番茄社区

CHICAGO -- To chants of "AMA, get out of the way!," a coalition of several hundred doctors, nurses, medical students, community organizers, and patients rallied outside the American Medical Association's (AMA) House of Delegates annual meeting to demand that the organization support a Medicare for All single-payer health system.

"We are here for those who cannot be here today," Claudia Fegan, MD, national coordinator of Physicians for a National Health Program (PNHP), said as the group began gathering at the headquarters of the Blue Cross and Blue Shield Association, an organization of Blue Cross and Blue Shield insurers. "We are here for those who cannot afford their care. Twenty-nine million people are still uninsured and even the insured have deductibles so high they cannot afford their medications."

The group also heard from Talisa Hardin of National Nurses United, a labor union for nurses, who criticized the AMA for its "aggressive" lobbying tactics. "The AMA is violating one of its most ethical principles, 'Do No Harm,' by being on the wrong side of history," she said. "We want the AMA to publicly show its support for Medicare for All."

Jennifer Epps-Addison, co-executive director of the Center for Popular Democracy, a grass-roots lobbying organization, led the group in chants of "Everybody In, Nobody Out!" She explained that her husband was diagnosed with multiple sclerosis a few years ago, and even though she has good health insurance, it costs the family $800 per month in premiums, and still more in other out-of-pocket costs. "This current healthcare system not only doesn't work for low-income and no-income people, but it doesn't work for the middle class families who are struggling to get by either," she said. "My family is one job transition away from risking my husband's life. That ain't right."

After the speakers finished, the group marched from the Blue Cross building to the Hyatt Regency Hotel, where the AMA was meeting. One of the marchers was David Mair, MD, a psychiatrist from Minneapolis and a member of PNHP, who said the AMA "needs to get with the 21st century. I was in the AMA as a student in 2000, and then I started looking at [how] we needed to get coverage for everybody.. I realized after doing much research that the obvious answer was single-payer, and I learned that the AMA was opposed to it."

The reason the AMA isn't getting on board with Medicare for All is that "they're afraid of getting less money [as individual physicians]," Mair told 番茄社区. "The overall cost to run the business would go down [because] you'd have to have less admin staff, fewer prior authorizations, all the nonsense paperwork we have to do now. It's still possible the pay would come down a little bit, but I think if all the doctors were united and they had the same payer, they could make the case [for higher] reimbursement rates, but they don't want to bite the hand that feeds them."

Outside the Hyatt Regency, the assembled marchers heard from other speakers, including Peter Lorenz, a medical student at the Chicago Medical School at Rosalind Franklin University here. "The first step of medical education is to take the Oath of Geneva, a pledge that the health of my patient is my first consideration. I cannot fulfill this oath in a society whose healthcare resources are so unequally distributed, resulting in a 'pay-to-live' system that benefits those with means and condemns those without."

"Just across the river in Streeterville, a primarily affluent and white neighborhood, the life expectancy is 90 years," he said. "Nine miles away in Englewood, primarily African American and low-income, the life expectancy is a full 30 years less ... We have to work together to build a healthcare system that doesn't perpetuate these injustices. We need Medicare for All."

While the rally was going on outside, a smaller group of about 30 physicians disrupted the meeting's opening session. They marched to the front of the room, held up a large banner reading "AMA: Support Medicare for All" along with several signs in the shape of gravestones with messages like "Here lies an infant whose mother couldn't afford healthcare" and "Here lies your friend waiting for insurance approval."

Over a dozen activists sat or lay on the ground in front of the stage, and a few stood on the stage by the podium, while activists in wheelchairs chanted and sang along with the group. A few of the activists also shared stories of patients who were harmed by their lack of health insurance. After 10 or 15 minutes, the activists exited peacefully, flanked by a couple of hotel staff; the activists were singing and chanting "Ain't going to let nobody turn us around" as they left.

During the protest, Sue Bailey, MD, speaker of the AMA House of Delegates -- who on Saturday was voted the organization's president-elect for the coming year -- called for order and ultimately a short recess. She reminded the protesters that just as they had a right to speak, the AMA also had a right to convene its meeting.

This is not the first time the AMA meeting has contended with protesters. In 2009, Tea Party activists demonstrated outside the AMA's meeting to urge the organization not to support the Affordable Care Act, which the AMA later voted to support.

In her speech to the delegates as outgoing president, Barbara McAneny, MD, said she was "proud that the AMA is taking on insurance companies to reform prior authorization, helping a dozen states remove prior authorization for medication-assisted therapy to get timely treatment for a substance use disorder."

"Our nation's largest health insurance plans made billions last year," she said. "Do we want a health system that simply fills insurer's pockets or one that allows us to deliver our best care to patients?"

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