A.M.A. on the Wrong Side of History

In 1968, Dr. Sidney Wolfe politely and briefly took over a microphone at the American Medical Association’s national meeting because of the A.M.A.'s opposition to the right to health care.

 

Fifty-one years later, the A.M.A., along with its well-financed corporate partners in the Partnership for America's Health Care Future, is still leading the charge against universal, single-payer health care, also known as Medicare for All.

Schnall’s outburst, coordinated by members of Martin Luther King, Jr.’s Poor People’s Campaign and the Medical Committee for Human Rights (M.C.H.R.), aimed to be a wake-up call to an institution that was highly successful at protecting physicians' interests against encroachment but failed to meet the public health and human needs of patients by opposing both civil rights and the expansion of safety-net health programs.

More than 50 years ago, at the 1968 meeting of the American Medical Association, a fourth-year medical student named Peter Schnall seized the microphone and scolded several hundred of the most prestigious, highly educated white men in America.

 

“Organized medicine has never felt responsible and accountable to the American people for its actions and continues to deny them any significant voice in determining the nature of services offered to them,” Schnall chastised the group.

 

“Shut up!” yelled the doctors, who were accustomed to being treated with respect and deference, not with outrage and indignation.

 

The A.M.A. Against Civil Rights

“There, King spoke words that have since become a maxim: ‘Of all the inequalities that exist, the injustice in health care is the most shocking and inhuman.’ In the moment, it reflected the work that King and...the [Medical Committee for Human Rights], were doing to advance one of the since-forgotten pillars of the civil-rights movement: the idea that health care is a right. To those heroes of the civil-rights movement, it was clear that the demons of inequality that have always haunted America could not be vanquished without the establishment and protection of that right.”

At a time when Jim Crow racism harmed the health of millions of African Americans in the South, the A.M.A. repeatedly rebuffed requests from the National Medical Association, an organization that represents African-American physicians, to work together to end racial health disparities. Even after the passage of the Civil Rights Act in 1964, the A.M.A. allowed local medical societies to discriminate against physicians and patients of color.

 

It was in this context that Dr. Martin Luther King, Jr. used the pulpit to show how the human right to health is inextricably linked with labor and racial issues.

 

“Speaking to a packed, mixed-race crowd of physicians and health care workers in Chicago, King gave one of his most influential late-career speeches, blasting the A.M.A. and other organizations for a ‘conspiracy of inaction’ in the maintenance of a medical apartheid that persisted even then in 1966,” wrote Vann R. Newkirk II for The Atlantic.

 

The A.M.A. Against the Human Right to Health Care

Last year, the A.M.A. joined hands with lobbyists from the pharmaceutical and insurance industries to form the Partnership for America’s Health Care Future. According to documents obtained by The Intercept, the partnership is explicitly organized to “change the conversation around Medicare for All” and “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.”

Today, in the midst of a revived Poor People's Campaign, we find a reformed A.M.A. that has worked to make amends for its racist past by making a break from what King called a “conspiracy of inaction.” However, the A.M.A. continues to play an outsized role in opposing reforms that would establish and protect the human right to health, evidenced by the organization’s sustained animosity towards the implementation of a universal, single-payer health program.

 

Throughout the 20th Century, the A.M.A. mobilized attacks against major social programs, from Social Security to Medicare and Medicaid, but reserved special animus for any attempt to pass compulsory health insurance, even over the objections of its members. In 1949, the A.M.A. leadership declared war against President Truman’s proposed national health insurance program, spending $5 million on a powerful lobbying and media campaign to mislabel single-payer healthcare as “socialized medicine.”

 

The A.M.A. Against Physicians, Students,
and the American Public

Will the A.M.A. choose to move toward guaranteeing health care as a human right or continue down the wrong side of history by linking their patients’ health to the whims of the private insurance market?

In response to the A.M.A.’s continued intransigence, physicians and medical students are again pressuring the AMA to be more responsive to the needs of the nation's uninsured and underinsured. At the A.M.A. annual conference last June, medical students demanded the organization end its decades-long opposition to a national health program. Taking similar action, members of the Student Osteopathic Medical Association (S.O.M.A.) asked the American Osteopathic Association (A.O.A.) to pledge its support for Medicare for All in July. The activists are doing this because, for better or for worse, the A.M.A. sets the agenda for American health policy.

 

Contrary to the A.M.A.’s assertions, a single-payer system would give health care providers more autonomy because their clinical decisions can’t be second-guessed by insurance companies. Patients would have free choice of any doctor, allowing providers to compete based on quality of care. Physicians would spend less time on administrative responsibilities like paperwork and billing, and more time seeing patients, which boosts both their work satisfaction and income. In fact, when Canada implemented their single-payer program, physicians enjoyed long-term salary increases.

 

The A.M.A.’s opposition to Medicare for all puts the organization at odds with the public, and America’s doctors. The overwhelming majority of Americans—70 percent—now favor the creation of a publicly financed but privately delivered single-payer program, more popularly known as Medicare for All, the best option for ensuring that every American has access to quality health care.

 

Meanwhile, the majority of practicing physicians—56 percent—also favor single payer. H.R. 1384, the single-payer bill in the House, currently has 106 co-sponsors; Sen. Bernie Sanders introduced his updated Medicare for All Act in 2017 with a record 16 Senate co-sponsors, including most of the leading Democratic contenders for president in 2020.

 

Although its membership has steadily declined since the 1950s, the A.M.A. remains the most powerful doctors group in the country. Since 1998, the A.M.A. has shelled out nearly $380 million lobbying members of Congress and government officials, outspent only by the U.S. Chamber of Commerce and the National Association of Realtors.

 

Portions of this history appeared in an editorial written by Jonathan Michels, Robertha Barnes and Sydney Russell Leed and published in STAT News.

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