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The AMA's Endorsement of a Government Takeover of Health Care: What Doctors Should Know

Posted By John O'Shea, M.D. On July 17, 2009 @ 2:22 pm In Obamacare | Comments Disabled

The recent letter to Congressman Rangel from the AMA in appreciation and support for H.R. 3200, the “America’s Affordable Health Choices Act of 2009” is disconcerting and fails to accurately represent the concerns of many of America’s physicians, myself included. The AMA has failed to clearly discuss the significant trade-offs that private practice physicians and their patients will face if this legislation is rushed through congress.

First of all, if the legislation is passed along with the option of a public plan that competes with private plans, physicians will bear a significant financial burden. According to testimony before the House Energy and Commerce Committee by The Lewin Group, a health care and human services policy research organization, if the public plan is open to individuals and all employers using Medicare payment levels plus 5 percent, as planned, physician net income would fall by 5.4 percent. The loss of net-income would average about $16,207 per physician.

However, these numbers are likely to significantly underestimate the losses in physician income. This analysis assumes that baseline payments in the public program will be based on current Medicare levels. Physicians in the Medicare program currently face a statutory fee cut of 21 percent in January 2010. According to the President’s commitment to budget neutrality, either Congress will need to find a funding source for this shortfall or Medicare payments to physicians (as well as baseline payments in the public option) will be 21 percent lower, making the impact of a public plan option on physician incomes significantly larger.

More important than how much doctors are paid, however, is the effect this legislation will have on the private practice of medicine, an institution that the AMA has sustained since the organization was founded in 1847. If Congress passes H.R. 3200 with a public plan provision, as many as 113.5 persons could be shifted from private insurance into public programs, according to The Lewin Group estimates. This would not only erode private insurance, but the significant cuts in income coupled with an exponential increase in government intrusion will erode the private practice of medicine as it now exists. This contradicts President Obama’s promise to build on what is good in the system.

A considerable number of physicians are puzzled by the AMA’s decision to support legislation that cuts income to physicians, erodes the private practice of medicine and, according to the Congressional Budget Office, has no chance of curtailing health care spending.


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