The evils of the American Medical Association

The American Medical Association (AMA) was founded in 1847 around two propositions: one, all doctors should have a “suitable education” and two, a “uniform elevated standard of requirements for the degree of M.D. should be adopted by all medical schools in the U.S.” [1] In the days of its founding AMA was much more open–at its conferences and in its publications–about its real goal: building a government-enforced monopoly for the purpose of dramatically increasing physician incomes. It eventually succeeded, becoming the most formidable labor union on the face of the earth.

AMA created its Council on Medical Education in 1904 with the goal of shutting down more than half of all medical schools in existence. (This is the Council having its 100th anniversary celebrated in Chicago this weekend.) In six years the Council managed to close down 35 schools and its secretary N.P. Colwell engineered what came to be known as the Flexner Report of 1910. The Report was supposedly written by Abraham Flexner, the former owner of a bankrupt prep school who was neither a doctor nor a recognized authority on medical education. Years later Flexner admitted that he knew little about medicine or how to differentiate between different qualities of medical education. Regardless, state medical boards used the Report as a basis for closing 25 medical schools in three years and reducing the number of students by 50% at remaining schools.

Many people, even otherwise sensible conservatives, wrongly believe that having strict standards imposed by the state is a desirable thing. They are appalled by the notion that just anyone be permitted to practice medicine, and yet, the history of the AMA proves beyond any shadow of a doubt that it has nothing to do with the quality of healthcare and everything to do with protecting its members incomes.

AMA certification is fine. Private organizations should exist to identify those practitioners who meet certain standards. But putting the force of the law behind the trade union will help ultimately destroy quality health care in America as well as doctors’ incomes, as the state is compelled to get involved to reduce the cost of what, as is inevitable in the case of an artificially limited supply, has risen.

As Dale Steinrich points out, this is no different than if the government decided that no one should drive a lower quality car than a Lexus. The price of cars would rise, many people would be forced to go without, and the government would then step in to force Lexus to provide cars to those who can’t afford them. Much better to have a range of health cares available, distinguished by private organizations, so that those unable to afford the best health care would still have access to what they could afford.

As Canada, the Netherlands, the UK and the Soviet Union have proved, equal health care means nothing more than awful health care for everyone. There’s a reason they call it the LOWEST common denominator, after all.