President's Message

The AMA vs. Mr. Calio

Todd L. Sack, M.D., President

 
The name of Nick Calio is one that must be learned by those of us who care dearly about the medical profession. Mr. Calio has been for many years a high-stakes Washington lobbyist as co-owner of the lobbying shop of O'Brien Calio. His reported income is said to approach $1 million per year from the peddling of the agendas of some of America's biggest corporate and insurance interests, including HMO's such as Blue Cross Blue Shield. Now Mr. Calio is taking a leave of absence from his firm to work for the U. S. Government for a salary of just $130,000.

Why accept the pay cut? Because now he works in the White House as President Bush's chief lobbyist! This has to be the ultimate fox-in-the-hen-house picture. It is a potential disaster for physicians. Mr. Calio, long on the payroll of the HMOs, is now one of the President's key strategists for all legislation going to or from the Congress. The HMO's have their man right where they want him, right in the Oval Office. The President will hear from the HMO industry first, and loudest, and perhaps exclusively. You can thank Mr. Calio for now on when you hear that the President is bending and twisting to favor the managed care industry.

Mr. Calio is the newest and most forceful reason to support the American Medical Association. No organization in Washington but the AMA has the legislative savvy and prestige to stand up to the forces from the pharmaceutical industry and the managed care industry which are at work against the best interests of patients and physicians. The AMA has the access and influence in the Congress and at the White House that is enjoyed by no other professional organization.

It is odd that many physicians have lost sight of the significance of the AMA. Today just one in three physicians is a member of the AMA, though still that represents a sizable force of 290,357 doctors. Most of us belong to several professional organizations. We belong to our local and state medical society. Likely we belong as well to several specialty societies. We were drawn to join these specialty societies—the American Academy of Family Practice, the American College of Surgeons, American College of Physicians, etc.—for services such as Board certification and continuing medical education.

It is a mistake, however, to think that membership in our specialty societies can substitute for membership in the American Medical Association. In fact, usually the opposite is true. There are now dozens of specialty societies that represent physicians in Washington. Each has an important expertise and worthy agenda to bring to our politicians and bureaucrats. Unfortunately, it is usually the case that the agenda of one organization is in direct competition with the agenda of another society. This occurs because once the government's budget is determined, the societies find themselves competing with each other for their share of the budget pie. When my American Gastroenterological Association advocates higher reimbursement for colonoscopy the money must be taken from the funds of one of my colleagues, perhaps a surgeon or a family physician.

Only the AMA speaks for us all, and with great vigor and success. Thanks primarily to the work of the AMA we received a Medicare payment update of 5.4% in 2000 and of 4.5% in 2001. This is a rising tide that raises all of our ships. The AMA is hard at work to sustain these increases, with preliminary budget commitments predicting a 6% increase for 2002!

Take a look at the AMA's overall agenda in Washington. It can be supported heartily by most, if not all, physicians. Among the many issues pressed by the AMA are the Patient's Bill of Rights, anti-trust relief to "level the playing field" in negotiations with payers, a Medicare pharmaceutical benefit that does not steal from other health sectors, full tax deductibility for student loans, greater support of our academic medical centers, the expansion of health insurance coverage through tax credits, and the protection of medical record privacy.

I am afraid that for the next few years it will be the AMA vs. Mr. Calio on many of these topics. But only the AMA is there with the clout to face Mr. Calio and his special interest friends. Now more than ever we need to support the American Medical Association.

August/September, 2001/ Jacksonville Medicine

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