THE INFLUENCE GAME: Doctors' Lobby in Tricky Spot

Does the AMA matter in the health care debate? Congress is beginning to have its doubts, despite the medical association's deep pockets and platoons of lobbyists.

FILE - In this Oct. 5, 2009, file photo President Barack Obama shakes hands with doctors after...

FILE - In this Oct. 5, 2009, file photo President Barack Obama shakes hands with doctors after making remarks on health care reform in the Rose Garden of the White House in Washington. After a humiliating defeat in the Senate in mid-October, the venerable American Medical Association faces a revolt from both its doctor members and one-time political allies as it struggles to influence an overhaul of the nation's health system. (AP Photo/Gerald Herbert, file)

(AP)

It's lost its principles, some lawmakers and physicians say. Perhaps more damaging: It can't produce votes.

After a humiliating defeat in the Senate, the venerable American Medical Association faces a revolt from both its member doctors and one-time political allies as it struggles to influence an overhaul of the nation's health system.

The group had pinned its hopes on winning a $247 billion, 10-year reprieve from scheduled reimbursement cuts for physicians who treat Medicare patients in return for supporting the White House push for broader changes in health care coverage. When the pay boost was sidetracked last week in the Senate, it undercut the doctors' leverage — just as final negotiations on the broader health bill intensify.

"I can't think of a more ineffective organization when it comes to dealing with Congress," said Sen. John Cornyn, R-Texas, who has tangled with the group in the past. "The lesson I've learned ... is if you agree to fix their compensation, they will basically get in the tank with their natural adversaries."

Democrats aren't as harsh, and they still fear alienating the doctors lobby. But Senate Majority Leader Harry Reid strongly suggested the group had failed to deliver on a pledge of lining up enough votes to pass its high-priority pay rate legislation. "I had been told" they had several Republican votes, he said — votes that didn't materialize.

The AMA's president-elect, Dr. Cecil Wilson, said the group had made no such promises but merely pointed out that many GOP senators had backed similar legislation in the past. The setback followed the AMA's airing of what it said was $1 million worth of television ads in targeted states, designed to bolster support for the bill. It failed because of bipartisan concerns that it would raise federal deficits.