Topic: Health Care

Time to Boycott AMA Members?

A quick look at the press releases coming from the AMA during their annual meeting this week revealed numerous protectionist or otherwise paternalistic positions taken by the physician lobby. The august AMA House of Delegates approved resolutions that called for:

  • greater efforts by health insurers to make price information available to patients (physician, heal thyself)
  • a prohibition on direct-to-consumer advertising of every new drug until physicians feel they’ve had enough time to learn about the drug (pity the poor MD who doesn’t know the answers to his patients’ questions – and First Amendment be damned!)
  • regulation of nurse practitioner-run clinics, which offer affordable access to basic care (and pose a threat to physician incomes; blogged previously here)
  • ending alcohol ads on college sports telecasts, smoking bans, warning labels on video games,” etc., etc.
  • urging the Food and Drug Administration (FDA) to revoke the ‘generally recognized as safe’ (GRAS) status of salt and to develop regulatory measures to limit sodium in processed and restaurant foods,” etc., etc.
  • requiring Americans to purchase health insurance (which increases the appetite for physician services; blogged previously here)

Paging Dr. Bastiat …

But not all was venal and meddlesome in Chicago this week. On a (barely) positive note, the AMA gave a “cautious green light” to the practice of “solicitation of organs from potential donors who have no preexisting relationship with the recipient.” So for all of you who are reading this while your blood is flowing through a dialysis machine, and who don’t want to be one of the thousands who will die on the kidney transplant waiting list this year, if you go out and try to find someone who will give you a kidney so that you can live, the AMA has decided that would be “ethically acceptable.” There. Feel better? 

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Voluntary Charity vs. Government Charity

Chris Edwards’ post on FEMA brought to mind a 2002 New York Times article, which I recently found on FreeRepublic.com. The article concerned fiscal shenanigans at the United Way, and FreeRepublic.com allowed readers to post comments. The following were representative:

“Why anyone would give money to (through) the United Way so they can skim their take is beyond me. Pick your favorite charity or cause, and give to them.”

“If anyone at work asks you to give through United Way, point them to the Salvation Army. The difference is like night and day.”

Pity we never see comments like:

Why anyone would give money to FEMA is beyond me. Pick your favorite charity or cause, and give to them.

If anyone at work asks you to contribute to Medicaid or Food Stamps, point them to the Salvation Army. The difference is like night and day.

As I told a (hostile) room of graduate social work students this morning, when charity is coerced, charities don’t have to try nearly as hard.

AMA to the Devil: “Let’s Make a Deal”

A reporter at the AMA annual meeting informs me that the House of Delegates has adopted a resolution with the adorable title of “Individual Responsibility to Obtain Health Insurance.”  An early draft [.doc] of the resolution (prepared by the AMA’s Council on Medical Service, and which may have been modified before passage) recommends this change to AMA policy:

That our American Medical Association support a requirement to purchase a minimum of catastrophic and preventive health insurance coverage for individuals and families earning greater than 500% of the federal poverty level, with substantial tax penalties for noncompliance. 

Once sufficient government subsidies are put in place, the resolution calls for slapping everyone with an individual mandate and “substantial tax penalties for noncompliance.”

As I wrote earlier, the AMA has a long history of using state power to restrict consumer freedom when that freedom might threaten its members’ incomes.  Yes, the AMA used to oppose tax-and-mandate schemes.  But ”in light of shifting public opinion in favor of requiring some individuals to purchase coverage” the AMA now supports requiring consumers to purchase a product that — wait for it — increases the quantity of physician services that consumers demand.

The Council’s reasoning also includes this gem:

In considering an individual requirement for health insurance, the Council believes that at some point incomes rise to a threshold where personal responsibility should be required…

Hmm.  And when incomes rise even higher, say to physician-like levels, what should be required then?

In September, Cato will publish a book by professor of law and medicine David Hyman that catalogues the damage done by physicians’ last deal with the devil.

The AMA: Protectionist to the Core

Radley Balko catalogues some of the wackier things going on at the American Medical Association annual meeting this week.  However, those who were worried that the AMA may have abandoned its old tricks should have no fear.

Among the topics the AMA will consider this week is a call for increased regulation of “convenience clinics” that offer an alternative to the physician’s office (and thus threaten physicians’ incomes).  Such clinics are mushrooming in locations like retail stores.  They provide quick access to basic care by trained nurse practitioners, who refer patients to physicians when necessary.  According to a Chicago Tribune report:

“We see lots of minor illnesses like colds, sore throats, and write a lot of prescriptions, typically for viruses,” said Maxwell, who views her clinic as a complement to a physician’s care. “It’s a place they can go when the doctor’s office is closed.”

…As at most other retail clinics, the operators say their offices are open seven days a week, with evening hours, and no appointment is necessary. A doctor comes by to review charts and other decisions made by the nurse practitioners but typically does not see patients.

Such clinics advertise that they will treat patients with routine maladies in 15 minutes or less, the amount of time you might spend in a waiting room at a doctor’s office as physicians pack more patients into a day.

There’s a very simple solution that the AMA could recommend to physicians who feel threatened by the competition:

  1. Expand your office hours;
  2. Shorten your waiting times;
  3. Lower your prices.

But that’s wishful thinking.  The AMA has a long history of using state power to restrict consumer freedom when that freedom might threaten its members’ incomes.  That unsavory tradition is alive and well.

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Local Musician Tired of Being Hassled by the Man

A recent article on the new Massachusetts health insurance law quotes an aspiring young musician who is skeptical of both the individual mandate and the subsidies designed to help low-income individuals satisfy the mandate:

“I’m aware that I lead a lifestyle where you have to live really cheaply. So something I think about is what if I tried to do something to make a little more money?” said Crosby. “What if I get a job and I start having to pay several hundreds of dollars for health insurance just because I come out of making a low income? Sometimes I think the state does things that encourage people to stay poor.”

Rock on, Ryan Crosby.  Rock on.

Health Care Policy Interview

I am interviewed by Max Borders here.

There are various views on the right. Mine is probably a bit unusual. But the right is often put in the position of trying to defend our existing so-called private insurance system. I prefer to think of our insurance system as not being very private and being sort of more corporatist in the sense of designed by government and implemented by private firms.

There’s lots more. And even more in Crisis of Abundance.

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