They’re the most interested in what we have to say,” Verhoef said.
However, the groups are also looking at the AMA’s finances and leadership, searching for ways to influence them, Clark said. She said the group has deep pockets, taking in more than $360 million in 2018, according to tax reports. It makes decisions about its lobbying positions based on votes cast by individual delegates.
AMA Stance
After the failed vote on a single-payer amendment, 83% of AMA delegates at that same meeting signed on to a report from the AMA Council of Medical Service calling for policies to “build upon and fix” the Affordable Care Act.
The AMA has fought most expansions of public health insurance programs, including the creation of Medicare in 1965.
The AMA spent nearly $20 million in 2018 on lobbying efforts, partly to fight the push toward Medicare for All, according to lobbying disclosure forms.
The AMA referred questions to the Partnership. Lauren Crawford Shaver, the executive director of the Partnership, said support for Medicare for All is waning, not growing.
“If you look at the polls, people are getting educated and realizing what it means,” Shaver said.
A June 18 poll from the Kaiser Family Foundation showed that most Americans are unaware of how dramatically a single-payer system would change the U.S. health care industry. About 40% of those Kaiser polled thought private insurance would continue in a single-payer system, something the Jayapal bill would nearly eliminate.