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As soon as an A.M.A. lobbyist learns that a Congressman is inclined to vote against the A.M.A. line and seems immune to Washington persuaders, he sends the word back to A.M.A. headquarters in Chicago. From there it is relayed through the Congressman's state and county society to his personal physician. This doctor usually does what he is asked: he phones or wires the Congressman. The legislator is far more likely to heed a trusted, intimate adviser than any number of relative strangers. This technique works poorly with Senators and some big-city Congressmen, but it has proved to be magic with small-town and rural members of the House.
The lobby has lost many a battle. It fought Blue Cross hospital insurance (a "half-baked scheme" that would result in "mechanization of medical practice"), the American Red Cross Blood Bank, federal aid to medical schools ("a backdoor route" to socialized medicine), federal aid to states to reduce infant and maternal death rates, disability payments under social security. All are now in effect. But in the greatest of all contests, the 1949-51 battle over the Truman-Ewing national health insurance plan, A.M.A. scored a smashing win. Through the 19403, opinion polls had shown that a majority of the U.S. electorate—74% in a FORTUNE poll—favored such a plan. Ewing's idea was to levy a 4% payroll tax (to yield $4.5 billion as of 1950), toss in a couple of billions from general revenues, and cover hospital and medical care for 85% of the population. Patients would have free choice of physician. Doctors would be free to join the plan or not; those in it would decide whether they wanted to be paid by fee for service, a per capita rate, or (in group practice) salary. Though the A.M.A. had powerful allies, it was the biggest single force in squelching the plan so thoroughly that it has never been revived.
K.M. v. K.-A. As the A.M.A. met last week in Manhattan for its uoth convention, the House of Delegates lined up against what seemed to them—unanimously—to be the newest federal threat: the Kennedy Administration's bill to make the hospital and nursing-home costs of Americans over 65 a responsibility of social security. For consistency's sake, they also turned down a proposal backed by 51% in a poll of U.S. doctors, that would put them into the social security system for old-age pensions. (Doctors get "courtesy medical care" from their colleagues for themselves and families, both while in practice and during retirement.)
The Administration bill, sponsored by New Mexico's Senator Clinton Anderson and California's Congressman Cecil R. King, would not pay doctors' fees, but the A.M.A. argues that it would be only the first step toward "socializing" all U.S. medicine. New York's Dr. Gerald D. Dorman, an A.M.A. trustee, points out: "Why 65? That's an arbitrary retirement age set up by Bismarck in the last century. Why not 60—or 50?"