Re: FW: AMA Past president's wisdom vs current officer's foolishness

[Guest guest]



That is the most intelligent thing I heard from any AMA pundits in years!! There is hope.

AMA Past president's wisdom vs current officer's foolishnessAMA Past Presidents Drs. , Palmisano and Plested have, in my opinion, elequently stated the opinion of the vast majority of AMA members and of the HOD. See Washington Times OP ED below.So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO and Imediate Past Presdient of the AMA, what is your responce and what are you going to do now?Withdrawl of your unwise endorsment of HR 3200 would seem to be the most rational thing to do at this point don't you think? It is the only action that will calm the storm. W. LaGrelius, MD, FAAFPChair and Immediate Past President, SIMPDDirector, LACMAPresident, LACMA 9Member, CMA HODetc.Washington Times: Government threat to world-class medicineJuly 23, 2009Source: Washington Timesby Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested IIIWe have the best health care system in the world. Most Americans live within an hour's drive of a world-class medical facility filled with expertly trained individuals and state-of-the-art technology delivering medical miracles every day.But today, as our government attempts an overhaul that will significantly restructure and restrict the way in which doctors provide care to their patients, the health care system that so many Americans depend on is at risk. Currently, more than 250 million Americans have health insurance and the vast majority of them are satisfied with the coverage they have and the doctors they see.Why, then, is government trying to upend the entire medical system? The government claims the reason is cost and quality. But the government plan increases the cost and gives a dystopic future of rules that stifle innovation and diminish quality through long waits for care and rationing.What's more perplexing is the American Medical Association's (AMA) recent letter of support of the House health care bill (H.R. 3200), which ignores or violates many of AMA's most important legislative priorities and implements a government option that could restrict doctors' ability to provide patients with the care they need.While we strongly support the AMA as an organization, we do not support this latest action.The AMA's tacit endorsement of the public option in H.R. 3200 is in direct conflict with its long-standing policy, approved by the AMA House of Delegates, of reducing government interference with the work that goes on in a doctor's office or an operating room and is antithetical to what most doctors in America support. A government-controlled health care system, as we've seen in countries around the world, will lead to patients losing their current coverage and choice of doctor, long waiting lines for care, and a government formula to ration medical treatments.In a land founded on liberty, it is wrong that the federal government would dictate to doctors what medical treatments can, or worse, cannot be given to their patients. Unfortunately, in nations around the world, this is already happening.Take, for example, these comments from the then-chairman of the British Medical Association in 2003 as he characterized his nation's government-controlled health care system as "the stifling of innovation by excessive, intrusive audit ... the shackling of doctors by prescribing guidelines, referral guidelines and protocols ... the suffocation of professional responsibility by target-setting and production line values that leave little room for the professional judgment of individual doctors or the needs of individual patients."The House health care bill also ignores two of the AMA's top advocacy priorities: the right of patients and physicians to privately contract with each other without government interference or penalty, and the addition of proven medical-liability reforms.Presently, it is illegal for doctors who accept Medicare payments to waive copayments if a patient is unable to afford them, unless the doctor gets out of Medicare for two years. The rising cost of health care will never be solved without such right of private contract, placing the patient back in control with the physician as trusted adviser.As physicians, we have spent our adult lives caring for patients and advocating what is in their best interests. We've each had the privilege of being president of the AMA. But, instead of endorsing the government plan of health care contained in H.R. 3200, we believe the current health system reform must focus on three key points.First, we should expand the choices of types of plan and access to primary and specialized care.Second, every American should have the opportunity and the responsibility to choose and own the insurance plan that meets their needs and those of their family, with the periodic right to change if dissatisfied with the previous choice. Because the beneficiary owns the coverage, it is totally portable and not locked to specific employment.Third, whoever puts up a subsidy (defined contribution) for the purchase of the insurance should put up the same subsidy, no matter what choice the person makes.Thus, these reforms allow beneficiaries to become prudent purchasers of insurance, and beneficiaries become accountable since they are ultimately in control of the financing system, rather than the employers and/or the government.At some point in our lives, we're all patients, and the way to strengthen our system, to control both cost and quality, is to empower the patient. If the federal government is allowed to expand its role in medicine, our country will see the long waiting lines for care, patients will lose trust in their doctors, and the medical discovery and innovation that has saved and enhanced lives across the country will end.That's something patients -- and doctors -- should not allow to happen.Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested III, are all former presidents of the American Medical Association.

[Guest guest]

,

I am 100% with you.  I hate when they disguise themselves behind

the banner of freedom, choice and best care in the world (true if you can

afford it).  I can’t believe that doctor’s can write these half-lies with

impunity.

José from Hoboken

From:

[mailto: ] On Behalf Of Dr.

Brady

Sent: Friday, July 24, 2009 7:37 AM

To:

Subject: RE: FW: AMA Past president's wisdom vs

current officer's foolishness

There is so much wrong with this letter

that I do not have the time or the inclination to break it down. Let’s just say

it starts with a lie (“We have the best medical system in the world.â€), adds a

bunch of half-truths in the middle (250 million “happy†with insurance means

that 50 million or 20% don’t have any. Also, this ignores the fact that the

government pays for nearly 125 million of the 250 million who are happy with

their insurance), and ends with the three things they want, which actually kind

of supports the legislation they hate (more competition is added by a public

plan, and an insurance mandate makes the insurance individualized and portable

(unlike it is today)).

This letter makes me very happy I have

not been a member of the AMA since med school. It is a wonderful example of

obstructionist (where is the AMA proposal on how to fix the medical

non-system—oh that’s right, we have the greatest system in the world, why would

it need fixed??) crap that leaves one fifth of all our citizens without health

care and the rest with care that is as good as a flip of the coin and worsening

every day.

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, July 23, 2009 11:23 PM

To:

Subject: FW: AMA Past president's wisdom vs

current officer's foolishness

An interesting post from the Washington Times today...

AMA Past president's wisdom vs current officer's foolishness

AMA Past Presidents Drs. , Palmisano and Plested have, in my opinion,

elequently stated the opinion of the vast majority of AMA members and of the

HOD. See Washington Times OP ED below.

So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO

and Imediate Past Presdient of the AMA, what is your responce and what are you

going to do now?

Withdrawl of your unwise endorsment of HR 3200 would seem to be the most

rational thing to do at this point don't you think? It is the only action that

will calm the storm.

W. LaGrelius, MD, FAAFP

Chair and Immediate Past President, SIMPD

Director, LACMA

President, LACMA 9

Member, CMA HOD

etc.

Washington Times: Government threat to world-class medicine

July 23, 2009

Source: Washington Times

by Dr. H. Jr., Dr. J. Palmisano and Dr. G.

Plested III

We have the best health care system in the world. Most Americans live within an

hour's drive of a world-class medical facility filled with expertly trained

individuals and state-of-the-art technology delivering medical miracles every

day.

But today, as our government attempts an overhaul that will significantly

restructure and restrict the way in which doctors provide care to their

patients, the health care system that so many Americans depend on is at risk.

Currently, more than 250 million Americans have health insurance and the vast

majority of them are satisfied with the coverage they have and the doctors they

see.

Why, then, is government trying to upend the entire medical system? The

government claims the reason is cost and quality. But the government plan

increases the cost and gives a dystopic future of rules that stifle innovation

and diminish quality through long waits for care and rationing.

What's more perplexing is the American Medical Association's (AMA) recent

letter of support of the House health care bill (H.R. 3200), which ignores or

violates many of AMA's most important legislative priorities and implements a

government option that could restrict doctors' ability to provide patients with

the care they need.

While we strongly support the AMA as an organization, we do not support this

latest action.

The AMA's tacit endorsement of the public option in H.R. 3200 is in direct

conflict with its long-standing policy, approved by the AMA House of Delegates,

of reducing government interference with the work that goes on in a doctor's

office or an operating room and is antithetical to what most doctors in America

support. A government-controlled health care system, as we've seen in countries

around the world, will lead to patients losing their current coverage and

choice of doctor, long waiting lines for care, and a government formula to

ration medical treatments.

In a land founded on liberty, it is wrong that the federal government would

dictate to doctors what medical treatments can, or worse, cannot be given to

their patients. Unfortunately, in nations around the world, this is already

happening.

Take, for example, these comments from the then-chairman of the British Medical

Association in 2003 as he characterized his nation's government-controlled

health care system as " the stifling of innovation by excessive, intrusive

audit ... the shackling of doctors by prescribing guidelines, referral

guidelines and protocols ... the suffocation of professional responsibility by

target-setting and production line values that leave little room for the

professional judgment of individual doctors or the needs of individual

patients. "

The House health care bill also ignores two of the AMA's top advocacy

priorities: the right of patients and physicians to privately contract with

each other without government interference or penalty, and the addition of

proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to waive

copayments if a patient is unable to afford them, unless the doctor gets out of

Medicare for two years. The rising cost of health care will never be solved

without such right of private contract, placing the patient back in control

with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and advocating

what is in their best interests. We've each had the privilege of being

president of the AMA. But, instead of endorsing the government plan of health

care contained in H.R. 3200, we believe the current health system reform must

focus on three key points.

First, we should expand the choices of types of plan and access to primary and

specialized care.

Second, every American should have the opportunity and the responsibility to

choose and own the insurance plan that meets their needs and those of their

family, with the periodic right to change if dissatisfied with the previous

choice. Because the beneficiary owns the coverage, it is totally portable and

not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the purchase of the

insurance should put up the same subsidy, no matter what choice the person

makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of

insurance, and beneficiaries become accountable since they are ultimately in

control of the financing system, rather than the employers and/or the

government.

At some point in our lives, we're all patients, and the way to strengthen our

system, to control both cost and quality, is to empower the patient. If the

federal government is allowed to expand its role in medicine, our country will

see the long waiting lines for care, patients will lose trust in their doctors,

and the medical discovery and innovation that has saved and enhanced lives

across the country will end.

That's something patients -- and doctors -- should not allow to happen.

Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested

III, are all former presidents of the American Medical Association.

[Guest guest]

Mike,

You are absolutely correct, and after sending the rant, I re-read

what I had written and thought the same thing. But then I got to thinking and I

am not sure how else to describe it (not just the editorial, but the AMAs

position that we have the best care period). When you are generally considered

the “voice of doctors†by nonmedical folks and your position is consistently that

there is nothing wrong and all you have to do is leave us docs alone, but then

when studies come out and patients realize that something is dreadfully wrong, they

go to their legislators (because the voice of doctors is still saying nothing

is wrong). So the legislators come up with a plan and the response is the same

as it always is—this is terrible and will lead to horrible consequences. Well

to me that means they remain an obstruction to changing things for the better. Now,

if they had come up with an alternative plan which tried to do anything other

than keep the failing status quo as it is, then I would say they were simply

disagreeing with the details of the current plan. Remember whining is easy,

doing something is much harder.

I do wish I had used a better word and I yield the conversation

to others who might be more articulate.

From:

[mailto: ] On Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 9:09 AM

To:

Subject: Re: FW: AMA Past president's wisdom vs

current officer's foolishness

, just because someone doesn't agree with the current proposal does not

make them an obstructionist.

Mike

There is so much wrong with this letter

that I do not have the time or the inclination to break it down. Let’s just say

it starts with a lie (“We have the best medical system in the world.â€), adds a

bunch of half-truths in the middle (250 million “happy†with insurance means

that 50 million or 20% don’t have any. Also, this ignores the fact that the

government pays for nearly 125 million of the 250 million who are happy with

their insurance), and ends with the three things they want, which actually kind

of supports the legislation they hate (more competition is added by a public

plan, and an insurance mandate makes the insurance individualized and portable

(unlike it is today)).

This letter makes me very happy I have

not been a member of the AMA since med school. It is a wonderful example of

obstructionist (where is the AMA proposal on how to fix the medical

non-system—oh that’s right, we have the greatest system in the world, why would

it need fixed??) crap that leaves one fifth of all our citizens without health

care and the rest with care that is as good as a flip of the coin and worsening

every day.

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, July 23, 2009 11:23 PM

To:

Subject: FW: AMA Past president's wisdom vs

current officer's foolishness

An interesting post from the Washington Times today...

AMA Past president's wisdom vs current officer's foolishness

AMA Past Presidents Drs. , Palmisano and Plested have, in my opinion,

elequently stated the opinion of the vast majority of AMA members and of the

HOD. See Washington Times OP ED below.

So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO

and Imediate Past Presdient of the AMA, what is your responce and what are you

going to do now?

Withdrawl of your unwise endorsment of HR 3200 would seem to be the most

rational thing to do at this point don't you think? It is the only action that

will calm the storm.

W. LaGrelius, MD, FAAFP

Chair and Immediate Past President, SIMPD

Director, LACMA

President, LACMA 9

Member, CMA HOD

etc.

Washington Times: Government threat to world-class medicine

July 23, 2009

Source: Washington Times

by Dr. H. Jr., Dr. J. Palmisano and Dr. G.

Plested III

We have the best health care system in the world. Most Americans live within an

hour's drive of a world-class medical facility filled with expertly trained

individuals and state-of-the-art technology delivering medical miracles every day.

But today, as our government attempts an overhaul that will significantly

restructure and restrict the way in which doctors provide care to their

patients, the health care system that so many Americans depend on is at risk.

Currently, more than 250 million Americans have health insurance and the vast

majority of them are satisfied with the coverage they have and the doctors they

see.

Why, then, is government trying to upend the entire medical system? The

government claims the reason is cost and quality. But the government plan

increases the cost and gives a dystopic future of rules that stifle innovation

and diminish quality through long waits for care and rationing.

What's more perplexing is the American Medical Association's (AMA) recent

letter of support of the House health care bill (H.R. 3200), which ignores or

violates many of AMA's most important legislative priorities and implements a

government option that could restrict doctors' ability to provide patients with

the care they need.

While we strongly support the AMA as an organization, we do not support this

latest action.

The AMA's tacit endorsement of the public option in H.R. 3200 is in direct

conflict with its long-standing policy, approved by the AMA House of Delegates,

of reducing government interference with the work that goes on in a doctor's

office or an operating room and is antithetical to what most doctors in America

support. A government-controlled health care system, as we've seen in countries

around the world, will lead to patients losing their current coverage and

choice of doctor, long waiting lines for care, and a government formula to

ration medical treatments.

In a land founded on liberty, it is wrong that the federal government would

dictate to doctors what medical treatments can, or worse, cannot be given to

their patients. Unfortunately, in nations around the world, this is already

happening.

Take, for example, these comments from the then-chairman of the British Medical

Association in 2003 as he characterized his nation's government-controlled

health care system as " the stifling of innovation by excessive, intrusive

audit ... the shackling of doctors by prescribing guidelines, referral

guidelines and protocols ... the suffocation of professional responsibility by

target-setting and production line values that leave little room for the

professional judgment of individual doctors or the needs of individual

patients. "

The House health care bill also ignores two of the AMA's top advocacy

priorities: the right of patients and physicians to privately contract with

each other without government interference or penalty, and the addition of

proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to waive

copayments if a patient is unable to afford them, unless the doctor gets out of

Medicare for two years. The rising cost of health care will never be solved

without such right of private contract, placing the patient back in control

with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and advocating

what is in their best interests. We've each had the privilege of being

president of the AMA. But, instead of endorsing the government plan of health

care contained in H.R. 3200, we believe the current health system reform must

focus on three key points.

First, we should expand the choices of types of plan and access to primary and

specialized care.

Second, every American should have the opportunity and the responsibility to

choose and own the insurance plan that meets their needs and those of their

family, with the periodic right to change if dissatisfied with the previous

choice. Because the beneficiary owns the coverage, it is totally portable and

not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the purchase of the

insurance should put up the same subsidy, no matter what choice the person

makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of

insurance, and beneficiaries become accountable since they are ultimately in

control of the financing system, rather than the employers and/or the

government.

At some point in our lives, we're all patients, and the way to strengthen our

system, to control both cost and quality, is to empower the patient. If the

federal government is allowed to expand its role in medicine, our country will

see the long waiting lines for care, patients will lose trust in their doctors,

and the medical discovery and innovation that has saved and enhanced lives

across the country will end.

That's something patients -- and doctors -- should not allow to happen.

Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested

III, are all former presidents of the American Medical Association.

[Guest guest]

,

I had the same thoughts about sending my reply also after it went out,

I was in between folks and hit a quick send. 

So much for me being quick to listen and  slow to speak.  I really

think the majority of physicians would like to see as many patients

covered as possible.  I think that most primary care doctors work in

the trenches and honestly try to give good care.

Everyone recognizes the system has problems.  I think we disagree when

we look at the solutions.  I think the same love for our patients that

might have us support universal care might also cause us to pull back

if we feel the current solution might harm or worsen the care of other

patients. Mike

 

Mike,

You are absolutely

correct, and after sending the rant, I re-read

what I had written and thought the same thing. But then I got to

thinking and I

am not sure how else to describe it (not just the editorial, but the

AMAs

position that we have the best care period). When you are generally

considered

the “voice of doctors†by nonmedical folks and your position is

consistently that

there is nothing wrong and all you have to do is leave us docs alone,

but then

when studies come out and patients realize that something is dreadfully

wrong, they

go to their legislators (because the voice of doctors is still saying

nothing

is wrong). So the legislators come up with a plan and the response is

the same

as it always is—this is terrible and will lead to horrible

consequences. Well

to me that means they remain an obstruction to changing things for the

better. Now,

if they had come up with an alternative plan which tried to do anything

other

than keep the failing status quo as it is, then I would say they were

simply

disagreeing with the details of the current plan. Remember whining is

easy,

doing something is much harder.

I do wish I had used

a better word and I yield the conversation

to others who might be more articulate.

 

From:

[mailto: ] On

Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 9:09 AM

To:

Subject: Re: FW: AMA Past

president's wisdom vs

current officer's foolishness

 

 

, just because someone doesn't agree with the current proposal

does not

make them an obstructionist. 

Mike

 

There is so much

wrong with this letter

that I do not have the time or the inclination to break it down. Let’s

just say

it starts with a lie (“We have the best medical system in the world.â€),

adds a

bunch of half-truths in the middle (250 million “happy†with insurance

means

that 50 million or 20% don’t have any. Also, this ignores the fact that

the

government pays for nearly 125 million of the 250 million who are happy

with

their insurance), and ends with the three things they want, which

actually kind

of supports the legislation they hate (more competition is added by a

public

plan, and an insurance mandate makes the insurance individualized and

portable

(unlike it is today)).

This letter makes me

very happy I have

not been a member of the AMA since med school. It is a wonderful

example of

obstructionist (where is the AMA proposal on how to fix the medical

non-system—oh that’s right, we have the greatest system in the world,

why would

it need fixed??) crap that leaves one fifth of all our citizens without

health

care and the rest with care that is as good as a flip of the coin and

worsening

every day.

 

 

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, July 23, 2009 11:23 PM

To:

Subject: FW: AMA Past

president's wisdom vs

current officer's foolishness

 

 

An interesting post from the Washington Times today...

AMA Past president's wisdom vs current officer's foolishness

AMA Past Presidents Drs. , Palmisano and Plested have, in my

opinion,

elequently stated the opinion of the vast majority of AMA members and

of the

HOD. See Washington Times OP ED below.

So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT

Chair, CEO

and Imediate Past Presdient of the AMA, what is your responce and what

are you

going to do now?

Withdrawl of your unwise endorsment of HR 3200 would seem to be the

most

rational thing to do at this point don't you think? It is the only

action that

will calm the storm.

W. LaGrelius, MD, FAAFP

Chair and Immediate Past President, SIMPD

Director, LACMA

President, LACMA 9

Member, CMA HOD

etc.

Washington Times: Government threat to world-class medicine

July 23, 2009

Source: Washington Times

by Dr. H. Jr., Dr. J. Palmisano and Dr.

G.

Plested III

We have the best health care system in the world. Most Americans live

within an

hour's drive of a world-class medical facility filled with expertly

trained

individuals and state-of-the-art technology delivering medical

miracles every day.

But today, as our government attempts an overhaul that will

significantly

restructure and restrict the way in which doctors provide care to their

patients, the health care system that so many Americans depend on is at

risk.

Currently, more than 250 million Americans have health insurance and

the vast

majority of them are satisfied with the coverage they have and the

doctors they

see.

Why, then, is government trying to upend the entire medical system? The

government claims the reason is cost and quality. But the government

plan

increases the cost and gives a dystopic future of rules that stifle

innovation

and diminish quality through long waits for care and rationing.

What's more perplexing is the American Medical Association's (AMA)

recent

letter of support of the House health care bill (H.R. 3200), which

ignores or

violates many of AMA's most important legislative priorities and

implements a

government option that could restrict doctors' ability to provide

patients with

the care they need.

While we strongly support the AMA as an organization, we do not support

this

latest action.

The AMA's tacit endorsement of the public option in H.R. 3200 is in

direct

conflict with its long-standing policy, approved by the AMA House of

Delegates,

of reducing government interference with the work that goes on in a

doctor's

office or an operating room and is antithetical to what most doctors in

America

support. A government-controlled health care system, as we've seen

in countries

around the world, will lead to patients losing their current coverage

and

choice of doctor, long waiting lines for care, and a government formula

to

ration medical treatments.

In a land founded on liberty, it is wrong that the federal government

would

dictate to doctors what medical treatments can, or worse, cannot be

given to

their patients. Unfortunately, in nations around the world, this is

already

happening.

Take, for example, these comments from the then-chairman of the British

Medical

Association in 2003 as he characterized his nation's government-controlled

health

care system as "the stifling of innovation by excessive, intrusive

audit ... the shackling of doctors by prescribing guidelines, referral

guidelines and protocols ... the suffocation of professional

responsibility by

target-setting and production line values that leave little room for

the

professional judgment of individual doctors or the needs of individual

patients."

The House health care bill also ignores two of the AMA's top advocacy

priorities: the right of patients and physicians to privately contract

with

each other without government interference or penalty, and the addition

of

proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to

waive

copayments if a patient is unable to afford them, unless the doctor

gets out of

Medicare for two years. The rising cost of health care will never be

solved

without such right of private contract, placing the patient back in

control

with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and

advocating

what is in their best interests. We've each had the privilege of being

president of the AMA. But, instead of endorsing the government plan of

health

care contained in H.R. 3200, we believe the current health system

reform must

focus on three key points.

First, we should expand the choices of types of plan and access to

primary and

specialized care.

Second, every American should have the opportunity and the

responsibility to

choose and own the insurance plan that meets their needs and those of

their

family, with the periodic right to change if dissatisfied with the

previous

choice. Because the beneficiary owns the coverage, it is totally

portable and

not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the

purchase of the

insurance should put up the same subsidy, no matter what choice the

person

makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of

insurance, and beneficiaries become accountable since they are

ultimately in

control of the financing system, rather than the employers and/or the

government.

At some point in our lives, we're all patients, and the way to

strengthen our

system, to control both cost and quality, is to empower the patient. If

the

federal government is allowed to expand its role in medicine, our

country will

see the long waiting lines for care, patients will lose trust in their

doctors,

and the medical discovery and innovation that has saved and enhanced

lives

across the country will end.

That's something patients -- and doctors -- should not allow to happen.

Dr. H. Jr., Dr. J. Palmisano and Dr. G.

Plested

III, are all former presidents of the American Medical Association.

 

[Guest guest]

I don't typically want to get into a point by point rebuttal, but this letter is a perfect example of political posturing, fear mongering, and demagoguery that it cries out for correction. The letter is a study in false representation and a willful disregard of reality."We have the best health care system in the world."Untrue by study after study after study. Well documented. This opening statement speaks to a willful disregard of fact akin to those who in the past claimed that the world was flat and that the sun orbited the earth."Currently, more than 250 million Americans have health insurance and the vast majority of them are satisfied with the coverage they have and the doctors they see."Untrue in numerous studies. At best displaying an ignorance of studies documenting the immense and growing dismay with health coverage in America."But the government plan increases the cost and gives a dystopic future of rules that stifle innovation and diminish quality through long waits for care and rationing."This is strait from the boardrooms and PR firms of the insurance industry. This hyperbolic demonizing of reform proposals serves nothing but the status quo. Remember who wins if nothing changes - the insurance industry, pharma, and the major corporate players in health care.Another point - the idea that reform plans will result in delays in care and waits keeps coming up in talking points from the status-quo champions. They keep saying that folks in the UK and Canada are miserable with waits and delays compared to the US. This is again factually untrue. Americans report more misery from waits and delays than patients of the NHS in the UK or in Canada. I'm not saying everything is wonderful and perfect in either of those systems, but the "long lines" argument is a false."...it is wrong that the federal government would dictate to doctors what medical treatments can, or worse, cannot be given to their patients."Two points here: 1: Cheap demagoguery here again - this is not what the reform plans are proposing.2: On the other hand this is EXACTLY what the insurance industry is doing RIGHT NOW. Again and example of willful disregard of reality.I come then to the most bizarre turn in the letter - the three key points. What is most bizarre to me is that I totally agree with all three points and each point is included in the very bill they oppose."First, we should expand the choices of types of plan and access to primary and specialized care."That's exactly the point of the public option. It is an option. It is in addition to the current plans. It expands choice."Second, every American should have the opportunity and the responsibility to choose and own the insurance plan that meets their needs and those of their family, with the periodic right to change if dissatisfied with the previous choice. Because the beneficiary owns the coverage, it is totally portable and not locked to specific employment.That is again an essential component of the current reform plans. A basic plan and then choice. Choice to add whatever components meet the needs of the individual & family. It is totally portable and not locked into employment."Third, whoever puts up a subsidy (defined contribution) for the purchase of the insurance should put up the same subsidy, no matter what choice the person makes."Once again - this is in the very bill these folks are saying they oppose.I'm stumped. These guys use bizarre mis-statements of reality to make the case for opposing a bill that does exactly what they claim they support. The basic premise of the letter is "the status quo is working, leave it alone." Remember who wins the status-quo game. Not our patients. Not all the small and large businesses swamped with health care premiums or unable to afford any health coverage for their employees.Not the American taxpayer. Not the 45 million Americans with no health coverage. Not the 26 million additional Americans with health coverage they can't afford to use. Not the 50 percent of people who file for personal bankruptcy because of medical debt (75% of whom had insurance at the time)Certainly not us on the front lines of health care struggling to survive in this oh-so-wonderful status quo environment.I don't know what the future will bring, but the status quo holds no charms for me. The status quo is broken.We are the heart of any high performing health system.Our contribution to framing reform helps make that reform better.No solution will be perfect, but any solution would be better from our involvement and diminished by our absence.We can and should continue our work outside the strictures of the health system, but we have a chance to also work within the system to change it. That chance may be slim and the risks may be great, but to deny ourselves even the slimmest chance would be a shame.I'm willing to speak out against reform that stifles innovation, choice, freedom, care, outcomes, but I'm also willing to speak up for our patients, for reform that inspires and supports innovation, choice, freedom, care, outcomes.Merely obstructing change and calling for status quo serves those who win the status quo game.Gordon AMA Past president's wisdom vs current officer's foolishnessAMA Past Presidents Drs. , Palmisano and Plested have, in my opinion, elequently stated the opinion of the vast majority of AMA members and of the HOD. See Washington Times OP ED below.So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO and Imediate Past Presdient of the AMA, what is your responce and what are you going to do now?Withdrawl of your unwise endorsment of HR 3200 would seem to be the most rational thing to do at this point don't you think? It is the only action that will calm the storm. W. LaGrelius, MD, FAAFPChair and Immediate Past President, SIMPDDirector, LACMAPresident, LACMA 9Member, CMA HODetc.Washington Times: Government threat to world-class medicineJuly 23, 2009Source: Washington Timesby Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested IIIWe have the best health care system in the world. Most Americans live within an hour's drive of a world-class medical facility filled with expertly trained individuals and state-of-the-art technology delivering medical miracles every day.But today, as our government attempts an overhaul that will significantly restructure and restrict the way in which doctors provide care to their patients, the health care system that so many Americans depend on is at risk. Currently, more than 250 million Americans have health insurance and the vast majority of them are satisfied with the coverage they have and the doctors they see.Why, then, is government trying to upend the entire medical system? The government claims the reason is cost and quality. But the government plan increases the cost and gives a dystopic future of rules that stifle innovation and diminish quality through long waits for care and rationing.What's more perplexing is the American Medical Association's (AMA) recent letter of support of the House health care bill (H.R. 3200), which ignores or violates many of AMA's most important legislative priorities and implements a government option that could restrict doctors' ability to provide patients with the care they need.While we strongly support the AMA as an organization, we do not support this latest action.The AMA's tacit endorsement of the public option in H.R. 3200 is in direct conflict with its long-standing policy, approved by the AMA House of Delegates, of reducing government interference with the work that goes on in a doctor's office or an operating room and is antithetical to what most doctors in America support. A government-controlled health care system, as we've seen in countries around the world, will lead to patients losing their current coverage and choice of doctor, long waiting lines for care, and a government formula to ration medical treatments.In a land founded on liberty, it is wrong that the federal government would dictate to doctors what medical treatments can, or worse, cannot be given to their patients. Unfortunately, in nations around the world, this is already happening.Take, for example, these comments from the then-chairman of the British Medical Association in 2003 as he characterized his nation's government-controlled health care system as "the stifling of innovation by excessive, intrusive audit ... the shackling of doctors by prescribing guidelines, referral guidelines and protocols ... the suffocation of professional responsibility by target-setting and production line values that leave little room for the professional judgment of individual doctors or the needs of individual patients."The House health care bill also ignores two of the AMA's top advocacy priorities: the right of patients and physicians to privately contract with each other without government interference or penalty, and the addition of proven medical-liability reforms.Presently, it is illegal for doctors who accept Medicare payments to waive copayments if a patient is unable to afford them, unless the doctor gets out of Medicare for two years. The rising cost of health care will never be solved without such right of private contract, placing the patient back in control with the physician as trusted adviser.As physicians, we have spent our adult lives caring for patients and advocating what is in their best interests. We've each had the privilege of being president of the AMA. But, instead of endorsing the government plan of health care contained in H.R. 3200, we believe the current health system reform must focus on three key points.First, we should expand the choices of types of plan and access to primary and specialized care.Second, every American should have the opportunity and the responsibility to choose and own the insurance plan that meets their needs and those of their family, with the periodic right to change if dissatisfied with the previous choice. Because the beneficiary owns the coverage, it is totally portable and not locked to specific employment.Third, whoever puts up a subsidy (defined contribution) for the purchase of the insurance should put up the same subsidy, no matter what choice the person makes.Thus, these reforms allow beneficiaries to become prudent purchasers of insurance, and beneficiaries become accountable since they are ultimately in control of the financing system, rather than the employers and/or the government.At some point in our lives, we're all patients, and the way to strengthen our system, to control both cost and quality, is to empower the patient. If the federal government is allowed to expand its role in medicine, our country will see the long waiting lines for care, patients will lose trust in their doctors, and the medical discovery and innovation that has saved and enhanced lives across the country will end.That's something patients -- and doctors -- should not allow to happen.Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested III, are all former presidents of the American Medical Association.

[Guest guest]

From Drain, Oregon.

There is one thing I do like about the letter we are all talking about. It proves my contention that all of us, on all sides of the political fence, want the same thing for our patients. Our problems lie elsewhere; in the political polarization that has happened in our country over the last couple of decades, which polarization seems to benefit some folks who do not want us all on the same page.

I hope we can learn patience and trust in each others good intentions, and join in protecting our patients from all those who seek to exploit them for inappropriate ends.

Joanne Holland

[Guest guest]

Nicely said.GFrom Drain, Oregon. There is one thing I do like about the letter we are all talking about. It proves my contention that all of us, on all sides of the political fence, want the same thing for our patients. Our problems lie elsewhere; in the political polarization that has happened in our country over the last couple of decades, which polarization seems to benefit some folks who do not want us all on the same page. I hope we can learn patience and trust in each others good intentions, and join in protecting our patients from all those who seek to exploit them for inappropriate ends. Joanne Holland

[Guest guest]

Mike,

Yep. The devil with all of this is in the yet to be released

details. Perhaps one of the issues is that we are all approaching this with our

own assumptions of what will be in the legislation which serves to do nothing

but create a firestorm. In the meantime, I will heed your advice and be quicker

to listen and slower to speak. Thanks!

From:

[mailto: ] On Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 12:48 PM

To:

Subject: Re: FW: AMA Past president's wisdom vs

current officer's foolishness

,

I had the same thoughts about sending my reply also after it went out, I was in

between folks and hit a quick send.

So much for me being quick to listen and slow to speak. I really think

the majority of physicians would like to see as many patients covered as

possible. I think that most primary care doctors work in the trenches and

honestly try to give good care.

Everyone recognizes the system has problems. I think we disagree when we

look at the solutions. I think the same love for our patients that might

have us support universal care might also cause us to pull back if we feel the

current solution might harm or worsen the care of other patients. Mike

Mike,

You are absolutely correct, and after

sending the rant, I re-read what I had written and thought the same thing. But

then I got to thinking and I am not sure how else to describe it (not just the

editorial, but the AMAs position that we have the best care period). When you

are generally considered the “voice of doctors†by nonmedical folks and your

position is consistently that there is nothing wrong and all you have to do is

leave us docs alone, but then when studies come out and patients realize that

something is dreadfully wrong, they go to their legislators (because the voice

of doctors is still saying nothing is wrong). So the legislators come up with a

plan and the response is the same as it always is—this is terrible and will

lead to horrible consequences. Well to me that means they remain an obstruction

to changing things for the better. Now, if they had come up with an alternative

plan which tried to do anything other than keep the failing status quo as it

is, then I would say they were simply disagreeing with the details of the

current plan. Remember whining is easy, doing something is much harder.

I do wish I had used a better word and I

yield the conversation to others who might be more articulate.

From:

[mailto: ]

On Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 9:09 AM

To:

Subject: Re: FW: AMA Past president's wisdom vs

current officer's foolishness

, just because someone doesn't agree with the current proposal does not

make them an obstructionist.

Mike

There is so much wrong with this letter

that I do not have the time or the inclination to break it down. Let’s just say

it starts with a lie (“We have the best medical system in the world.â€), adds a

bunch of half-truths in the middle (250 million “happy†with insurance means

that 50 million or 20% don’t have any. Also, this ignores the fact that the

government pays for nearly 125 million of the 250 million who are happy with

their insurance), and ends with the three things they want, which actually kind

of supports the legislation they hate (more competition is added by a public

plan, and an insurance mandate makes the insurance individualized and portable

(unlike it is today)).

This letter makes me very happy I have

not been a member of the AMA since med school. It is a wonderful example of obstructionist

(where is the AMA proposal on how to fix the medical non-system—oh that’s

right, we have the greatest system in the world, why would it need fixed??)

crap that leaves one fifth of all our citizens without health care and the rest

with care that is as good as a flip of the coin and worsening every day.

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, July 23, 2009 11:23 PM

To:

Subject: FW: AMA Past president's wisdom vs

current officer's foolishness

An interesting post from the Washington Times today...

AMA Past president's wisdom vs current officer's foolishness

AMA Past Presidents Drs. , Palmisano and Plested have, in my opinion,

elequently stated the opinion of the vast majority of AMA members and of the

HOD. See Washington Times OP ED below.

So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO

and Imediate Past Presdient of the AMA, what is your responce and what are you

going to do now?

Withdrawl of your unwise endorsment of HR 3200 would seem to be the most

rational thing to do at this point don't you think? It is the only action that

will calm the storm.

W. LaGrelius, MD, FAAFP

Chair and Immediate Past President, SIMPD

Director, LACMA

President, LACMA 9

Member, CMA HOD

etc.

Washington Times: Government threat to world-class medicine

July 23, 2009

Source: Washington Times

by Dr. H. Jr., Dr. J. Palmisano and Dr. G.

Plested III

We have the best health care system in the world. Most Americans live within an

hour's drive of a world-class medical facility filled with expertly trained

individuals and state-of-the-art technology delivering medical miracles every

day.

But today, as our government attempts an overhaul that will significantly

restructure and restrict the way in which doctors provide care to their

patients, the health care system that so many Americans depend on is at risk.

Currently, more than 250 million Americans have health insurance and the vast

majority of them are satisfied with the coverage they have and the doctors they

see.

Why, then, is government trying to upend the entire medical system? The

government claims the reason is cost and quality. But the government plan

increases the cost and gives a dystopic future of rules that stifle innovation

and diminish quality through long waits for care and rationing.

What's more perplexing is the American Medical Association's (AMA) recent

letter of support of the House health care bill (H.R. 3200), which ignores or

violates many of AMA's most important legislative priorities and implements a

government option that could restrict doctors' ability to provide patients with

the care they need.

While we strongly support the AMA as an organization, we do not support this

latest action.

The AMA's tacit endorsement of the public option in H.R. 3200 is in direct

conflict with its long-standing policy, approved by the AMA House of Delegates,

of reducing government interference with the work that goes on in a doctor's

office or an operating room and is antithetical to what most doctors in America

support. A government-controlled health care system, as we've seen in countries

around the world, will lead to patients losing their current coverage and

choice of doctor, long waiting lines for care, and a government formula to

ration medical treatments.

In a land founded on liberty, it is wrong that the federal government would

dictate to doctors what medical treatments can, or worse, cannot be given to

their patients. Unfortunately, in nations around the world, this is already

happening.

Take, for example, these comments from the then-chairman of the British Medical

Association in 2003 as he characterized his nation's government-controlled

health care system as " the stifling of innovation by excessive, intrusive

audit ... the shackling of doctors by prescribing guidelines, referral

guidelines and protocols ... the suffocation of professional responsibility by

target-setting and production line values that leave little room for the

professional judgment of individual doctors or the needs of individual

patients. "

The House health care bill also ignores two of the AMA's top advocacy

priorities: the right of patients and physicians to privately contract with

each other without government interference or penalty, and the addition of

proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to waive

copayments if a patient is unable to afford them, unless the doctor gets out of

Medicare for two years. The rising cost of health care will never be solved

without such right of private contract, placing the patient back in control

with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and advocating

what is in their best interests. We've each had the privilege of being

president of the AMA. But, instead of endorsing the government plan of health

care contained in H.R. 3200, we believe the current health system reform must

focus on three key points.

First, we should expand the choices of types of plan and access to primary and

specialized care.

Second, every American should have the opportunity and the responsibility to

choose and own the insurance plan that meets their needs and those of their

family, with the periodic right to change if dissatisfied with the previous

choice. Because the beneficiary owns the coverage, it is totally portable and

not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the purchase of the

insurance should put up the same subsidy, no matter what choice the person

makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of insurance,

and beneficiaries become accountable since they are ultimately in control of

the financing system, rather than the employers and/or the government.

At some point in our lives, we're all patients, and the way to strengthen our

system, to control both cost and quality, is to empower the patient. If the

federal government is allowed to expand its role in medicine, our country will

see the long waiting lines for care, patients will lose trust in their doctors,

and the medical discovery and innovation that has saved and enhanced lives

across the country will end.

That's something patients -- and doctors -- should not allow to happen.

Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested

III, are all former presidents of the American Medical Association.

[Guest guest]

OOPs, I should have said, “I will try to be quicker to listen….â€

No use making empty promises. J

From:

[mailto: ] On Behalf Of Dr.

Brady

Sent: Friday, July 24, 2009 9:42 PM

To:

Subject: RE: FW: AMA Past president's wisdom vs

current officer's foolishness

Mike,

Yep. The devil with all of this is in

the yet to be released details. Perhaps one of the issues is that we are all

approaching this with our own assumptions of what will be in the legislation

which serves to do nothing but create a firestorm. In the meantime, I will heed

your advice and be quicker to listen and slower to speak. Thanks!

From:

[mailto: ]

On Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 12:48 PM

To:

Subject: Re: FW: AMA Past president's wisdom vs

current officer's foolishness

,

I had the same thoughts about sending my reply also after it went out, I was in

between folks and hit a quick send.

So much for me being quick to listen and slow to speak. I really

think the majority of physicians would like to see as many patients covered as

possible. I think that most primary care doctors work in the trenches and

honestly try to give good care.

Everyone recognizes the system has problems. I think we disagree when we

look at the solutions. I think the same love for our patients that might

have us support universal care might also cause us to pull back if we feel the

current solution might harm or worsen the care of other patients. Mike

Mike,

You are absolutely correct, and after

sending the rant, I re-read what I had written and thought the same thing. But

then I got to thinking and I am not sure how else to describe it (not just the

editorial, but the AMAs position that we have the best care period). When you

are generally considered the “voice of doctors†by nonmedical folks and your

position is consistently that there is nothing wrong and all you have to do is

leave us docs alone, but then when studies come out and patients realize that

something is dreadfully wrong, they go to their legislators (because the voice

of doctors is still saying nothing is wrong). So the legislators come up with a

plan and the response is the same as it always is—this is terrible and will

lead to horrible consequences. Well to me that means they remain an obstruction

to changing things for the better. Now, if they had come up with an alternative

plan which tried to do anything other than keep the failing status quo as it

is, then I would say they were simply disagreeing with the details of the

current plan. Remember whining is easy, doing something is much harder.

I do wish I had used a better word and I

yield the conversation to others who might be more articulate.

From:

[mailto: ]

On Behalf Of Kari Jewett

Sent: Friday, July 24, 2009 9:09 AM

To:

Subject: Re: FW: AMA Past president's wisdom vs

current officer's foolishness

, just because someone doesn't agree with the current proposal does not

make them an obstructionist.

Mike

There is so much wrong with this letter

that I do not have the time or the inclination to break it down. Let’s just say

it starts with a lie (“We have the best medical system in the world.â€), adds a

bunch of half-truths in the middle (250 million “happy†with insurance means

that 50 million or 20% don’t have any. Also, this ignores the fact that the

government pays for nearly 125 million of the 250 million who are happy with

their insurance), and ends with the three things they want, which actually kind

of supports the legislation they hate (more competition is added by a public

plan, and an insurance mandate makes the insurance individualized and portable

(unlike it is today)).

This letter makes me very happy I have

not been a member of the AMA since med school. It is a wonderful example of

obstructionist (where is the AMA proposal on how to fix the medical

non-system—oh that’s right, we have the greatest system in the world, why would

it need fixed??) crap that leaves one fifth of all our citizens without health

care and the rest with care that is as good as a flip of the coin and worsening

every day.

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, July 23, 2009 11:23 PM

To:

Subject: FW: AMA Past president's wisdom vs

current officer's foolishness

An interesting post from the Washington Times today...

AMA Past president's wisdom vs current officer's foolishness

AMA Past Presidents Drs. , Palmisano and Plested have, in my opinion,

elequently stated the opinion of the vast majority of AMA members and of the

HOD. See Washington Times OP ED below.

So we ask Drs. Rohack, Patchin, Maves and Nielsen, as President, BOT Chair, CEO

and Imediate Past Presdient of the AMA, what is your responce and what are you

going to do now?

Withdrawl of your unwise endorsment of HR 3200 would seem to be the most

rational thing to do at this point don't you think? It is the only action that

will calm the storm.

W. LaGrelius, MD, FAAFP

Chair and Immediate Past President, SIMPD

Director, LACMA

President, LACMA 9

Member, CMA HOD

etc.

Washington Times: Government threat to world-class medicine

July 23, 2009

Source: Washington Times

by Dr. H. Jr., Dr. J. Palmisano and Dr. G.

Plested III

We have the best health care system in the world. Most Americans live within an

hour's drive of a world-class medical facility filled with expertly trained

individuals and state-of-the-art technology delivering medical miracles every

day.

But today, as our government attempts an overhaul that will significantly

restructure and restrict the way in which doctors provide care to their

patients, the health care system that so many Americans depend on is at risk.

Currently, more than 250 million Americans have health insurance and the vast

majority of them are satisfied with the coverage they have and the doctors they

see.

Why, then, is government trying to upend the entire medical system? The

government claims the reason is cost and quality. But the government plan

increases the cost and gives a dystopic future of rules that stifle innovation

and diminish quality through long waits for care and rationing.

What's more perplexing is the American Medical Association's (AMA) recent

letter of support of the House health care bill (H.R. 3200), which ignores or

violates many of AMA's most important legislative priorities and implements a

government option that could restrict doctors' ability to provide patients with

the care they need.

While we strongly support the AMA as an organization, we do not support this

latest action.

The AMA's tacit endorsement of the public option in H.R. 3200 is in direct conflict

with its long-standing policy, approved by the AMA House of Delegates, of

reducing government interference with the work that goes on in a doctor's

office or an operating room and is antithetical to what most doctors in America

support. A government-controlled health care system, as we've seen in countries

around the world, will lead to patients losing their current coverage and

choice of doctor, long waiting lines for care, and a government formula to

ration medical treatments.

In a land founded on liberty, it is wrong that the federal government would

dictate to doctors what medical treatments can, or worse, cannot be given to

their patients. Unfortunately, in nations around the world, this is already

happening.

Take, for example, these comments from the then-chairman of the British Medical

Association in 2003 as he characterized his nation's government-controlled

health care system as " the stifling of innovation by excessive, intrusive

audit ... the shackling of doctors by prescribing guidelines, referral

guidelines and protocols ... the suffocation of professional responsibility by

target-setting and production line values that leave little room for the

professional judgment of individual doctors or the needs of individual

patients. "

The House health care bill also ignores two of the AMA's top advocacy

priorities: the right of patients and physicians to privately contract with

each other without government interference or penalty, and the addition of

proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to waive

copayments if a patient is unable to afford them, unless the doctor gets out of

Medicare for two years. The rising cost of health care will never be solved

without such right of private contract, placing the patient back in control

with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and advocating

what is in their best interests. We've each had the privilege of being

president of the AMA. But, instead of endorsing the government plan of health

care contained in H.R. 3200, we believe the current health system reform must

focus on three key points.

First, we should expand the choices of types of plan and access to primary and

specialized care.

Second, every American should have the opportunity and the responsibility to

choose and own the insurance plan that meets their needs and those of their

family, with the periodic right to change if dissatisfied with the previous

choice. Because the beneficiary owns the coverage, it is totally portable and

not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the purchase of the

insurance should put up the same subsidy, no matter what choice the person

makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of

insurance, and beneficiaries become accountable since they are ultimately in

control of the financing system, rather than the employers and/or the

government.

At some point in our lives, we're all patients, and the way to strengthen our

system, to control both cost and quality, is to empower the patient. If the

federal government is allowed to expand its role in medicine, our country will

see the long waiting lines for care, patients will lose trust in their doctors,

and the medical discovery and innovation that has saved and enhanced lives

across the country will end.

That's something patients -- and doctors -- should not allow to happen.

Dr. H. Jr., Dr. J. Palmisano and Dr. G. Plested

III, are all former presidents of the American Medical Association.

[Guest guest]

As they exploit all you hard working primaries as well... the polarization you speak of became a fine tuned weapon against real Liberal compromise by Newt the most mean spirited A'hole other than perhaps Cheney. As a NY downstate raised creative type who was a young boy in the 60's can remember, a real Liberal was the guy in the middle between the left and the right, the fence sitter who waffled as the pressure would mount from both sides to finally declare a position and a stance.

Newt's real genious (which I hate but it was a stroke of new speak genious for a manipulative velvet glove and iron fisted SOB like himself) was to turn this middle of the road term into his definition of the "left" effectively cutting off 50% of the more leftist extreme discussion and issues to be compromised on and we have been stuck in this half the real facts and perspectives, like no one even discussing single payor, govt' run health insurance as a great present day example. To be Dick Cheney's left extreme polar opposite, one would have to be Abby Hoffman and the Yippies, Anarcists, but now we are stuck with the like of Bill Clinton's middle of the road (pretty decent, but still sold out the middle class and the unions to NAFTA, large multi-national corporations and un regulated free instead of fair trade) ala NYC's republican Mayor, Lidsay Liberals as the newly defined far left. Yes real Liberals could be from

either side of the debate, the waffled around the middle because either extreme was just that, too extreme to win a majority of voters or to reach a real satisfying compromise for both sides... now today the honest real left side has been cut off and emasculated by Newt's awesome and manipulative use of Orwellian New Speak... I promise you he read 1984 and studied it to be his political bible.

So now today we compromise somewhere between the extreme right to only somewhere around the middle of the road instead of from the far right and the far left to actually meet somewhere in a real middle, ala President Clinton and Mayor Lidsay... Which now even when the right loses they really always win...

So, instead We are always compromsing within the boundaries of the conservative establishment kind of ways of doing things and therefore we never really get to the point of incorporating the spirited and creative voices of the real opposite left of center side of any arguement... Like at least discussing Single Payor and de-centeralized types of primary care as we IMP's are attempting to show and practice the value of smaller is frequently more personal, more aware and involved and much better... We may not get to single payor or really want it either, but by incorporating it we can then get a few of it's best qualities incorporated into what ever version of this we would get, like perhaps one big single insurance pool that can never be used for ANYTHING else, like Gore's lockbox concept that got teased to hell for SS but was a perfectly valid idea that everyone agrees with, stop raiding SS to

close other budge gaps...

Why are we not discussing the de-centalriztion of medicine and data, the elimination of the super large inpersonal factory practices and clinics as a real model for quality and change, or to NOT have centralized medical records databases that are BIG BOTHER at its worst with the risk of everyone's PHI and demographics being used against them or stolen for ID theft. and I refuse to put our kids or our patients into the NYS vaccine registry because it is the being of government accessed and controlled medical information with diagnosis that one can never get away from even if incorrect because some nut job labled you 20 years earlier.... Today employers can access credit scores and history, how long until medical records and history are next??? Every patient who ever speaks about actual care and doctor patient relationships loves the solo, small (2 or 3 docs max) IMP like models of care and practice and knows that

this is the right model for the best care.... Someone who knows your name, your chart and meds without first pulling your chart or asking one of their nurses "who is that crazy old lady???" And yet all the Medical Home models and other forms of reform are all designed to be surrounded and done in the large factory practice kind of model. Most IMP's and other small, solos could never be included or pull it off because they need the secondary army of people following and working behind the doc to make them work...

I'll tell ya, it's Pure evil manipulative genious...

To: Sent: Friday, July 24, 2009 4:44:26 PMSubject: Re: FW: AMA Past president's wisdom vs current officer's foolishness

Nicely said.

G

From Drain, Oregon.

There is one thing I do like about the letter we are all talking about. It proves my contention that all of us, on all sides of the political fence, want the same thing for our patients. Our problems lie elsewhere; in the political polarization that has happened in our country over the last couple of decades, which polarization seems to benefit some folks who do not want us all on the same page.

I hope we can learn patience and trust in each others good intentions, and join in protecting our patients from all those who seek to exploit them for inappropriate ends.

Joanne Holland