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US states begin outlawing abortions, which have been practiced legally in most societies for thousands of years; at the time of the adoption of the US Constitution, abortions before “quickening” (i.e. birth) were commonly performed. In 2010, the National Abortion Federation will explain: “The motivations for anti-abortion laws varied from state to state. One of the reasons included fears that the population would be dominated by the children of newly arriving immigrants, whose birth rates were higher than those of ‘native’ Anglo-Saxon women.” As medical procedures were developed to increase the safety of both births and abortions, medical doctors began attempting to legally exclude practicioners such as homeopaths, midwives, and apothecaries from performing abortions, in part due to legitimate medical concerns and in part to ensure that they collected the fees paid by clients for abortions. In the late 1800s, the newly formed American Medical Association (AMA) argues that abortion is both immoral and dangerous. By 1910, all but one state has criminalized abortion except where necessary, in a doctor’s judgment, to save the woman’s life. “Back-alley,” or “criminal” abortions become commonplace, often performed by untrained “practitioners” in dangerous and unsanitary conditions or by the women themselves; many women are unnecessarily killed or injured during these procedures. Though in the mid-1960s some states will begin liberalizing their abortion laws, it will not be until 1973 that abortion becomes legal throughout the United States (see January 22, 1973). (National Abortion Federation 2010)
The American Medical Association (AMA) releases an 11-minute spoken-word album (LP) featuring actor and promising conservative politician Ronald Reagan. Reagan speaks against what he and the AMA call the “socialized medicine” of Medicare, currently being considered in Congress as part of legislation proposed by Democrats Cecil King and Clinton Anderson; many refer to the legislation as the King-Anderson bill. The AMA, along with most Congressional Republicans and a good number of Democrats, has been fighting the idea of government-provided health care since 1945 (see 1962).
Socialism Advancing under Cover of Liberal Policies - Reagan begins by warning that as far back as 1927, American socialists determined to advance their cause “under the name of liberalism.” King-Anderson is a major component of the secret socialist agenda, Reagan says. “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,” he says. “It’s very easy to disguise a medical program as a humanitarian project.” No real American wants socialized medicine, Reagan says, but Congress is attempting to fool the nation into adopting just such a program. It has already succeeded in imposing a socialist program on the country by creating and implementing Social Security, which was originally envisioned to bring “all people of Social Security age… under a program of compulsory health insurance.” Reagan, following the AMA’s position, says that the current “Eldercare” program, often called “Kerr-Mills” for its Congressional sponsors, is more than enough to cover elderly Americans’ medical needs. (Author Larry DeWitt notes that in 1965, Kerr-Mills will be superseded by Medicaid, the medical program for the poor. He will write, “So Reagan—on behalf of the AMA—was suggesting that the nation should be content with welfare benefits under a Medicaid-type program as the only form of government-provided health care coverage.”) King-Anderson is nothing more than “simply an excuse to bring about what [Democrats and liberals] wanted all the time: socialized medicine,” Reagan says. And once the Medicare proposal of King-Anderson is in place, he argues, the government will begin constructing an entire raft of socialist programs, and that, he says, will lead to the destruction of American democracy. “The doctor begins to lose freedom,” he warns. “First you decide that the doctor can have so many patients. They are equally divided among the various doctors by the government. But then doctors aren’t equally divided geographically. So a doctor decides he wants to practice in one town and the government has to say to him, you can’t live in that town. They already have enough doctors. You have to go someplace else. And from here it’s only a short step to dictating where he will go.… All of us can see what happens once you establish the precedent that the government can determine a man’s working place and his working methods, determine his employment. From here it’s a short step to all the rest of socialism, to determining his pay. And pretty soon your son won’t decide, when he’s in school, where he will go or what he will do for a living. He will wait for the government to tell him where he will go to work and what he will do.” DeWitt will note that this is far more extravagant than any of the Medicare proposals ever advanced by any lawmaker: “It was this more apocalyptic version of Medicare’s potential effects on the practice of medicine that Reagan used to scare his listeners.”
Advocating Letter-Writing Campaign - Reagan tells his listeners that they can head off the incipient socialization of America by engaging in a nationwide letter-writing campaign to flood Congress with their letters opposing King-Anderson. “You and I can do this,” he says. “The only way we can do it is by writing to our congressman even if we believe he’s on our side to begin with. Write to strengthen his hand. Give him the ability to stand before his colleagues in Congress and say, ‘I heard from my constituents and this is what they want.’”
Apocalypse - If the effort fails, if Medicare passes into law, the consequences will be dire beyond imagining, Reagan tells his audience: “And if you don’t do this and if I don’t do it, one of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.” Reagan is followed up by an unidentified male announcer who reiterates Reagan’s points and gives “a little background on the subject of socialized medicine… that now threatens the free practice of medicine.” Reagan then makes a brief closing statement, promising that if his listeners do not write those letters, “this program I promise you will pass just as surely as the sun will come up tomorrow. And behind it will come other federal programs that will invade every area of freedom as we have known it in this country, until, one day… we will awake to find that we have socialism. And if you don’t do this, and if I don’t do it, one of these days, you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.” (Larry DeWitt 9/2004; Beutler 8/25/2009)
The American Medical Association (AMA), in conjunction with many Congressional Republicans and some Democrats, attempts to beat back attempts to create a new government-run program to provide medical care for the elderly, to be called “Medicare.” The AMA and its political allies have fought the idea of a government-provided health care program for senior citizens since 1945, when then-President Harry Truman first suggested universal health care for all Americans.
Minimal 'Eldercare' Considered Too Much - Currently, a modest health care program for senior citizens, called “Eldercare,” is the only government coverage American seniors have. It is based on a compromise proposal written by conservative Democratic Senator Robert Kerr (D-OK) and Representative Wilbur Mills (D-AR) and signed into law by President Dwight Eisenhower. Eldercare provides government benefits only for senior citizens who can demonstrate economic need, and states that choose not to participate in the program can opt out entirely. However, the AMA considers even this truncated program far too invasive, and fiercely opposes the more sweeping “Medicare” proposal, called King-Anderson after its main authors, Senator Clinton Anderson (D-NM) and Representative Cecil King (D-CA). The legislation is mired in Congressional committees. (Time 2/19/1965; Larry DeWitt 9/2004)
WHAM - The opposition to King-Anderson is led by the Women’s Auxilary of the AMA, which is given the task of coordinating the WHAM program—Women Help American Medicine. WHAM is directly dedicated to defeating the King-Anderson bill in Congress, “a bill which would provide a system of socialized medicine for our senior citizens and seriously curtail the quality of medical care in the United States.” The public campaign consists of the usual rallies and advertisements, most funded by corporate lobbyists working for the AMA and other health care firms. WHAM accuses King-Anderson proponents of being “socialists” and warns of federal bureaucrats violently invading “the privacy of the examination room.” WHAM coordinates an extensive grassroots effort under the rubric of “Operation Hometown,” enlisting local medical societies to speak out against King-Anderson, and providing pamphlets, reprints of press releases and articles, and talking points to local physicians.
Operation Coffeecup - Operation Coffeecup is a less visible, but just as important, element of the WHAM campaign. It centers around a series of “coffee klatches,” or “impromptu” get-togethers in kitchens and living rooms across America, hosted by WHAM members. WHAM members are told to downplay the significance of the events. One instruction tells them to portray the events as nothing more than “spontaneous” neighborhood get-togethers: “Drop a note—just say ‘Come for coffee at 10 a.m. on Wednesday. I want to play the Ronald Reagan record for you.’” The attendees are shown how to write equally “spontaneous” letters to members of Congress opposing the King-Anderson bill. The letters are carefully constructed to give the appearance of real, unsolicited missives written by concerned Americans, not the product of an orchestrated lobbying effort. Each WHAM member uses a 10-point checklist to ensure that the letters cover the points needed to make the argument against King-Anderson, and are not full of boilerplate, obviously copied-over material. The program is deliberately kept quiet, for fear that the media will portray it as an attempt to manipulate public opinion.
Reagan on Vinyl - The centerpiece of the Operation Coffeecup material is a vinyl LP entitled Ronald Reagan Speaks Out Against Socialized Medicine (see 1962). The album is a 19-minute recording featuring an 11-minute address by Reagan, followed by an eight-minute follow-up by an announcer. WHAM members are assured that Reagan’s work for the organization is unpaid and voluntary, though they are not told that his father is a top AMA executive. Instead, they are told Reagan is motivated entirely by his sincere political convictions. The hope is that Reagan’s message will inspire legions of housewives to write letters demanding that King-Anderson be defeated. The AMA claims that Operation Coffeecup prompts a “legion” of responses. (Larry DeWitt 9/2004)
Exposed - In June 1962, investigative reporter Drew Pearson exposes Operation Coffeecup in his newspaper column. Pearson writes: “Ronald Reagan of Hollywood has pitted his mellifluous voice against President Kennedy in the battle for medical aid for the elderly. As a result it looks as if the old folks would lose out. He has caused such a deluge of mail to swamp Congress that congressmen want to postpone action on the medical bill until 1962. What they don’t know, of course, is that Ron Reagan is behind the mail; also that the American Medical Association is paying for it.… Reagan is the handsome TV star for General Electric.… Just how this background qualifies him as an expert on medical care for the elderly remains a mystery. Nevertheless, thanks to a deal with the AMA, and the acquiescence of General Electric, Ronald may be able to outinfluence the president of the United States with Congress.” (Larry DeWitt 9/2004; Beutler 8/25/2009)
A study conducted by the American Medical Association (AMA) finds that health insurance companies are becoming near-monopolies. Ninety-five percent of the 294 HMO/PPO metropolitan markets surveyed have a Herfindahl-Hirschman Index (HHI) above 1,800. The HHI is used to determine whether a company’s control of the market warrants antitrust concern. A market with a rating of 1,800 is considered by the Department of Justice to be “highly concentrated.” Sixty-five percent of the companies surveyed have a rating over 3,000. The concentration is apparently the product of a period of intense consolidation within the industry. According to the AMA, there were more than 400 mergers during the preceding ten years. (American Medical Association 2006 ; Associated Press 4/18/2006) “Patients do not appear to be benefiting from the consolidation of health insurance markets,” says AMA board member Dr. J. James Rohack. “Health insurers are posting historically high profit margins, yet patient health insurance premiums continue to rise without an expansion of benefits.” (Consumer Affairs 4/18/2006) The AMA has asked the Department of Justice to take up antitrust action. But the organization says that in spite of the extremely high market concentration, regulators seem uninterested. (Associated Press 4/18/2006)
The Department of Health and Human Services rescinds the controversial “conscience rule” that allows health care workers to refuse to provide abortion counseling or other family-planning services if doing so would violate their moral or religious beliefs. The rule was announced on December 19, 2008 as one of the Bush administration’s final policy initiatives. Seven states have already challenged the rule in court, arguing that it sacrifices the health of patients to religious beliefs of medical providers. The American College of Obstetrics and Gynecology has reported numerous cases regarding the rule, including a Virginia mother of two who became pregnant after being denied emergency contraception, and a rape victim whose prescription for emergency contraception was rejected by a pharmacist. Obama officials say the administration will consider drafting a new rule to clarify what health care workers can reasonably refuse for patients. The public has 30 days to respond to the move before it becomes viable. Sister Carol Keehan, president of the Catholic Health Association, said in December that her organization supported the rule because in recent years “we have seen a variety of efforts to force Catholic and other health care providers to perform or refer for abortions and sterilizations.” However, opponents of the rule, including the American Medical Association, the National Association of Chain Drug Stores, and Planned Parenthood, said it could have voided state laws requiring insurance plans to cover contraceptives and requiring hospitals to offer emergency contraception to rape victims. It could also allow drugstore employees to refuse to fill prescriptions for contraceptives. And the Civil Rights Act of 1964 already offers broad protection against discrimination based on religion, mandating that an employer must make reasonable accommodations for an employee’s practices and beliefs. Cecile Richards of Planned Parenthood says, “Today’s action by the Obama administration demonstrates that this president is not going to stand by and let women’s health be placed in jeopardy.” (Levey 2/27/2009; Stout 2/27/2009)
Psychologists and medical ethicists react with horror to recent reports that a psychologist and various medical professionals took part in torturing prisoners—information that was revealed by recently released Justice Department memos (see April 16, 2009). A psychologist, whose name was redacted from the memos but is apparently James Mitchell (see January 2002 and After), provided, as the Washington Post reports, “ideas, practical advice, and even legal justification for interrogation methods that would break [detainee] Abu Zubaida, physically and mentally. Extreme sleep deprivation, waterboarding, the use of insects to provoke fear—all were deemed acceptable, in part because the psychologist said so.” The names of other psychologists and medical practicioners were also redacted from the memos. They monitored torture victims, helped keep them alive during sometimes-brutal interrogation sessions, and sometimes, the Post writes, “actively participated in designing the interrogation program and monitoring its implementation. Their presence also enabled the government to argue that the interrogations did not include torture.” The detainees were not the only ones being monitored. Psychologists were dispatched to each secret CIA prison, or “black site,” to make sure the medical professionals involved in the daily torture “could stand up, psychologically handle it,” says a former CIA official. Most of the psychologists were contract employees of the CIA.
Debate over Ethics of Participating in Torture - Frank Donaghue of the advocacy group Physicians for Human Rights says: “The health professionals involved in the CIA program broke the law and shame the bedrock ethical traditions of medicine and psychology. All psychologists and physicians found to be involved in the torture of detainees must lose their license and never be allowed to practice again.” George Annas, a professor of health law and bioethics, says, “I don’t think we had any idea doctors were involved to this extent, and it will shock most physicians.” The use of doctors to monitor torture victims is “totally unethical.… In terms of ethics, it’s not even a close call.” The American Medical Association’s policy guidelines state that physicians “must not be present when torture is used or threatened,” and doctors can treat detainees only “if doing so is in their best interest” and not merely to monitor their health “so that torture can begin or continue.” Author and professor of medicine Steven Miles says the actions described in the memos are the “kind of stuff that doctors have been tried, convicted, and imprisoned for in other countries—and that’s what should happen here.” But Michael Gross, an Israeli author and professor, says if medical professionals believe particular interrogation tactics do not constitute torture, then there is no reason for them not to participate. “Physicians are faced with a hard dilemma,” he says. “They have professional obligations to do no harm, but they also have a duty as a citizen to provide expertise to their government when the national security is at stake. In a national security crisis, I believe our duties as citizens take precedence.” The American Psychological Association (APA) has condemned any participation by its members in interrogations involving torture, but critics of the organization have noted that the APA has failed to censure members involved in harsh interrogations. The International Committee of the Red Cross said in a 2006 report, “The interrogation process is contrary to international law and the participation of health personnel in such a process is contrary to international standards of medical ethics.”
Memos Say US Doctors' Participation Morally Distinct from Instances in Other Countries - The memos acknowledged that the participation of medical professionals in torturing prisoners posed an ethical dilemma, but contended that the CIA’s use of doctors in such interrogations is morally distinct from the practices of other countries that practice torture. One such distinction was that doctors observing interrogations could stop them “if in their professional judgment the detainee may suffer severe physical or mental pain or suffering.” In one instance, the CIA chose not to subject a detainee to waterboarding due to a “medical contraindication,” according to a May 10, 2005, memo. (Warrick and Finn 4/18/2009)
The Republican National Committee (RNC) mails a survey to thousands of recipients that implies the Democrats’ health care reform efforts will use voter registration information to ration health care, and to deny care to Republicans. A question in the survey asks: “It has been suggested that the government could use voter registration to determine a person’s political affiliation, prompting fears that GOP voters might be discriminated against for medical treatment in a Democrat-imposed health care rationing system. Does this possibility concern you?”
'Inartfully' Worded - Democratic National Committee spokeswoman Brandi Hoffine retorts, “Even we can’t believe the latest in the RNC’s effort to scare voters, lie to the public, and ‘kill’ health insurance reform.” RNC spokeswoman Katie Wright says the question might have been “inartfully” written, but reflects legitimate concerns about confidentiality: “Americans have reason to be concerned about the failure of the Democrats’ health care experiment to adequately protect the privacy of Americans’ personal information.” Politico’s Glenn Thrush says of Wright’s wording, “‘Inartfully’ seems to fall short of a loaded question which seems to have little basis in reality.” He notes that though the House bill gives the government the right to glean “point of service” data about someone’s health care payments or remittances through the use of an electronic benefits card, “nowhere in the proposed bill is any reference to tapping voter registration information.” (Thrush 8/27/2009; Republican National Committee 8/27/2009 )
AMA Criticizes Survey - The American Medical Association (AMA) denounces the survey’s implication, writing, “Patients should rest assured that the health care legislation under consideration in the House does not ration medical care or discriminate based on political affiliation.” (Beutler 8/27/2009) Progressive television host Rachel Maddow says of the survey, “In the horrible Hobbesian, no rules, no shame, free-for-all of lies, overstatements, and outrageous mischaracterizations that has been the health care debate this summer thus far, this one—this health reform is a secret plot to kill Republicans lie offered up by the Republican Party itself—was so bad that the Republican Party actually had to apologize for it today.” (MSNBC 8/28/2009)
'Fundraising Appeal' Designed to 'Inflam[e] the Republican Base' - Retired insurance underwriter Raymond Denny, who received the survey, equates the question to the classic “Have you stopped beating your wife yet?” He says: “It’s so blatantly lopsided. I called them [the RNC] up and said, ‘This is ridiculous!’ They just said, ‘All right.’” Denny tells a reporter he is concerned that such baseless insinuations—that the Obama administration would deny health care to Republicans—would become yet another talking point for anti-reform proponents. Another question asks: “Rationing of health care in countries with socialized medicine has led to patients dying because they were forced to wait too long for treatment.… Are you concerned that this would be inevitable in the US under the Democrats’ plan?” Denny says: “I wrote insurance policies. I know how words can be used to make people do what you want them to do. The law allows a lot of latitude with politicians. That I understand. Some of these techniques are used by both parties. But this to me seems way over the edge of normal politics.” Pollster Mike Riley says the survey is not, apparently, a legitimate information-gathering device, but rather a means of inflaming the Republican base and garnering donations. Such “surveys” are standard practice, he notes. “It’s common, trying to stir the pot to see what kinds of issues get attention. Both parties do that. They are using some of the hot-button issues to see what activates the voters. It’s politics as usual within the party faithful. No one that I know puts any credibility in these types of polls.” Another pollster, Bob Moore, calls the “survey” little more than “a fundraising appeal.” If such tactics “weren’t effective, they wouldn’t be using them,” he says. (Durbin 8/27/2009; Weigel 8/27/2009; Weigel 8/27/2009)
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