well, let’s just say that my reaction is the same, if not quite so virulent, as if George Bush is for something. At best it’s “what am I missing. In what way is what they are for evil or stupid and probably both?”
I bring this up because the AMA has endorsed the House health care plan.
The AMA primarily represents the interests of proceduralists in the medical professions. That is, they look after doctors who get paid for doing things – heart surgery, tests, etc…
Payment by procedure is one of the biggest problems facing the US. American doctors do more surgeries and order more tests than doctors in any other country. You might think it’s good, but in fact the data shows it doesn’t improve health outcomes, in fact, too many procedures and tests seem to have a slight negative result.
In their letter the AMA refers to the Sustainable Growth Rate (SGR). This is the formula by which Congress tries to restrain the growth in Medicare costs. If they grow too fast, it leads to blanket cuts in rates for future years. Every year the AMA has to lobby against it, to stop it from taking effect.
There seems to be a wide consensus that the SGR is a bad idea, but it’s also true that increasing rates for procedures is one of the things which is causing health care costs to explode in the US and that paying too much for procedures and too little for other types of preventative and cognitive care (for example, checking medications to be sure they don’t have negative interactions) has lead to perverse incentives.
TNR’s Cohn thinks that if it’s part of a package that tries to reduce health care costs and improve quality, he’s all for it. But I’m dubious. The AMA isn’t going to sign onto anything which reduces its members income.
Something else to keep an eye on.