In a departure from its 1998 decision to back Democratic-sponsored patient-protection legislation, the American Medical Association this year is declining to endorse any bill and wants a bipartisan outcome.
As two more major HMO-reform measures were introduced last week, top AMA lobbyists said the organization of 300,000 physicians instead has advanced principles that it sees as essential.
Among them are requiring that medical necessity be determined by the physicians treating the patient, that health plans not restrict what doctors tell patients about treatment options, that access to emergency and specialty care be guaranteed, and that patients be able to sue health plans when a plan's negligent denial of care results in injury or death.
Last year, Republican congressional leaders pushed through the House a GOP task force bill and largely excluded Democratic advice by keeping the bill out of the normal committee process.
This year, the GOP leadership has indicated that patient-protection legislation will move through the committees.
Because the shape of legislation is likely to change as a result of that process, the AMA will reserve judgment on any specific bill, said Richard Deem, the AMA's vice president of federal affairs and coalitions.
"Our political goals are the same. We haven't backed away from anything," Deem said. "We want to encourage both (parties). I don't think at this point in time it's wise to get locked in."
The AMA's decision in 1998 to endorse the Democratic "Patients' Bill of Rights," as well as an appearance with President Clinton at two events stumping for the bill, caused a rift with GOP leaders, with whom the AMA is closely allied (Aug. 17, 1998, p. 6). Then-Speaker Newt Gingrich (R-Ga.) charged that the AMA Washington office had been responsible for pulling the organization to the left.
Deem said the AMA endorsed the Democratic bill to push Congress into a debate on patient protection.