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STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. Good morning, I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne.

Today, two of the major players in the health care debate get a good look at each other. President Obama will step before the meeting of the American Medical Association.

INSKEEP: That's the group of doctors notable for helping to wreck several previous efforts to change the health care system. The AMA is active once again as the president tries to make his changes this year. But the doctors' group is not quite as powerful as it used to be.

Here's NPR's Julie Rovner.

JULIE ROVNER: Today, the AMA represents only about a third of the nation's practicing doctors, if that. To have their voices heard in the corridors of power, many doctors today turn to their specialty organizations - heart doctors, to the American College of Cardiology, for example; or surgeons, to the American College of Surgeons. But Republican Congressman Michael Burgess of Texas, a doctor and former AMA delegate himself, says when it comes to medical issues, the AMA is still relevant.

Representative MICHAEL BURGESS (Republican, Texas): While it may not be what it once was, anytime you talk to a member about something in regards to the health care, they will ultimately ask you where's the AMA on this? That explains why President Obama has been wooing the AMA along with other health care provider groups, as part of his effort to muster a health care overhaul through Congress. And it explains why comments like this one, made by AMA trustee Samantha Rosman, at a Senate hearing last week, are so troubling to many Congressional Democrats.

Ms. SAMANTHA ROSMAN (Pediatrician and AMA trustee): The AMA strongly opposes a public health insurance plan operated by the Federal Government with a pay schedule that's based on Medicare.

ROVNER: Now to translate, that means the group is pitting itself against the stated wish of President Obama and many leading Democrats. They'd like to create a new type of government sponsored insurance that would let consumers opt out of private insurance coverage. Doctors fear that might mean lower pay for them. But Rosman was quick to add that the organization is still willing to compromise.

Ms. ROSMAN: The AMA is open to consideration of a new health insurance option that's market based and not run by government. The semi about-face, which one observer described as a debate the AMA got into with itself, is just the latest misstep for the organization. In the late 1990s, the organization ousted most of its leadership after it tarnished its image by endorsing consumer health products made by the Sunbeam Company. It also angered its traditional Republican base by siding with Democrats during the Patient's Bill of Rights fight a decade ago. Then it angered Democrats with the relentless and so far unsuccessful fight for caps on malpractice damage awards. Health care consultant Robert Lyshevski(ph) says one of the AMA's biggest problems is that medicine is no longer monolithic.

Mr. ROBERT LYSHEVSKI (Health care consultant): And really, you know you have 700,000 different physicians with different political persuasions, belonging to different subspecialty organizations, about the only thing every physician can agree on in America is don't cut my pay.

ROVNER: Which is about to present a big, big problem in a health care overhaul, he says, because pretty much everyone agrees that primary care doctors like those in family practice and pediatrics are underpaid and need to get paid more. But finding that money is likely to touch off a civil war within the medical profession.

Mr. LESHEVSKI: The only way primary care physicians get more money is if certain specialties get less money. So it really gets down to a contest between the various specialty groups, as to who gives up and who doesn't.

ROVNER: But despite its internal struggles and declining membership, the AMA does still count, says Lyshevski. It might not have that much influence on what gets passed, but individually, its members probably still have the power to stop a bill they really hate. That's because health care is so complicated that doctors are among the few who can explain it to the public.

Mr. LYSHEVSKI: If the physician community stands up and says this would be bad for you, a lot of consumers are going to believe and accept that. So the president does not want the American Medical Association standing up and saying this would be bad.

ROVNER: Which is why President Obama is making a house call of his own in Chicago today.

Julie Rovner NPR News, Washington.

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