Medical Care is a Privilege

Whereas, The physician-patient relationship is under assault; and

Whereas, Our Texas Medical Association and our American Medical Association need to have a clear understanding of what we stand for; therefore be it

RESOLVED, That our Texas Medical Association and our American Medical Association adopt as policy that access to medical care is not a right guaranteed by the Constitution of the United States of America but a privilege that can be both used and abused.

Relevant TMA Policy

120.003     Health System Reform Managed Care . To provide a basic framework for association policies and activities in health system reform, the Texas Medical Association:  (1) supports the concept of universal access to appropriate health care; (2) supports freedom of patients to select their own physicians; (3) supports meaningful professional liability reform for physicians as a key element of health system reform; (4) supports genuine relief from red-tape hassles and excessive administrative costs of health care; (5) supports freedom from unreasonable restrictions, including antitrust prohibitions, that prevent physicians from conducting peer review of quality and fees; (6) continues to support a health care system that includes a multiplicity of funding sources and payment mechanisms; (7) supports the right of a physician organization to negotiate at the federal or state level for payment of physician services, quality and utilization review, professional liability reform, and to reduce the hassle and cost of regulation; (8) continues to support sufficient autonomy for physicians to be advocates for patients and to make decisions in the best interests of their patients; (9) supports efforts to control costs in an efficient and effective manner that considers the needs of patients and allows the exercise of good medical judgment; (10) supports the funding of research and medical education in any health system reform proposal and believes that all corporate payers of health care share in the costs of graduate medical education; (11) supports quality assurance through practice parameters and outcomes research; (12) supports patient responsibility for first dollar coverage to allow patients to make individual decisions regarding their own health care spending with consideration given to patients' ability to pay.

In addition, TMA offers the following principles for managed care for adoption as AMA policy: (1) physician participation in any managed care organization he/she chooses, (2) patient freedom to select his or her own physician, (3) physician autonomy and freedom to be patient advocates (Second Supplemental Board of Trustees, p 36P-36S, A-93; amended CSE Rep. 6-A-03).

60.004       Freedom of Choice . Free and open competition of physicians and free choice of physicians for the primary benefit of patients is a goal which public and private policy should support. Hospital governing bodies should (1) seek the advice and expert opinion of their hospital medical staffs in making policy decisions regarding medical coverage and privileges; and (2) honor the commitments expressed in adopted and approved medical staff bylaws when considering action to limit or restrict the patient's free choice of physicians and the right of qualified physicians to diagnose and treat patients who seek their services utilizing all hospital facilities and equipment for which they are qualified.

A variety of health care delivery plans offers to patients the greatest freedom of choice and the best opportunity for further improvements in health care.

A patient should be free to select the physician, insurance company, or type of policies which he or she prefers. The physician, in turn, except in an emergency, is free to select the patients whom he or she will serve, to accept or not accept reimbursement from a third party, and to participate or not participate in any type of legal insurance contract.

Multiple systems of medical care delivery, such as fee-for-service and prepaid, and multiple kinds of insurance contracts (i.e., indemnity, service, or participating physician) are acceptable arrangements between physicians and third parties for delivery of and payment for medical services (Council on Socioeconomics, p 178, I-94; reaffirmed CSE Rep. 3-A-04).

TMA House of Delegates: TexMed 2007