Two years ago, when the American Medical Association’s House of Delegates endorsed the Affordable Care Act in late 2009, the margin of victory was 52 percent to 48 percent.
This year, in votes related to the healthcare reform act, the percentages were more like 60 percent to 40 percent. The AMA delegates voted 326-165 to support the individual mandate in the Affordable Care Act, for example.
The growing disparity led Dr. F. Dean Griffen, president of the Louisiana State Medical Society, to tweet “Would LA docs join the AMA just to increase conservative delegates? If I recommend joining for that reason, would it hurt LSMS membership?”
Griffen blames the higher percentage of support for Affordable Care Act-related issues on the fact that so many conservative physicians have dropped out of the AMA.
“What happened was without intent they disenfranchised a significant portion of their membership in areas that were in that 48 percent vote,” Griffen said. “And by supporting the Healthcare Reform Act, a lot of the people that would be classified as conservative, in other words people who opposed the Healthcare Reform Act, simply stopped paying AMA dues,” Griffen said.
According to the AMA, it lost more than 12,000 members last year, or around 5 percent of its members. The 2011 numbers are not yet available.
Griffen said the Louisiana State Medical Society has different policies and political stances than the AMA; the society strongly opposed the healthcare reform act as it was written.
But some people didn’t realize that being LSMS members didn’t mean they were supporting the AMA, Griffen said. So the state society lost some of its members, somewhere around 300 or so, but Louisiana lost a large number of AMA members.
“That’s no big deal to us except when things came up along the lines of the Healthcare Reform Act that were in contradiction to what the conservatives might want,” Griffen said.
When that happened, the vote in favor of “the liberal approach” was 60-40 instead of 52-48, Griffen said.
The voting margin shows that many conservative areas lost votes in the AMA’s House of Delegates, he said. Louisiana lost one delegate, but Mississippi lost virtually its entire delegation because so many members quit.
The number of delegates is based on the number of AMA members in the state, Griffen said.
Instead of conservatives being able to offer reasonable alternatives and overcoming a 4 percent margin, the conservatives, including Louisiana doctors, lost influence, Griffen said.
Griffen said his tweet was an effort to help doctors understand that if they don’t play, they pay.
“In other words, if you’re not a member of the AMA, you have no say. The way you get what you want is by having a vote,” Griffen said. “Once you don’t pay dues, you lose that vote.”
Griffen said it’s a delicate issue.
On the one hand, he is trying to encourage Louisiana physicians, who are angry at the AMA for endorsing the Affordable Care Act, to join the AMA, Griffen said. On the other, he wants to avoid the misperception that the State Medical Society is climbing into bed with the AMA, that the LSMS is like the bad guys.
The distinction is important because the LSMS works at the state level to support legislation like tort reform and other laws that will benefit members, Griffen said.
The LSMS is funded almost entirely by members’ dues, he said. So if the society doesn’t have the resources, it may lose a lobbyist.
“Without that lobbyist, we can’t be as effective. We lose our effectiveness,” he said.
Griffen said the society doesn’t want to lose any members.
“We want our members to realize our policies are in contradistinction from the AMA,” Griffen said. “But in order to get the AMA to buy into our policies, we got to have votes.”
The AMA is concerned about its membership losses, Griffen said. The group’s speaker of the house and two other representatives have actually visited the state.
They sat down with medical society leaders, who explained why the AMA is losing members, Griffen said.
LSMS has not tackled the issue with its members yet, Griffen said. He is hoping the society will be able to explain why it’s a good idea for physicians to join a group whose policies they oppose through LSMS publications like its monthly newsletter.
Griffen is also hoping the AMA will regain some credibility through dealing with the Sustainable Growth Rate, the federal formula used to determine how much the Centers for Medicare & Medicaid receive for providing Medicare services.
“The amount of money that the formula dictates each year is paltry compared to the amount of services that are being provided,” Griffen said.
Congress has avoided making a permanent fix to the SGR, despite years and years of physician requests, Griffen said.