Rep. Schaaf resigns from AMA, Urges others to follow

In response to the endorsement
by the American Medical Association
of the Senate Health Bill,
Missouri State Representative
Rob Schaaf, M.D., a practicing
family physician, is dropping out
of the AMA and urges fellow
physicians to do the same.
The AMA has ignored the best
interests of patients, opting to protect
special interests. Physicians
need to send the AMA a strong message
that they will not tolerate
AMA’s support of this horrible bill.
The proposal before the Senate
ignores several basic problems with
our health system while enlarging
an already broken Medicaid program
and burdening all patients
with increased health insurance
costs and taxes. Among other problems…
The high cost of defensive medicine
due to frivolous lawsuits is not
addressed.
Market reforms, such as allowing
the purchase of insurance across
state lines and the addition of transparency
to the medical marketplace,
would lower the cost of healthcare
through increased competition but
are left out of the bill.
The perverse incentives built into
the Medicaid program are addressed
for neither patients nor providers.
While the bill includes a huge
expansion of the Medicaid program,
it does nothing to fix the problem
patients have seeing specialists,
many of whom refuse to schedule
adequate visit slots for Medicaid
patients because of the insufficient
payments for care. Medicaid would
continue to pay physicians less than
their cost of providing care. The
Medicaid patients added to the program
by the bill will further worsen
the already severe access problem.
The Medicare Physician Payment
formula is broken and has led to
many physicians refusing to see
Medicare patients. The bill does
not provide the needed fix.
Younger patients would be burdened
with the cost of health insurance
as a result of the prohibition
against preexisting condition exclusions
coupled with the mandate to
purchase insurance.
Political payoffs have resulted in
some states getting greater subsidies
for Medicaid at the expense of other
states such as Missouri under the
bill.
Even though physician-owned
hospitals have been shown to provide
lower cost and more effective
care to patients, physicians would
be banned from future hospital
ownership. This political payoff to
the hospital industry will protect
them from the competition needed
to force down costs and will deny
patients the benefits of better and
less expensive care.
The perverse incentive of costbased
reimbursement of some
providers, including hospitals, is not
addressed.
Patients are not guaranteed access
to their own physicians, as under
the bill, insurance companies would
continue to be allowed to refuse
panel membership to any physician
willing to accept a company’s terms.
According to a recent poll, this simple
reform is supported by over
ninety percent of the public.
The bill contains more regulatory
burdens on physicians and will
make it harder for them to provide
care to patients. Many older physicians
would retire early as as a
result, frustrated with an already
over-regulated medical practice.
The employer mandates in the bill
would strain many businesses, thus
putting many workers out of work.
This political payoff would enrich
insurance companies.
Insurance companies would continue
to enjoy exemption from
antitrust law as a result of one senator’s
demand, blatantly protecting
this special interest group that supported
him.
The costs of Medicaid expansion
would eventually become an
unfunded mandate, straining the
budgets of states such as Missouri,
which already has a severe budget
problem.
Increased taxation of makers of
medical devices would reduce innovation
and increase costs for
patients.
While some patients would
receive free or subsidized health
care, they would do so at the
expense of fellow citizens, all of
whom would see increased health
insurance costs as a result of this
bill. Congress has squandered an
opportunity to make changes that
would lower costs for everyone and
instead, Congress plans to move us
closer to socialized medicine. They
are forcing this bill down the
throats of the American public,
which poll after poll show are in
opposition.
I urge AMA member physicians
to contact member services at (800)
262-3211, or by emailing
msc@ama-assn.org, and drop membership
until such time as AMA
demands a meaningful bill before
giving its support. He also urges
physicians to retain membership in
their state organizations, such as the
Missouri State Medical Association,
which has objected to the legislation
before Congress.
Hopefully, if enough physicians
act quickly, the AMA will realize
the seriousness of this mistake and
reverse it. If AMA does so, I will
encourage physicians to reconsider,
as I will, this painful decision to
leave the organization.