AMA: Docs Debate Managed Care, E-Health, Death Penalty
The nation's largest group of physicians met Sunday at the AMA's annual conference to debate issues such as managed care and Internet medicine, the AP/Ft. Worth Star-Telegram reports. Missouri delegates led the charge against HMOs, asking the AMA to help states organize class-action lawsuits against insurers who deny or delay payment of legitimate claims. According to C.C. Swarens of the Missouri State Medical Association, "if insurers are going to put up roadblocks at every occasion, instead of trying to work with the medical community," then lawsuits may serve as the "best recourse." Susan Pisano of the American Association of Health Plans called the plan "misguided," saying, "There are many other and better avenues for problem solving that don't involve sending things to the courts." Several managed care proposals stand before the association's 550-member policymaking House of Delegates, asking the AMA to:
- back legislation that would prevent HMOs from offering doctors financial incentives to limit care and grant patients access to any physician in a health plan;
- develop legislation banning "all-products clauses" that force doctors to accept patients from all health plans offered by an insurer, rather than allowing them to select the least restrictive;
- launch a campaign urging Congress to amend antitrust laws and allow doctors to collectively bargain with HMOs.
Joining the e-Health Rage
Delegates also debated a "growing challenge" the AMA faces as a provider of medical information during the rapid proliferation of competing health news Internet sites. Dr. E. Radcliffe Anderson, the AMA's executive vice president, announced that the association will redirect proceeds from the $20 million sale of its former headquarters in Chicago into e-commerce. Delegates also urged the AMA to develop a rating system for medical information online and devise methods for protecting patient privacy in cyberspace. Lawrence Gostin, the health, law and ethics editor of the Journal of the American Medical Association, notes that while these issues "may not currently be the most important thing to doctors," they will emerge as top priorities in the next five years (Tanner, 6/10).
AMA conference participants will also debate the death penalty. The American Association of Public Health Physicians today asked the AMA to back a national moratorium on capital punishment, pending debate on controversial issues such as the availability of DNA evidence, the AP/St. Paul Pioneer Press reports. "The principle of 'Do No Harm' is clearly violated when defendants are executed for crimes they did not commit," the AAPHP resolution states. An AMA committee will debate the proposal today and could refer it to the House of Delegates later this week. The resolution refers to a moratorium imposed by Illinois Gov. George Ryan (R) in January, citing 13 death row inmates who were cleared and released since Illinois reinstated the death penalty in 1977. "The possibility exists that in several states innocent individuals may be executed because medical technology will not be made available in time to prevent their death," the AAPHP resolution adds. The AAPHP also urged the AMA to recommend the executions ban to the National Governor's Association until questions about DNA evidence and other legal concerns are resolved (Tanner, 6/12).
Is There Anybody Out There?
While managed care issues, e-health and a proposed capital punishment ban topped the list of doctors' concerns, AMA leaders also face a more pressing plight -- anemic membership and ailing finances. Leaders fear that the AMA could "lose the clout it needs to address physicians' and patients' worries." A recent letter sent to delegates states, "Membership must be a prime consideration in everything the AMA does." While the AMA gained 3,000 new members last year, about two-thirds of the nation's 800,000 doctors, residents and medical students have not joined. Meanwhile, membership revenue dropped by $4.8 million in 1999, contributing to a $9.2 million budget shortfall (AP/Ft. Worth Star-Telegram, 6/10).