Letters to the Editor - July 12, 2004

There are plenty of reasons why physicians should join the AMA - Tax credit plan not market-based - Tax credit plan not right for many - Global tobacco treaty a chance for U.S. to demonstrate goodwill

There are plenty of reasons why physicians should join the AMA

Why is the AMA not supported by more of us? I believe that the AMA is our organization and requires our support. Having been an AMA member since I finished my residency in 1971, I finally attended a House of Delegates meeting last year. As an observer, I was impressed with the representation by delegates from the state medical societies and the democratic process involved.

Why, then, isn't membership higher? Is there a reason we are so reluctant to be a part of the solution rather than being a detractor to an organization that has served us well for over 150 years? And why are we so ready to accept the benefits of its hard work when we have not lifted a finger to assist in the work? I would agree that the AMA has not done everything right over the years. But considering the good the AMA has done with great principles and leadership, how can we, with clear conscience, avoid joining the work in progress for our patients and our profession?

Among the AMA's goals, when established in 1847, was to write a code of ethics and create a uniform and elevated standard for the medical degree. Your education and mine is a direct result of this effort. We are the products of a vastly improved system.

In the more than a century and a half since then, the AMA also has taken a leadership role in every aspect in the development of modern American medicine. It has revealed quackery, championed vaccination and achieved numerous public health victories.

In more recent years, the AMA fought for and got Medicare reimbursement concessions that, in Texas, translate to thousands of dollars per physician; that ought to pay their AMA dues for years!

Since insurance companies base some rates on Medicare fees, stabilizing these fees can hold off insurance rate changes thus creating a multiplier effect.

The modern AMA, of course, also has pushed for other necessary improvements -- including tort reform, medical savings accounts, improved due process for physicians. I will stop now, but there are scores of other initiatives the AMA has undertaken on our behalf.

Perhaps you feel your specialty society does a good enough job. My specialty society (the American Academy of Orthopaedic Surgeons), with 15,000 members, is good but doesn't hold a candle to the more than 200,000 in the AMA. Just think what would happen if, for example, when a senator asks how many doctors the AMA represented, it could say 500,000. Imagine how strong the AMA would be if we all joined.

--Christopher S. Chenault, MD, president, Travis County Medical Society, Austin, Texas

Tax credit plan not market-based

Regarding "Tax credits are best approach for uninsured" (Editorial, June 14): Your call for tax credits as a way to cover the uninsured laughably demonstrates an inept grasp of economics and human behavior.

Your call for "refundable" tax credits for those not paying taxes is not only pure Orwellian doublespeak, but also inappropriate tax policy meddling disguised as health advocacy. You state that "demand would drive the creation of new options." These would be paid for by others -- which will lead to further unrestricted demand and worsening price inflation.

We have more uninsured because of inflation in health care costs, caused by government involvement. Your solution only adds more government and will be anything but "market-based."

--Pat Conrad, MD, Destin, Fla.

Tax credit plan not right for many

Your editorial on tax credits sounds nice but will actually solve few problems (Editorial, June 14). How will that help the legions whose insurance does not cover pregnancy? How will that help people in my office who will not tolerate another payroll deduction? How will that help the unemployed? How will that stop "medical underwriting," whose sole purpose is to deny coverage for pre-existing conditions?

Tax credits and high deductible insurance plans are, at best, a rich man's solution. America and American business need some form of universal health insurance that is not linked to anyone's tenuous employment.

--Martha J. Brewer, MD, Metairie, La.

Global tobacco treaty a chance for U.S. to demonstrate goodwill

Regarding "Global tobacco control: U.S. must prove its mettle" (Editorial, June 28): With tens of millions of lives on the line, and America's credibility in matters of health at stake, it could be argued that no politician can ever wield so much power for good as will President Bush when he sends the world's first-ever health treaty to the U.S. Senate for its requisite 67-vote ratification.

Your editorial on the Framework Convention for Tobacco Control captures the import and urgency of a unanimous World Health Assembly vote. Please don't wait too long, Mr. Bush. Big Tobacco is nobody's friend, really.

--Stephen L. Hansen, MD, San Luis Obispo, Calif.