WASHINGTON — The American Medical Assn., after 60 years of opposing any government overhaul of healthcare, is now lobbying and advertising to win public support for President Obama's sweeping plan -- a proposal that promises hundreds of billions of dollars for America's doctors.
Of all the interest groups that have won favorable terms in closed-door negotiations this year, the association representing the nation's physicians may have taken home the biggest prizes, including an agreement to stop planned cuts in Medicare payments that are worth $228 billion to doctors over 10 years.
In addition, the proposal that would require all individuals to obtain medical insurance includes premium subsidies to ensure that their doctor bills would be paid.
The AMA, which many still regard as the country's premier lobbying force, is providing money and grass-roots backing for these and other reforms.
Critics charge that, although doctors will be among those with the most to gain financially, the AMA -- unlike the pharmaceutical and insurance industries -- made relatively few concessions in return. The drug industry, for example, pledged $80 billion in cost reductions. Health insurers agreed to give up restrictions on preexisting conditions.
"To our knowledge, this deal is better than those negotiated so far by drug companies, hospitals or health insurers," said Dr. Henry Simmons, founder of the National Coalition on Health Care, which represents labor, business and medical provider interests. "The question is why."
Health industry analyst Robert Laszewski, a former insurance company executive who tracks health policy for industry clients in Washington, thinks that all of the major interests that once opposed reform, including insurance and drug companies, have received sweetheart deals in exchange for their support.
AMA officials acknowledge the huge turnaround in the organization's position, but they say it reflects changes in the healthcare system and the way doctors feel about it.
In the past, the AMA saw the government as endangering doctors' incomes and independence. Now, with the advent of Medicare and other federal programs, which the organization originally opposed, the government has become a vital source of revenue and stability for doctors.
"Doctors are really, really discouraged now about people not getting access to medical care," said Dr. Nancy Nielsen, immediate past president of the AMA, who has been meeting with top congressional officials this summer on behalf of the association.
