Medicine as a Public Trust

Nick Kristof has a good column taking note of the fact that there’s no real reason to listen to the AMA on the question of a public plan. After all, “the A.M.A. now represents only 19 percent of practicing physicians” and references the group’s long record of reactionary politics: “the A.M.A. supported segregation, opposed President Harry Truman’s plans for national health insurance, backed tobacco, denounced Medicare and opposed President Bill Clinton’s health reform plan.” For more information on that, see what Lee Fang wrote here. Kristof offers a better source of medical advice:

So I hope President Obama tunes out the A.M.A. and reaches out instead to somebody to whom he’s turned often for medical advice. That’s Dr. David Scheiner, a Chicago internist who was Mr. Obama’s doctor for more than two decades, until he moved into the White House this year.

“They’ve always been on the wrong side of things,” Dr. Scheiner told me, speaking of the A.M.A. “They may be protecting their interests, but they’re not protecting the interests of the American public.

“In the past, physicians have risked their lives to take care of patients. The patient’s health was the bottom line, not the checkbook. Today, it’s just immoral what’s going on. It’s abominable, all these people without health care.

Scheiner, it seems, strongly supports a public option and in an ideal world “would love to go further and see Medicare for all.” Obviously, the outcome of a legislative process never gets you to an ideal world. But I do think that as you head into negotiations and practical politics it is important to keep one eye on where you’d like to end up. Lots of programs—Social Security, to name one—began life as pale shadows of their current selves. And what Scheiner’s getting at here is a fairly fundamental