AMSA Follies: Rent-Seeking, Ignorance, and Close Calls

Today was “Advocacy Day” at the 2011 AMSA Convention. Three hundred medical students descended on the Hill to push AMSA’s talking points on various pieces of legislation. There’s a Sparta joke in there somewhere.

We started off with a talk from Dr. Atul Grover, the “Chief Advocacy Officer” for the Association of American Medical Colleges (AAMC). His description of the AAMC’s recent lobbying efforts were a stark reminder that regardless of what one might think of the cause, there is something very, very ugly about rent-seeking… and medical schools do lots of it.

“Highlights” from Dr. Grover:

• “Democrats go out and buy banned books and read them individually. Republicans form censorship committees, read them as a group, and then maybe burn them.” I know the Republicans probably don’t feel any great affinity for the AAMC, but even this strikes me as a bit much from the guy whose job it is to make nice with them.
• In the coming weeks, over 100 AAMC member schools and hospitals will commit to a major patient safety and quality initiative, including curricular changes at medical schools, and universal usage of pre-operative checklists and central line checklists in ICUs. You heard it here first!
• The AAMC is also planning an initiative on inter-professional collaboration together with schools of nursing, osteopathy, and pharmacy [no word on the quacks naturopaths]. While the education-oriented professional organizations are on board, there has been some resistance from other professional organizations representing these groups. And people wonder why medicine never seems to speak with a coherent voice.

From there, we moved to “issue training.” Foolishly/fortuitously, I was assigned to lobby for “Health Care For All.” Lucky AMSA… not only did they not have to pay the~300 white-coat-clad medical students to go out and parrot their talking points for them, we actually paid them conference fees! Yet parrots we were expected to be. The sheets with talking points were passed around, and the presentation about the pending legislation we were to discuss with our Senators and Representatives was given.

Of course, when the medical student audience has little knowledge of the policy issues, it’s easy for them to be told what to think, that they might do AMSA’s bidding.

The presentation was an exercise in entertaining ignorance… an appraisal shared even by the liberal (but informed) students sitting near me. Frighteningly, the presentation was given by AMSA’s senior people on advocacy/policy issues. To wit:

• They uncritically parroted the controversial assertion that lack of insurance is responsible for tens of thousands of excess deaths per year.
• They still cling to the absurd notion that more than 2/3 of bankruptcies are caused by inadequate health insurance.
• They believe that “single-payer” = “universal coverage,” and that all OECD countries except the US have single-payer health systems.

The lobbying itself was interesting. Myself and a partner from the same part of the country met with legislative aides for our Senator and Representative. For the first, we made a good faith effort to parrot the AMSA line (hey, why not?). After seeing the futility of a conversation in which we both disagreed not only with what the aide was saying but with what we were saying, we changed our tune ever-so-slightly for the second. It was fun.

My belief that AMSA is an organization that shouldn’t be taken seriously by policymakers is growing more and more…