Just days before President Barack Obama is set to address the American Medical Association to pitch its members on his vision for health care reform, the 250,000-member physician group announced it would oppose a major component of that effort.
On Wednesday night, the New York Times reported that AMA was "letting Congress know" that it would resist a public plan for health insurance coverage.
Politically, the revelation could be a potentially significant blow to progressive health care reform advocates, who contend that a public option is the best way to reduce costs and increase insurance coverage. AMA has the institutional resources and the prestige to impact debates in the halls of Congress.
Historically and philosophically, however, AMA's opposition is hardly newsworthy. Despite a lofty reputation and purported commitment to universal coverage, AMA has fought almost every major effort at health care reform of the past 70 years. The group's reputation on this matter is so notorious that historians pinpoint it with creating the ominous sounding phrase "socialized medicine" in the early decades of the 1900s.
"The AMA used it to mean any kind of proposal that involved an increased role for the government in the health care system," Jonathan Oberlander, a professor of health policy at the University of North Carolina, told NPR in a 2007 interview. "They also used it to mean things in the private system that they didn't like. So, at one point, HMOs were a form of socialized medicine."
Indeed, the role played by AMA throughout health care reform battles past has often been primarily as the defender of the status quo. In 1935, fears of an AMA backlash helped persuade Franklin Roosevelt's advisers to drop a health care article from the Social Security package -- fearful that the opposition would sink the legislation altogether.
Concerned about government restriction on and oversight over surgical activities -- not to mention the loss of physician income -- the group deployed the "socialized medicine" argument to undermine Harry Truman's effort at a national health care system years later.
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