Senate healthcare measure violates 'Do no harm' principle, AMA declares

The physicians group says the measure would leave too many without coverage

As the Senate inches towards a vote on its version of healthcare reform legislation, the influential American Medical Association (AMA) has declared itself against the measure.

“On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to express our opposition to the discussion draft of the ‘Better Care Reconciliation Act’ released on June 22, 2017,” said James L. Madara, M.D., CEO of the largest group representing physicians in the United States. 

“Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’  The draft legislation violates that standard on many levels,” Madara said.

Throughout the health system reform debate, the AMA has urged that reforms not result in individuals with health insurance losing access to affordable, quality coverage; that Medicaid, CHIP and other safety net programs be adequately funded; and that key market reforms, such as pre-existing conditions, be maintained. The Senate draft, however, violates many of those principles, Madara said.

Medicaid concerns

In the letter to Senate Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Chuck Schumer (D-Ill.), Madara said the AMA is "particularly concerned with proposals to convert the Medicaid program into a system that limits the federal obligation to care for needy patients to a predetermined formula based on per-capita-caps."

"Per-capita-caps fail to take into account unanticipated costs of new medical innovations or the fiscal impact of public health epidemics, such as the crisis of opioid abuse currently ravaging our nation," the letter said.

Many Republicans have been dismayed at the widespread opposition to the measure, but reports from Capitol Hill say that McConnell is confident he can achieve passage of the bill over the next five days before Congress adjourns for the July 4 recess. An unlimited amendment process is in place, giving senators a chance to hammer out a compromise. 

Voters worried about healthcare

If there's any doubt that voters are watching, a recent Gallup poll finds that the cost of healthcare leads the list of what Americans consider the most important financial problem facing their family.
The 17% who name healthcare costs as their family's most pressing financial problem is up seven percentage points since 2013 and is just two points shy of the all-time high of 19% recorded in 2007.
Some consumers are wondering how elected leaders will fare when they must face the voters in the next election. Patricia of Massachusetts recently wrote to ConsumerAffairs to ask how McConnell and House Majority Leader Paul Ryan are seen by their constituents.
"I'm very curious how the folks in Kentucky and Wisconsin feel about losing their health insurance. Are the people, and I don't mean lawmakers, I mean average people, really behind McConnell?" she asked. "Do they want him to slice away at Obamacare? Or are his low ratings because people want to keep things the way they are?"
It's a good question, and in fact one recent Morning Consult poll found that McConnell was the least popular senator in America while former Democratic presidential candidate -- and ardent supporter of universal healthcare -- Bernie Sanders was the most popular.

McConnell had a net negative approval rating — more of his constituents gave him a negative review than a positive one -- something that's unusual for a longtime senator. The poll found that 47% of McConnell's constituents disapproved of him while 44% approved.

That's an improvement since the 2016 election, however, when McConnell had a disapproval rating of 51%.

So it could be argued that, although he is still unpopular with the folks back home, he's not as unpopular as he once was.

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