The American Medical Association has adopted a shrewd strategy in unveiling its anti-insurer healthcare reform advertising campaign. But its effort-cloaking its attempt to ensure economic security for physicians as a crusade for patients' welfare-could backfire.
It's clear the healthcare reform package presented to Congress by President Clinton last fall is dead. The plan took another blow when the leadership of the House Ways and Means Committee shifted from Illinois Democrat Dan Rostenkowski to Sam Gibbons. The Florida Democrat is described by the Almanac of American Politics 1994 as "without great influence" in the Ways and Means Committee or on the floor of the House.
Even before Mr. Rostenkowski's indictment, public support for the Clinton reform proposal had sunk like a rock. Still, no other proposals have ignited vigorous support among the citizenry. Americans seem to want the healthcare system to survive as an enterprise with public and private components, including a strong voice for the medical profession.
But many Americans also see healthcare providers-and physicians in particular-as increasingly greedy and profit-driven. Given such perceptions, the AMA moved in to paint insurers as the villains of the healthcare system.
AMA leaders are arguing that patients, not bureaucrats, should have the final word on choosing physicians and health plans. Under the banner of choice, the medical establishment also seeks to require insurers to fully disclose their coverage terms to consumers. Both positions probably will win points with the public.
But the AMA leadership is dreaming if it expects to fulfill its other-perhaps more fundamental-desire: a healthcare system that is free from government control and that protects physicians from economic reality. The organization's demand that health plans be prohibited from taking costs into consideration when making decisions on physician contracts is a classic example of wanting to have it both ways. And disguising its effort as a patient crusade is misleading.
In a perfect world, price wouldn't be a primary consideration when choosing physicians. But we live in cost-conscious times and to prohibit economic considerations would destroy the gains employers have made in the last decade in achieving more cost-effective care.
If the medical establishment chooses to make the underlying theme of its reform battle physicians' economic security, it runs the risk of winning the battle and losing the healthcare reform war.