Obama Faces Tough Audience at AMA

CHICAGO, June 15, 2009— -- 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.

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.

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.