AMA jumping on reform bandwagon Says it wants its turn at the reins

March 04, 1993|By New York Times News Service

WASHINGTON -- Fearful of being left out of the debate on reshaping the nation's health-care system, the American Medical Association has told the White House that it will drop its long-held and formidable opposition to some proposals favored by President Clinton.

In return, AMA officials said, they are asking for a seat at the table as the policy group led by Hillary Rodham Clinton works out what promise to be sweeping changes in medicine.

In a letter sent yesterday to Ira Magaziner, Mrs. Clinton's right-hand man on health care, the group signaled its willingness to support the idea of "spending limits" on health care, to accept a National Health Board to review prices and practices in medicine and to accept that large "managed care" organizations like preferred-provider groups or health-maintenance organizations may be a large part of the health-care system in the future.

The AMA put caveats on some of these items, and repeated its opposition to other items under discussion by the White House, like the proposal for a "global budget" that would set a strict limit on the amount the nation spends on health care.

But the AMA did offer to support a cap plan, probably less restrictive than the global-budget approach, under which doctors would accept national or regional health-care spending limits if they can help set them.

Robert Boorstin, a White House spokesman on health care, said yesterday that the White House "welcomes the participation of the AMA, as we always have" and said that the AMA shift showed that a "consensus is being formed that there has to be immediate change, and that it is coalescing around the principles that the president's plan is being built on."

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