AMA Straddles the 'Public Plan' Option

June 17, 2009— -- The American Medical Association did not ring up a "no sale" on President Barack Obama's public plan option in his proposed revamp of the United States health care system, but neither did it sign on the dotted line.

After listening to Obama's words as he spoke to the 535-member house of delegates on Monday, the AMA today voted to "support health system reform alternatives that are consistent with AMA principles of pluralism, freedom of choice, freedom of practice, and universal access for patients."

The AMA initially considered -- then rejected -- a resolution from the Kansas State Medical Society that asked it to oppose the Medicare-like coverage plan for Americans of any age, the so-called public plan option.

In its place, the delegates were urged to support this substitute resolution a substitute resolution stating that the AMA supports " 'public option' alternatives that are consistent with AMA principles of pluralism, freedom of choice, freedom of practice, and universal access for patients."

But today, the delegates balked at including the words "public option" in AMA policy, substituting "health system reform."

In an email, Dr. Donald Palmisano, a Metairie, La., surgeon and former president of the AMA, said the vote today came after "much debate and two reconsiderations yesterday and today."

Palmisano, who has openly opposed the public plan option, called the result a "fascinating example of democracy and debate in action. "

It was also an example of wordsmithing designed to guarantee that the AMA will maintain its seat at the table while critical negotiations continue in Washington, yet at the same time convincing the AMA hardliners that the organization was not giving ground on a contentious issue.

AMA spokesperson Robert Mills described today's action this way: "Delegates decided today to broaden the policy, given the lack of details for 'public option' health insurance."

In a prepared statement, Dr. Nancy Nielsen, the AMA's immediate past president, said the AMA welcomed "and will thoughtfully consider all proposals consistent with AMA principles to provide Americans with affordable, high-quality health coverage."

AMA Remains Wary of 'Public Plan'

The public policy option has been a sticking point for the AMA since it was first proposed, and last week AMA found itself enmeshed in controversy for opposing the public option, and then for retracting its opposition.

The White House is not the only health care reform player pushing a public plan option as a choice in a menu of insurance plans that would be offered to Americans who are currently uninsured.

The public plan is also a key part of leading reform plans, including President Barack Obama's and Sen. Edward Kennedy's bill in the Senate, Health, Education, Labor, and Pensions (HELP) Committee.

But Republicans in Congress are sharply opposed to the idea, calling it a "government takeover," that would drive private insurance companies out of business.

AMA members opposed to the public plan said more government-run insurance would erode the physician-patient relationship.

On Monday, Obama again cemented his support of a public plan when he spoke to the AMA at their annual meeting in Chicago.

"We will stay engaged with Congress and the administration to ensure that health reform proposals meet the AMA's criteria so that health reform makes a positive difference in the lives of our patients," Nielsen said.