Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, January 25, 1994                   TAG: 9401250180
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-3   EDITION: METRO 
SOURCE: Chicago Tribune
DATELINE: WASHINGTON                                LENGTH: Medium

AMA PULLS OUT STOPS ON REFORM

The American Medical Association, in an unusual use of the physician-patient relationship, is arming physicians across the country with pamphlets, information sheets and other guidance on how to talk to patients about what they want out of health-care reform this year.

The AMA, which has more than a dozen lobbyists in Washington, is enlisting support from patients on the theory that their letters or calls to lawmakers will carry significant weight.

Both doctors and patients say discussions about health-care reform have been taking place since President Clinton took office pledging to reform the system. Clinton's proposal to cover all Americans and group them into giant purchasing alliances is expected to be a central part of his State of the Union address tonight.

The AMA has opposed Clinton's plan on the ground that it would limit patients' choice of doctors, but it has not endorsed an alternative plan.

While the AMA is sending literature to the doctors, it is up to the physicians to decide whether to display it. Many doctors say the subject comes up with or without outside influences, but some urge caution in dealing with the issue.

"Doctors have the trust of patients," said Dr. Quentin Young of Chicago, past president of Physicians for a National Health Program, which advocates a single, government-run health-care program. "I would hope the doctors would not abuse that trust."

The AMA generally has been considered the premier lobbying group on health care, although smaller organizations of doctors, especially specialists, have been gaining influence.

With its pamphlets and newspaper advertisements - titled "Would you rather trust your life to an MD or an MBA?" - the AMA hopes to persuade patients to lobby their representatives to support the doctors' main demands:

Universal coverage with choice of physicians, not a government-controlled system;

Relief from antitrust laws for doctors;

And a guarantee that doctors, not insurance companies or government workers, decide courses of treatment.

Clinton's plan envisions health-care governing groups at the state level that would set minimums for health-care coverage and determine, in general terms, how much the nation spends on its medical system.

Despite the apparent criticism of the Clinton plan, the AMA is likely to find that there is little agreement among doctors, let alone patients, on how to reform the nation's health-care system.