Tag: "American Medical Association"

Robots as Therapists, and Other Links

Robots better than humans at rehab coaching.

A calorie is not a calorie.

Therapeutic Libertarianism.

Michael Millenson: American patients have always been independent.

Medicaid expansion will cost jobs.

Doctor Poll: 69% Pessimistic About Future of Medicine Under ObamaCare

ObamaCare will cause higher costs and waiting lines:

The majority of doctors don’t believe that the AMA represents their views. The primary reason: the AMA’s support of [ObamaCare]. Just 13% of those surveyed backed the Affordable Care Act…

When surveyed by Deloitte, 83% of doctors said one likely change to the medical system as a result of the law would be increased wait times…an inevitable outcome of insuring millions more patients without a matching increase in the number of doctors.

It’s one thing to mandate insurance for all, but quite another to do so without incentivizing physicians or those considering the profession. In fact, the law does the opposite: For many doctors, there becomes a financial disincentive to practice medicine.

The Global Budget in Your Future

There were two announcements last week that I hope you paid attention to:

  • The American Medical Group Association, representing medical groups that provide care for roughly 1 in 3 Americans, said that 90% of its members would not participate in the new Accountable Care Organization (ACO) model the Obama administration wants to impose on Medicare providers.
  • Secretary of Health and Human Services Kathleen Sebelius, exercising new powers conferred upon her by health reform (ObamaCare), said insurers would have to justify any rate increases greater than 10%.

So what does one announcement have to do with the other? A lot. I’ll connect the dots below the fold.

Here’s the bottom line. The administration uses the rhetoric of choice and competition and some isolated souls within it may actually think competitive pressures can reduce health care costs. But if that doesn’t work out, it’s goodbye to volunteerism and hello to another way of constraining costs: global budgets.

If it don’t work out
Then you can tell me goodbye

Is Global Warming Harmful to Your Health?

American Medical Association: Yes

Scholarly studies: No

This is from a study by Tom Moore:

This study shows that climate change would probably reduce mortality in the United States by about 40,000 per year, assuming a 4.5° warmer climate – the IPCC best estimate of temperature change with a doubling of carbon dioxide. Benefits would extend to lower medical costs nationwide. Measuring willingness to pay by wage rates shows that people prefer warm climates and would be willing to give up between $30 billion and $100 billion annually for a 4.5° increase in temperatures.

See this Moore study as well. See also this study here as well as my own thoughts on global warming.

Why Do We Need Unions?

There is one group of workers who have signed a consent decree with the federal government, agreeing to never form a union. Do you know who they are? Answer below the fold.

The economics of unions is quite simple. Like medieval guilds, the goal of a modern union is to monopolize the supply of labor to a market. (See David Henderson here.) With that power, the union can then limit the labor supply and secure above-market wages. Why do unions push for higher wages and benefits even when they cause layoffs? Because trading off smaller output for higher prices is what all monopolies do.

It is sometimes thought that unions are needed to offset the superior bargaining power of employers. But this is bad economics. Do you need to band with other consumers in order to bargain better with Wal-mart? Of course not. Wal-mart’s prices are low not because of your bargaining power, but because it has competitors. Similarly, competition among employers is what keeps wages high in the labor market.

It is sometimes argued that unions are needed to lift people out of poverty. This is even worse economics. Above-market wages for unionized workers are possible only if less fortunate workers can be kept out of the market. Moreover, like the members of medieval guilds, the vast majority of unionized workers today have above-average incomes. They are squarely in the top half of the income distribution, not the bottom half. Unionized professional athletes are downright rich. Poor people almost never form successful labor unions.

Here is a song by Pete Seeger and Arlo Guthrie via Ezra Klein. I’ve added a different caption.

NFL Football Players
Have Learned this Lesson Well

The AMA and the Myth of the “Doc Fix”

Of all the huffery puffery in American health policy, what is the most ridiculous? I think a leading candidate is the never-ending lobbying by the American Medical Association and associated medical societies to implement a so-called “doc fix” for Medicare.  This refers to U.S. government’s spending on doctors who participate in the Medicare Part B program, through which American seniors receive outpatient care.

The federal government attempts to calculate the price and value of each medical service delivered to Medicare beneficiaries by using a formula called the Resource-Based Relative Value Scale (RVBS).  Furthermore, it attempts to limit the total growth of Medicare’s spending on physicians by a method called the Sustainable Growth Rate (SGR), which Congress imposed in 1997.

Should Eligibility for Medicare Be Lowered to Age 55?

“The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”  — Washington Post

“Any plan to expand Medicare, which is the government’s largest public plan, beyond its current scope does not solve the nation’s health care crisis, but compounds it. … This scenario follows the typical pattern for price controls —reduced access, compromised quality and increasing costs anyway. We need to address these problems — not perpetuate them — through health reform legislation.”                    — Mayo Clinic

“A Medicare buy-in…would add millions of more patients to a program where it is difficult for a new enrollee to get an appointment with a physician.”                       — American Medical Association

“Medicare pays hospitals just 91 cents for each dollar of care provided. …  Adding millions of people to these programs at a time when they already severely underfund hospitals is unwise and should be opposed.”  — American Hospital Association


When Franklin D. Roosevelt ran for his fourth term as president, did he and his doctor conceal the fact that he had elevated blood pressure, congestive heart failure and terminal cancer? It appears so.

Even with health reform, access to care to get worse, not better: “The American Medical Association estimates the country will be short 85,000 doctors in primary care, cardiology, oncology and general surgery by 2020.”

Going to an urgent care center or a doc-in-the-box to avoid higher-priced hospital emergency care? Surprise: You may get billed by the hospital anyway.

What Special Interests are Getting for Selling Out on Health Reform

The American Medical Association (AMA): A promise to repeal a scheduled 21 percent cut in physician’s Medicare reimbursements under the current law.

AARP: As many as 8.5 million seniors will lose their Medicare Advantage coverage and be forced to buy Medigap insurance instead. AARP (which has morphed into an insurance company) is one of the main sellers of Medigap.

The drug industry: A 10-year limit of $80 billion in cuts in prescription drug costs and administration assurances that it will continue to bar lower-cost Canadian drugs from coming into the U.S.

Insurance companies: Access to 40 million potential new customers.

Full article in The Hill’s Pundits Blog.

Who Does the AMA Really Represent?

People are fond of believing that the American Medical Association (AMA) represents physicians. But if representation follows revenues, the AMA’s most important customer is probably the federal government.

In1983, an agreement between the Health Care Financing Administration (HCFA) and the AMA made the AMA’s copyrighted Current Procedural Terminology codes (CPT) the sole coding system that could be used for billing Medicare.

An outline of the history of the CPT coding system is contained in a letter from Senator Trent Lott to the Secretary of the Department of Health and Human Services. It is posted on the Association of American Physicians and Surgeons website.