I was familiar with the AMA’s general history of root-and-branch opposition to health care reform over the years. It’s no surprise, after all, that a group which once warned that Medicare would lead to totalitarianism thinks that creating a public health insurance option for non-seniors will also result in apocalypse.
What I hadn’t known until I read my colleague Lee Fang’s excellent backgrounder “A Symbiotic Relationship — The AMA And The For-Profit Health Lobby” published yesterday on the Wonk Room was the real background behind some of this. The AMA’s self-presentation is as a membership organization of doctors. But many doctors, of course, are not AMA members, and the group “inflates its numbers by giving reduced membership fees to medical school students and retirees, who make up about half of the dues payers.” More to the point, over the course of at least a century the AMA has found that it can’t rely on membership dues to generate the kind of revenue that the AMA leadership is looking for. Instead, they’ve turned to corporate sponsorship — businesses with money to make by casting a veneer of medical respectability around their pursuit of profit find a relationship with the AMA to be useful.
Lee offers this charming anecdote about the quality of the public health advice that follows from this practice:
Through the 1930s to 1950s during the tenure of AMA President Morris Fishbein, the tobacco industry leaned on the AMA to substantiate its dubious health claims. Beginning in 1933, JAMA published tobacco advertisements, stating that it had done so only “after careful consideration of the extent to which cigarettes were used by physicians in practice.” The tobacco industry became the AMA’s largest advertiser, and its implicit endorsement of tobacco products allowed companies like Camel to proclaim slogans such as, “More doctors smoke Camels than any other cigarette.”
These days, fortunately, the AMA isn’t on the hook to tobacco companies for its money and it’s not into anything as deadly as touting the health benefits of cigarettes. What they are on the hook for, however, is the pharmaceutical lobby which provides at least 20 percent of the AMA’s budget. And PhRMA is in the midst of a multimillion dollar advocacy campaign against many progressive health reform ideas.