Sunday, June 27, 1999 | 9:27 a.m.
Brian Greenspun is editor of the Las Vegas Sun.
TELL ME it ain't so, Joe.
There are very few things that confuse me these days, especially in the wacky world of politics in which what was black yesterday is white today and black again tomorrow, just because a fickle voting public says it is so. In a way, the constant state of flux in which the voters of today find themselves should be called stability. It is when they don't change their minds the way they change their underwear -- now that would be a problem.
There are some aspects of our ever-changing society, though, by which you could set your watch for stability and consistency. One of those bastions of unchangeability is, of course, the medical profession. If ever there was a group of professionals that liked the staus quo, hated taxes and refused to listen to any reason that might cause them to change their minds, let alone their business practices, it is the one that contains my good friends, the doctors.
Make no mistake, there are very few elements of our society for which I would fight to my dying breath. The doctors are chief among them, in part because they will know first when my dying breath should come and, secondly, they will most likely be able to do something others can't to forestall the first occurrence.
Having expressed my admiration and undying gratitude for those who practice keeping the rest of us alive and healthy, I find it necessary to question what appears to be one of the grandest turnabouts in modern political and entrepreneurial history. Until last week, I would have bet heavily that the American Medical Association, which represents the interests of our doctors across the country, would never be caught even thinking about supporting the goals of a union. Nor would they have ever considered the idea of union activity as a necessary step in the growth of modern capitalistic America. Unions and entrepreneurship have always been like oil and water, at least to my doctor friends who have taken time out from their anti-tax diatribes to focus on other parts of living in what will soon be the 21st century.
Mind you, I am not suggesting that they have been right in their narrow-minded assessments of the labor-management equation, only that they have been consistent. Nor would I ever suggest that their anti-union stances have ever been anything other than what they perceive to be necessary pro-management positions, positions they all hoped to have in their own little medical practices.
So, now comes the great shock. The AMA -- the folks who signed on to the great scare of the early 1990s against any government efforts to provide universal health care to Americans and their families; the folks who bought into the concept that insurance companies were good and government apparatchiks who wished to spread the care out to those unable to get quality medical attention were bad; and the folks who joined with their anti-labor brethren to portray the health care crisis as a figment of government and poor people's imaginations; yes, the same folks who cheered when health care was left to the entrepreneurial HMOs who committed to do what was right for their customers -- now is committed to support a union for doctors.
I know, I know. I couldn't believe what was written either but the fact is that the AMA has voted to endorse the formation of a union to protect its members from insurers who it claims treat doctors "as little more than ditch diggers." And while I am confident they meant no disrespect to the people who work hard in those ditches all day, the message was clear and unequivocal.
The bad guys in the health care delivery system are no longer wearing government hats. They are working for insurance companies and some HMOs and are telling the doctors how they can and cannot treat their patients. And this the doctors cannot abide. Nor should they and nor should we.
What is most telling in this sad story is the level of frustration that is evident in the AMA's latest actions. With all due respect to the unions of America, the last place they need to be is somewhere in the examination rooms of America's medical offices. Those small rooms are already too crowded what with an insurance company clerk, an HMO busybody and myriads of government regulations telling the doctors what they can and cannot do. What about what the patient needs? What about what the doctor thinks the patient needs? Who is watching out for us?
The truth is that something must be done if we are to expect the medical professionals to fulfill their oaths by providing the best care for their patients that they can. As is often the case in this country, in our zeal to fix an excess we travelled to excess in seeking the cure. Somewhere in between is the kind of answer that will let doctors do their thing -- which is keeping us healthy -- and health care organizations do their thing -- which is keeping our costs down to manageable levels. That leaves very little room for a third party like a union official to get in the way.
The real debate about medical care and HMOs and insurance companies, of course, is just getting started. But by voting to support a union for the nation's doctors, the AMA has fired off a very telling shot. And what it should be telling us is that the doctors are mad as hell and not going to take it anymore. I hope so because that will be a significant first step toward the sane, efficient and affordable delivery of medical services to every American.
Can you imagine? Doctors and unions. Life sure is fun!
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