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2009-06-16

Dr. Chris McCoy: "Dear AMA: I Quit!"

Topics

Guests

Dr. Quentin Young, National coordinator for Physicians for a National Health Program. He has been a member of the American Medical Association since 1952. He was Reverend Martin Luther King’s doctor when King was organizing in Chicago and was a close ally of Barack Obama in Chicago

Dr. Chris McCoy, an instructor of medicine at the Mayo Clinic and the chair of the policy committee for the National Physicians Alliance. He recently withdrew his membership from the American Medical Association in protest over their position regarding a public healthcare option.

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President Obama is ramping up efforts for his proposed overhaul of the nation’s healthcare system. On Monday, the President spoke at the annual conference of the American Medical Association in Chicago, opening a week in which healthcare will dominate attention in Congress. Obama’s speech before the AMA on Monday came just days after the group signaled opposition to his proposal for a public health plan to compete with private insurers. We speak with Dr. Quentin Young, national coordinator for Physicians for a National Health Program, and Dr. Chris McCoy, an instructor of medicine at the Mayo Clinic and the chair of the policy committee for the National Physicians Alliance. He recently withdrew his membership from the American Medical Association in protest over their position regarding a public healthcare option. [includes rush transcript]

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: President Obama is ramping up efforts for his proposal to overhaul the nation’s healthcare system. On Monday, he spoke at the annual conference of the American Medical Association in Chicago, opening a week in which healthcare will dominate attention in Congress.

On Wednesday, leaders of the Senate Finance Committee hope to unveil what will be the one bipartisan measure in Congress. Obama revealed more details of his plan over the weekend, outlining $313 billion in cuts to Medicare and Medicaid, aimed primarily at the revenue of hospitals and drug makers.

Obama’s speech before the AMA on Monday came just days after the group signaled opposition to his proposal for a public health plan to compete with private insurers. In his speech, Obama defended his plan and used some of his strongest language to date to reject a single-payer system that would eliminate for-profit insurance companies entirely.

    PRESIDENT BARACK OBAMA: Now, I know that there’s some concern about a public option. Even within this organization, there’s healthy debate about it. In particular, I understand that you’re concerned that today’s Medicare rates, which many of you already feel are too low, will be applied broadly in a way that means our cost savings are coming off your backs.

    And these are legitimate concerns, but they’re ones, I believe, that can be overcome. As I stated earlier, the reforms we propose to reimbursement are to reward best practices, focus on patient care, not on the current piecework reimbursements. What we seek is more stability and a healthcare system that’s on a sounder financial footing.

    And the fact is, these reforms need to take place regardless of whether there’s a public option or not. With reform, we will ensure that you are being reimbursed in a thoughtful way that’s tied to patient outcomes, instead of relying on yearly negotiations about the Sustainable Growth Rate formula that’s based on politics and the immediate state of the federal budget in any given year.

    And I just want to point out, the alternative to such reform is a world where healthcare costs grow at an unsustainable rate. And if you don’t think that’s going to threaten your reimbursements and the stability of our healthcare system, you haven’t been paying attention.

    So, the public option is not your enemy; it is your friend, I believe.

    Let me also say that — let me also address a illegitimate concern that’s being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system. I’ll be honest. There are countries where a single-payer system works pretty well. But I believe — and I’ve taken some flak from members of my own party for this belief — that it’s important for our reform efforts to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run healthcare, know this: they’re not telling the truth.

AMY GOODMAN: President Obama, speaking before the American Medical Association in Chicago Monday.

With a quarter of a million members, the AMA is the nation’s largest physician group. It gave more than $1.8 million to federal candidates in the last election cycle. That’s according to the Center for Responsive Politics. Throughout its history, the AMA has opposed most efforts at healthcare reform, including leading the charge in the mid-’60s against the creation of Medicare.

Well, we’re joined right now by two members of the AMA.

Dr. Quentin Young, national coordinator for Physicians for a National Health Program, has been a member of the American Medical Association for more than half a century, since 1952. He was Reverend Dr. Martin Luther King’s doctor when King was organizing in Chicago and was a close ally of Barack Obama in Chicago. He joins us from Chicago.

And joining us on the phone from Rochester, Minnesota, is Dr. Chris McCoy. He is an instructor of medicine at the Mayo Clinic and chair of the policy committee for National Physicians Alliance. He recently withdrew his membership from the AMA in protest over its position against a public healthcare option.

We welcome you both to Democracy Now! I want to begin with Dr. McCoy in Rochester, Minnesota. Dr. McCoy, you just quit the AMA? Why?

DR. CHRIS McCOY: Well, thank you very much for having me on, and it’s an honor to be on with Dr. Young.

The reason I quit was, reviewing the documents that the AMA provided to the Senate Finance Committee regarding the proposals that were out by that committee, I realized that I couldn’t stay with an organization that opposed having a public option in essentially any form. They opposed the first version that was proposed out there. They opposed having, you know, a second version. And then there was an option B that the Senate Finance Committee proposed, which said, you know, no public option at all, and the AMA strongly supported that position. That was something that I couldn’t stand for.

AMY GOODMAN: This isn’t new. The AMA has opposed most healthcare reform. I mean, they were the key fighters against Frances Perkins under FDR. She was the Secretary of Labor. She could not overcome their resistance to national health plan back during the New Deal.

DR. CHRIS McCOY: Sure, and I was hopeful that the AMA’s leadership had changed in the last several years, and the new young physicians in the organization had been able to change the direction of the organization as a whole. But, unfortunately, as we arrived at the key discussion on this debate today, it sounds like they haven’t been able to change their position enough for me to be able to support it.

AMY GOODMAN: Do you have the letter in front of you, Dr. McCoy?

DR. CHRIS McCOY: I do.

AMY GOODMAN: Can you read a part of it?

DR. CHRIS McCOY: Sure. Which part would you like me to read?

AMY GOODMAN: Read the part that means most to you in expressing why you’re quitting the AMA. The headline, “Dear AMA: I quit!” And also, I want to reiterate, you’re speaking to us from Rochester, Minnesota. The Mayo Clinic is known as the leading cancer clinic, really, in the world. What about the significance of where you are?

DR. CHRIS McCOY: Sure. And, of course, I speak on behalf of the National Physicians Alliance, not on the organization, the Mayo Clinic, that I do happen to work for.

But I think it’s important to recognize that being paid for quality is the most important aspect of our healthcare system that we need to change. I think President Obama touched upon that, that our current payment system of a fee for service generates additional tests and procedures and things done to patients, rather than things done for patients. And so, recognizing a new way of paying physicians will cause and create incentives for physicians to provide better care.

But, you know, the key part in my letter, I think, is the discussion of having the public health option available to our public and recognizing that, as physicians, we advocate first what is best for our patients, and then, when that system is designed, we will be able to find our role as providers and as leaders of the healthcare system and guiding that system. And I’m not worried that, you know, our reimbursement will be cut back so much to the point that we won’t be able to make a living. I think physicians will always be respected members of the community, as long as we are doing what is in the public good.

AMY GOODMAN: I thought what you were saying about the fact that you couldn’t get through the second paragraph of the AMA’s opposition to a public health plan, announced last week, before bringing up the issue of physician reimbursement — can you keep going there, on your second paragraph?

DR. CHRIS McCOY: Sure. It’s the fact that the AMA’s sole focus in the last ten years on Capitol Hill has always been, you know, the SGR and physician reimbursement, to the point where they — when they meet with members of Congress, that’s all they ever talk about. They aren’t talking about public health issues, and they aren’t talking about what we need to do for patients. It’s, you know, what can we do for getting providers paid enough, which — that focus, I think, was brought out very well by Atul Gawande’s piece in The New Yorker on how physicians have visualized themselves as business centers and cost-generating centers, and that has driven up the cost of healthcare. And as a physician culture and a healthcare culture, we need to change if we’re going to get costs under control.

AMY GOODMAN: Dr. Quentin Young, you, too, are a member of the AMA. You haven’t quit yet. You’ve been a member for more than half a century. What was your reaction to President Obama’s speech right there in your hometown of Chicago, where he was addressing the AMA?

DR. QUENTIN YOUNG: Well, I was deeply disappointed, because Obama, as we all know, is a brilliant politician and a student of America’s problems, and he has abandoned earlier commitment to single payer for expediency reasons, as far as I can tell.

I am a member of the AMA. But let me explain. I’ve agreed with their policies in the last half-century about a minute and a half. I’m a very severe critic of what AMA has done. And it’s worth noting that AMA membership has dropped from some 90 percent of doctors when I started out a half-century ago, and now about a third of America’s doctors do belong.

The problem is the diagnosis here. America’s difficulties, indeed the crisis in healthcare, is due to one big thing: the multi-payer and private insurance companies. Everybody knows that. Obama knows that. He said he was for single payer not that many years ago, and if he was starting from scratch, was the way he put it, he would go with it. Well, he is starting from scratch, and the failure to grasp the nettle and really give America the kind of healthcare reform system it deserves is very painful and very dangerous.

AMY GOODMAN: President Obama said what are not legitimate concerns are those being put forward claiming “a public option is somehow a Trojan horse for a single-payer system.” He said, “When you hear the naysayers claim that I’m trying to bring about government-run healthcare, know this: they’re not telling the truth.” Dr. Young?

DR. QUENTIN YOUNG: Well, to that extent, he’s accurate. This public option is not a slide toward single payer, unfortunately. This is a bugbear that has haunted American medicine debate, and we have to bring it to an end, because it’s too costly, the whole idea that this is socialized medicine, government medicine. We have magnificent examples of government medicine; reactionaries would never dream of calling them back. I speak of the VA system for veterans; the public hospitals, the safety net for the very poor. We have a variety of public systems. Medicare. Is anybody here advocating an end of Medicare? And that’s the government medicine that they’re making a fuss about.

We haven’t got much time left. The system, as Obama aptly notes, is running amuck, and it’s up to $2.5 trillion and, as we all know, rising at a rate two or three times the rate of inflation. And he’s right in saying the economy can’t tolerate it.

Where he’s wrong is his unwillingness to do the serious job of getting the multi-payer insurance companies out of the mix. They add nothing; they subtract a great, great deal. Public experience with this system is horrible. We have a million people having personal bankruptcy due to unpaid medical bills, and that just went up from 50 percent of personal bankruptcies to 60 percent — 62, to be accurate. And this country, rich as it is, in this economic downturn cannot tolerate it.

Mr. Obama would be wisest to challenge the American people to support single payer, which, I might point out, America’s doctors, in a poll in the University of Indiana last year, April, showed 60 percent of our doctors now support a tax system that provides for healthcare. Doctors have learned there’s something worse than government; it’s called corporations. And we must trade on that insight. And the American public wants it. So, why is there this hesitancy and this currying favor with the reactionaries who talk about socialized medicine? It’s nonsense. It’s American medicine, and it can only grow and serve the people if we have a single-payer system.

AMY GOODMAN: I wanted to get your reaction, Dr. Young, to the new analysis by the Congressional Budget Office that’s concluded Senator Kennedy’s plan to expand healthcare coverage would cost about $1 trillion over the next decade and fall far short of providing universal healthcare coverage. They said the plan would reduce the number of uninsured by 16 million people, but even if the bill became law, 36 million would remain uninsured in 2017.

DR. QUENTIN YOUNG: I believe those estimates are very accurate, and they make my point vividly. Anything less than a national health insurance, which is exactly what nineteen other democratic industrial countries have enacted worldwide —- we’re the odd man out. And we pay twice as much per capita, twice as much for each person in the country, for a system that covers far short of everybody. So I’m sure that the 47 million uninsured we’ve been talking about in the past years has now exceeded 50 or more million people, because of all the people losing their jobs and job-related insurance. That is -—

AMY GOODMAN: We have to break.

DR. QUENTIN YOUNG: That’s a very good estimate. I understand, but I hope the message is out there: single payer.

AMY GOODMAN: We have to break. And when you say, Dr. Quentin Young, single payer, you mean government paying for healthcare, not providing the healthcare.

DR. QUENTIN YOUNG: That’s very important. A private system of delivery, such as we have, hospitals and doctors, and primarily in the private sector, but a government-sponsored insurance plan, which works so marvelously in Medicare. And we have to just make it universal, and we’ll get out of this morass.

AMY GOODMAN: Don’t go away, because we’re just breaking, and we’re going to come back. And we’re also going to go to Montana to speak with a reporter there who has been on the trail of Senator Max Baucus, who has had some pretty raucous caucuses recently, the Senate Finance Committee, which has been looking at the issue of healthcare. Thirteen people have been arrested in those hearings, doctors and nurses and others, simply calling for single payer even to be considered. They recently, after tremendous resistance, had a meeting with Senator Baucus, but it wasn’t a hearing, though Democracy Now! did play an excerpt of a hearing, the first one held on Capitol Hill around the issue of single payer. And you can go to our website to look at that and read that, listen to that, at democracynow.org.

Our guests are Dr. Chris McCoy — he has just quit the American Medical Association — instructor at the Mayo Clinic — because of its policy rejecting a national health option. Dr. Quentin Young was a longtime friend of President Obama. In fact, at the big birthday party for Quentin Young — Dr. Young, you just hit eighty-six?

DR. QUENTIN YOUNG: Well, eighty-six in a couple months. But I’m up there.

AMY GOODMAN: In a couple months. Eighty-five years old, big birthday, President Obama sent his good wishes. And you knew him well. You were the partner of his doctor in Chicago. Dr. Quentin Young has been with the AMA for more than half a century. Stay with us.

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