"It will also serve notice that the physician lobby and the AMA remains a very powerful force, a lesson that will be heeded when the health care reform process gets serious next year."He couldn't be more wrong. The physician lobby is pathetically weak and not well regarded on Capitol Hill. Iconic Chicago newspaperman Mike Royko famously defined "Clout" as political influence, as evidenced by results (in Chicago, usually patronage). We don't got any clout.
There's an urge for all of us politically aware policy wonks to slap ourselves on the back and say "Boy we really muscled that one through! Boo-yah!" But no. Seriously, Medicare is the second most popular program in the history of the federal government, and everybody knows it was facing absolute implosion (again) and there was bipartisan, nearly unanimous consensus that a fix was needed to avert catastrophe (again), and all we were able to get was an eleventh-hour stay (again). And only barely.
That ain't clout.
Look at the other national legislative priorities the physician lobby has favored. How'd that "Patient's bill of rights" turn out? How about tort reform? (hint: the trial lawyers' lobby has clout.) Did we ever get EMTALA funded? Balance billing? For that matter, can you name a single major piece of legislation the physicians' lobby has gotten passed at all, let alone over major opposition? And I hasten to point out that Congress was for 12 years in the iron fist of our ostensible "allies" in the GOP. How'd we do?
Compare that to, say, the insurance or energy or farm lobbies. They write their own bills, and they almost always pass. Let's not delude ourselves into thinking that this "win" indicates a powerful lobby on our behalf. We'll have a seat at the table for health reform in 2009, but we'll have a lot of work to do to make our actual voices heard.
It's a win, so I'll take it. It's better than losing. But I have to (much as it pains me) agree with Catron: all we really won was another stay of execution.