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Second Opinions

Harold Pollack, is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.

In Tuesday’s Los Angeles Times, Rahul Rajkumar and I chide the American Medical Association for its guild-like special-interest stance in the debate over health reform. We were hardly alone. While our op-ed was in the queue, Jonathan Cohn, Ezra Klein, and Nicholas Kristof noted the AMA’s history of opposition to many progressive public health policies.

Watching this latest twist in the health reform debate, I’m struck by extent that the AMA seems stuck in a narrow interest-group model that represents a shrinking segment of the medical profession. Yeah, doctors care about their livelihoods. They care about other things, too.

I’ve previously noted polling data that indicate broad support among doctors for universal coverage and for other progressive measures. These views don’t come from nowhere. They arise from powerful lived experience on the front-lines of American medical care, where doctors see our $2.4 trillion medical system fail to treat people with the effectiveness or the basic decency it should.

I am blessed to spend much of my working day with doctors who practice in the demanding circumstances on Chicago’s south side. I know no other group of privileged and accomplished professionals who work as hard or as skillfully to help low-income patients and others in difficult circumstances.

It’s therefore important to note that the AMA does not speak for all doctors. Its membership stands at 245,000 and has declined. Other voices within the profession are more consistent with public sentiment, and, arguably, with the long-term interests of the medical profession itself. At a press conference two weeks ago, seven physician groups expressed their support for a public insurance plan. Their combined memberships total 215,000. (Rajkumar and I are affiliated with one of these groups, Doctors for America.) That figure is a bit inflated because some doctors belong to multiple groups, but they are catching up.

The AMA has every right to bargain and lobby over lunch pail matters such as Medicare reimbursement rates and malpractice laws. Yet advocates for our society’s greatest profession should do other things, too. The AMA does not adequately represent the compassionate, progressive values that have long animated the best of the medical profession. It should do better, but it’s heartening that other voices are emerging to fill that void.

--Harold Pollack