Obama Faces Tough Audience at AMA

It's been a long, long time since a sitting president of the United States talked face-to-face with the American Medical Association. So it's not surprising that the more than 500 AMA delegates, friends and relatives assembled here are focusing all their energies on President Barack Obama takes the podium Monday.

Obama's speech will end a 26-year long drought for presidential speeches at the AMA; Ronald Reagan addressed the delegates in 1983, the same year he proposed to freeze Medicare payments to physicians while his administration worked to cobble together a Medicare overhaul.

The freeze, and a short-lived Medicare option called part C, which covered catastrophic medical expenses, were widely considered to be flops. When President Barack Obama delivers a speech today in front of the AMA House of Delegates, it will be poignant occasion for the divisive doctors' group for a number of reasons.

VIDEO: Health Care Controversy
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The years since the Reagan speech have been tough ones for the AMA, which has seen both its membership roles and its revenues shrink. The group still describes itself as the "house of medicine" with a membership of about 236,000 physicians, but 30 percent of them are students, who pay no dues, and only about half are practicing physicians.

Moreover, the AMA has a struggled with its image. Last year it issued a formal apology for its past history of racial discrimination.

Second, it's no secret that the group has vocally opposed many healthcare legislation and overhaul efforts in the past 40 years, from the creation of Medicare to the failed reform efforts of the 1990s.

Video of Obama talking about health care reform.
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In March, Dr. Nancy Nielsen, the AMA's outgoing president, told MedPage Today that the AMA felt spurned during the Clinton administration when it wasn't invited to a single healthcare reform discussion.

Rather than sitting out that the battle over the Clinton plan, the AMA, along with insurers, launched a major offensive that some say was the main reason the reform efforts failed.

American Medical Association Weighs in on Health Care Reform

"You know, we have sometimes drawn lines in the sand that have left our AMA blamed for blocking reforms," Nielsen told the delegates during the opening session of this year's meeting.

But she promised the crowd that it is different this time around.

Nielsen called the current climate, where healthcare reform may soon be a reality, "our profession's D-Day."

"The decisions we make in the next four days will have a profound impact, and the country is watching," she said.

Indeed, many are watching to see what side the AMA eventually comes down on as more specifics on healthcare reform plans from the White House and Congress are revealed.

It's not yet clear exactly how the AMA's ideology will meld with reform efforts. For instance, the AMA has come out against a public plan option that would pay physicians at Medicare-like rates. But the group was angered last week after it felt that a New York Times article mischaracterized the group as being in all-out opposition to any variation of the current health insurance system .

"The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians, " Nielsen said in a release.

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