Is the American Medical Association<\/strong> going soft on single-payer health care? We\u2019re about to find out.<\/p>\n

For more than a century, the most influential U.S. physician group has stridently opposed what could generally be described as \u201cnational health insurance.\u201d It famously helped defeat health reform efforts in the 1930s and 1940s, delayed the establishment of Medicare for years, and helped sink President Bill Clinton<\/strong>\u2019s health overhaul in the 1990s.<\/p>\n

So it was a big deal when the AMA endorsed the Affordable Care Act in 2009.\u00a0<\/p>\n

(An aside: A main reason the organization offered its support was the promise, in its early forms, that Obamacare would end a pernicious Medicare payment cut. That didn\u2019t happen until 2015. But that\u2019s a whole \u2018nother story.)<\/p>\n

The last time the AMA\u2019s House of Delegates, its policymaking body, debated single-payer health care was in 2019<\/strong>. That effort was spearheaded by the more left-leaning medical student section. The students\u2019 resolution would not have specifically endorsed a single-payer program, such as Medicare-for-all. Instead, they just aimed for the AMA to be neutral on single-payer, dropping its longtime official opposition.<\/p>\n

The students\u2019 resolution failed, but much more narrowly than anticipated: 53 percent<\/strong> to 47 percent<\/strong>.<\/p>\n

This time, it\u2019s not the student section of the organization pushing for a single-payer resolution to be offered at the House of Delegates meeting later this month, at National Harbor outside Washington. It\u2019s the delegation of practicing doctors from New England.<\/p>\n

That alone should help the resolution get taken more seriously than in 2019, said Rohan Khazanchi<\/strong>, who was involved in the student effort in 2019 and is now a second-year resident in internal medicine and pediatrics at Harvard<\/strong>.<\/p>\n

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\u201cFor better or worse, the student section is the conscience of the organization<\/strong>,\u201d Khazanchi said. \u201cThey\u2019re always bringing issues of health and social justice to the floor. But sometimes it\u2019s a little harder for other stakeholders in the House to get behind that.\u201d<\/li>\n<\/ul>\n
He\u2019s also more optimistic because the makeup and leadership of the AMA has shifted in recent years, embracing challenges like health inequities and racism in medicine. \u201cReally big, meaty health justice issues are now being taken on as an express priority of the organization,\u201d he said.<\/p>\n
That leftward shift in political outlook is showing up not just in the AMA, but in medicine as a whole.<\/strong> As the physician population has become younger, more female and less White, doctors (and other college graduates in medicine) have moved from being a reliable Republican constituency<\/u><\/a> to a more reliable Democratic one.<\/p>\n
But even if the AMA votes to stop fighting single-payer, as a practical matter, the resolution won\u2019t have much impact. The organization maintains other policies that would still preclude support for any proposal that would increase the power of payers \u2014 including the government \u2014 over patients and physicians, an AMA spokesperson said in an email.\u00a0<\/p>\n
Another stab at a broad overhaul of the U.S. health-care system is pretty unlikely in the near future anyway, said Zeke Emanuel<\/strong>, a physician who helped former president Barack Obama win passage of the Affordable Care Act and is now vice-provost for global issues and co-director of the Healthcare Transformation Institute<\/strong> at the University of Pennsylvania<\/strong>.<\/p>\n
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\u201cThe system sucks worse than ever<\/strong>. I do think there\u2019s more dissatisfaction\u201d among patients and care providers, he said, despite the ACA extending insurance coverage to millions of Americans.<\/li>\n
\u201cI don\u2019t think it\u2019s at a critical level<\/strong>, and more importantly, we don\u2019t know how to do the strategic reform,\u201d he added.<\/li>\n<\/ul>\n
So the AMA adopting a single-payer resolution won\u2019t \u201cfundamentally change the equation,\u201d Emanuel said. But he feels it would send an important signal. \u201cDocs feel pulled in a million different ways,\u201d he said, \u201cundermining their ability to do the job and their satisfaction. They\u2019re not doing what they came into medicine for, to care for patients.\u201d<\/p>\n
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This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org<\/a>.<\/em><\/p>\n
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