“What I hope is the members who disagree with the policy will stay in AMA and work hard to change it to what they think is better.”
membership with the AMA. It’s a chance you have to take when you’re a demo- cratic membership organization. What I hope is the members who disagree with the policy will stay in the AMA and work hard to change it to what they think is better.” A report released at the meeting showed that AMA lost 12,000 dues- paying members last year. AMA leaders say they will continue to look at alterna- tive membership models and at possible changes to the organizational structure of the association.
Law needs “vigorous work” Delegates showed very little dissent in debating and unanimously adopting a resolution directing AMA to “vigorously work” to change ACA so that it is in line with the association’s policies on health system reform.
AMA should advocate to “achieve
student at the Texas College of Osteo- pathic Medicine, will be Region III mem- bership chair. “We have excellent candidates who can advance the issues that Texans feel are important,” Texas Delegation Chair Lyle Thorstenson, MD, said of the del- egation’s success at the polls. “With the Texas coherence, the Lone Star approach, we have a mystique if you will, and we are able to carry the day.”
Insurance mandate retained The longest and most strident debate of the meeting came over a call to repeal the AMA’s support for a mandate that al- most all Americans buy health insurance. Delegates stood at the microphones for hours discussing the issue at the refer- ence committee hearing, and the Twit- tersphere was alive with sharply worded comments from both sides. Texas joined with a vocal minority of
physicians — many from the Old South and more conservative specialty societ- ies — who said the mandate, a critical piece of President Obama’s health insur- ance reform law, is an assault on Ameri- can’s individual liberties.
Supporters, including the family physicians and pediatricians and physi- cians from northern and western states, countered with studies showing insured
8 TEXAS MEDICINE August 2011
patients are healthier and have better medical outcomes. They also pointed out that popular features of ACA, such as the elimination of preexisting condi- tions clause, will not work financially without the mandate.
The issue was a holdover from a simi-
larly contentious debate at the House of Delegates’ 2010 interim meeting in San Diego. At that meeting, the house initially voted to repeal the universal insurance mandate policy, then decided to send the question back for further study. That resulted in the AMA Council on Medical Services’ recommendation at the June meeting that AMA continue to support the mandate. Sensing they didn’t have the votes to
reverse the policy entirely, opponents offered an amendment stating that “the choice to implement a requirement for individuals to purchase health insurance be left exclusively to the states.” That fell by a 3-2 margin. TMA President C. Bruce Malone, MD, said he and the other members of the Texas delegation were disappointed in the outcome. “I think the fact that we couldn’t come to more of a consensus will be an issue that will affect member- ship and people’s opinion,” he said. “Some people who strongly support the idea of no mandate may drop their
needed reforms of the many defects” of the law, the house said. Among other things, delegates called on the associa- tion to seek repeal of the Independent Payment Advisory Board and long- sought reforms to the Medicare physi- cian payment system, medical liability, and antitrust rules that bar physicians from bargaining collectively. The approach mirrors the current TMA strategy on health system reform:
“Find what’s missing; keep what works; fix what’s broken.” For details, see the TMA website at
www.texmed.org/hsr. The house also unanimously ap-
proved a Board of Trustees report call- ing on all federal health agencies to use evidence-based standards of care to “demonstrate the benefit of existing regu- lations and new regulations within three years of implementation.”
Texans in action Four Texans served on reference com- mittees for this session of the house. Dr. Thorstenson, of Nacogdoches, was on the reference committee on AMA finan- cial and organizational affairs. Robert Emmick, MD, of College Station, was a member of the reference committee on medical service. Austin anesthesiologist Catherine Scholl, MD, served on the ref- erence committee on amendments to the
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