You may have heard that Anthem and Cigna were planning to merge. Anthem’s share of the health care insurance market in Indiana is 54%, and Cigna’s is 15%. Let’s see; add that up (give me a minute and let me get a pencil), and that is a whopping 69%. Also, Humana and Aetna planned to merge, and if that had happened, we would have had two health insurance companies left in Indiana, essentially controlling 100% of the market. In both cases, the companies argued that merging would help decrease health insurance costs since they would have greater leverage in contracting with providers. Now, you do know what providers they were talking about, don’t you? Anybody out there worried that Anthem does not have enough leverage already? Don’t forget that if the last two solo physicians still practicing ever got together and decided that they were going to refuse an Anthem (or Cigna or Humana or Aetna) contract, they would be guilty of a federal crime, but 100% of the insurance market in the hands of two companies? What’s unreasonable about that? Moreover, you employed physicians, who might think that you are insulated from such strangulating control of the payers market, would soon find your reimbursement going down, as the big snakes started to squeeze.Worse than its impact on doctors, though, would be its effect on patient access to care, as doctors throughout the state retired early, decreased their scope of practice, or just quit taking care of patients altogether.
Well, it did not happen.And why didn’t it happen, I hear you asking, even though I know you know the answer? It did not happen because of the tireless work of the AMA, the ISMA and other state medical societies, and specialty societies. In other words, Organized Medicine. Both of these planned mergers were blocked by federal judges because they violated antitrust laws and would eliminate vigorous competition between the companies.The ISMA and the AMA were the advocates who provided the arguments and the physician polling data that helped to bring about both of these decisions. It took time, and it took resources to accomplish these great victories, and we are blessed to have such great people dedicated to looking out for our, and our patients’, interest. The very least we can do is to support the organizations that are supporting us, and we support them with our membership and our dues. You do not have to run the club, (you can if you want to) but you do need to be a member.
I know that in spite of these accomplishments. In spite of repeal of the SGA.In spite of the defeat of the IPB. In spite of the ongoing success of the defense of INCAP. In spite of hundreds of other battles waged successfully, and sometimes unsuccessfully, many of you are still saying, ͞The AMA and ISMA have never done anything for me.͟Well, you are simply wrong. They are pulling our tails out of the fire on a daily basis, and the pittance you pay for membership is far more than made up for by what they have gained for you.
So, if you are not a member of the ISMA/VCMS and the AMA you should join immediately. It is easy. Just go to their websites, www.ama-assn.org, and www.ismanet.org, and you will be directed. And while you are there, make a hefty contribution to AMPAC and IMPAC. They will be happy you joined. You will be happy you joined. I will be happy you joined. More importantly, you will be doing what’s right for yourself and your profession.
If you are already a member, God bless you. See if you can get one or two of your non-member friends to join up.
