The standard history of health reform is that for most of the early-20th Century, attempts at change were pummeled by the all-powerful American Medical Association. In his book National Health Insurance, Gerard Boychuck has a good revisionist take on this narrative. Among other things, the AMA spent most of 1949 denouncing Harry Truman's plans as socialism. But by December, polls showed fewer Americans thought the proposal a socialist white paper than had at the beginning of January. Indeed, Boychuck, quoting scholars like Ted Marmor, believes the AMA's influence was largely a convenient myth concocted by supporters of reform:Nevertheless, the AMA has been widely portrayed as determining the fate of national health insurance. In part, this is due to the visibility of the AMA in these debates. It is also, however, the result of a deliberate political strategy of supporters of national health insurance. Unable to get national health legislation through Congress, in no small part because of the recalcitrance of southern Democrats, Truman "responded with vitriolic criticism of the American Medical Association as the public's worst enemy in the effort to redistribute medical care more equitably."[...]In keeping with the strategy of focusing blame on the AMA, supporters of national health legislation portrayed the AMA as a small, powerful, and well-funded group that was waging a propaganda war against a program that would benefit average Americans. The 1949 AMA campaign was referred to by one congressional sponsor of national health legislation as "one of the shrewdest, one of the most calculating, and one of the most cold-blooded lobby operations in history" and by another as "the biggest, most powerful, and unscrupulous lobby in America." Paradoxically the latter would go on to taunt the AMA: "The American Medical Association was my chief opponent in the election last fall. I know their methods. I know that they have very little influence at the ballot box; in fact, their opposition got me so many votes that I won last fall by the largest majority I ever received."
I'd argue that there are certain parallels to the treatment of insurers since 1994. They get a lot of blame for the failure of Clinton's bill. But Clinton's bill failed because it never had congressional or popular support. It's true that the insurance industry also opposed it. But so too did bigger players like the business community. Insurers, however, are wildly unpopular, and so the blame has been laid at their feet. It's something of a face-saving explanation. Better to lose against moneyed villains than fail to have convinced the country of your claims. Gives your supporters someone else to blame.That, however, is a digression from the point of this post, which is that the modern AMA, a less important but still fairly visible institution, has released a letter offering support Obama's eight principles. You can download the full document here. Like all these documents, it's provisional until a specific plan is on the table. But it can't hurt.
