Episode Information

WWL: "Socialized" Medicine and the AMA
Where We Live - with John Dankosky
Aired:
07/10/2009
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Last month Barack Obama gave the first presidential speech to the American Medical Association in 26 years

 

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26:17 minutes (12.62 MB)
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Last month President Obama gave the first presidential speech to the American Medical Association in 26 years.

The President is looking to the AMA as a partner as he attempts a massive federal health care overhaul.

The last presidential speech to the group was in 1983 by Ronald Reagan.

Reagan launched his political career in the 1960sa as the spokesman for “operation coffeecup” – the AMA’s public relations effort that enlisted thousands of doctor’s wives to arrange coffee klatches to discuss health care issues.

The goal of the campaign was to defeat a congressional health care bill designed to assist elderly Americans – what later became Medicare. The AMA, with Reagan’s help, set the tone for a debate over “socialized medicine” that continues on conservative talk radio today.

Today where we live – we’ll take a look at the history, and how the debate has changed.


 
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Listener Email from Bette

I felt compelled to remark on the Doctor's final statement regarding American's unwillingness to accept "rationing" that occurs in British NHS because "the consumer" won't accept it.

To my mind, those words are the "fighting words" against universal care today.

I teach ethics to nurses and health professionals at the undergrad level. I find that talk of "rationing" sounds, o-so World War 2 and assumes grave sacrifice and poor health must necessarily follow.

But if we can successfully tie the word "ration" to it’s roots in reason and speak of rational health care or rationale for health care, we may come to understand that all reasonable societies require rationing of resources.

An example of irrational health case: My mother is over 90. She was a secretary at UCONN for 35 years and benefits from the CT state pension/insurance that is no longer available to state employees because it was far too expensive.

Mom’s prescriptions cost $3. With no co-pay, she goes to the doctor for every twinge and upset and, with the blessing of the insurance company, the doctors test, refer and prescribe like crazy. Heaven forfend that a 90 year old woman (read: "consumer") be less than perfectly comfortable!

Her cardiologist is especially rigorous. She weighs a mere 115 and he requires that she get her cholesterol checked regularly, have echograms and scans of every sort with abandon.

Her PCP and I have tried to encourage her to say the heck with her cholesterol — she already won that game: start drinking milkshakes and eating cheesecake daily for goodness’ sake!! Clog those arteries!

President Obama was right: we do what our doctors tell us because that’s what we do. And so, to cut cholesterol, my Mom eats Lean Cuisine - and wonders why she can't keep her weight on..

Further, and quite reasonably, Mom has trouble with her knees. After many referrals, talk of a knee replacement arose. That’s when it became clear to me: it would be easy to find a surgeon to do this surgery for her — because she has a “right” to her health care as a consumer. Translated: “She has the means to pay.”

I am enormously grateful for the good care my mother receives. Unlike many seniors she does not have to make hard choices between medicines and food. But I have to ask: Is it rational to test her cholesterol and heart function with such urgency? Is it rational to replace 90 year old knees? What is the medical rationale to do this? To continue to treat based on the ability to pay is not merely irrational, it is immoral.

socialized medicine

        Emily- I think you missed my point.  I'm personally not against a single payor system, nor necessarily against rationing, which will come because of budgetary restraints.  But consumers like your mother will not be very happy if they're told they can't get a total knee because they're too old, or get their cholesterol checked to reassure themselves, or get a prescription for every symptom.  In England, three generations have lived with the NHS and de facto rationing, and they are much more willing to accept the argument that age alone is a reason not to be offered certain treatments, or that marginally effective therapies (such as drugs for dementia) are too expensive to be covered.  I do agree that whatever health care system  evolves, we have to come up  with a form of rationing that is rational, based on good ev idence based guidelines.  For a more provocative view on the subject, I suggest you look at a book called "Too Much Medicine, by Dr. Dennis Gottfried, available through Amazon.com .