The AMA has one of the largest political lobbying budgets of any organization in the United States. Its political positions throughout its history have often been controversial. In the 1930s, the AMA attempted to prohibit its members from working for the health maintenance organizations established during the Great Depression, which violated the Sherman Antitrust Act and resulted in a conviction ultimately affirmed by the US Supreme Court.[80] In the 1940s, the AMA opposed President Truman's proposed healthcare reforms, which would have expanded healthcare facilities in low-income and rural communities, bolstered public health services, increased investments in medical research and education, and provided a national health insurance plan to help relieve the burden of excessive healthcare bills from sick persons.[81] The AMA condemned Truman's plan as "socialized medicine."[82]
The American Medical Association's vehement campaign against Medicare in the 1950s and 1960s included Operation Coffee Cup, supported by Ronald Reagan. Since the enactment of Medicare, the AMA reversed its position and now opposes any "cut to Medicare funding or shift [of] increased costs to beneficiaries at the expense of the quality or accessibility of care". However, the AMA remains opposed to any single-payer health care plan that might enact a National Health Service-style organization in the United States, such as the United States National Health Care Act. In the 1990s, the organization was part of the coalition that defeated the health care reform advanced by Hillary and Bill Clinton.[citation needed]
The AMA has also supported changes in medical malpractice law to limit damage awards, which, it contends, makes it difficult for patients to find appropriate medical care. In many states, high risk specialists have moved to other states that have enacted reform. For example, in 2004, all neurosurgeons had relocated out of the entire southern half of Illinois.[83] The main legislative emphasis in multiple states has been to effect caps on the amount that patients can receive for pain and suffering. These costs for pain and suffering are only those that exceed the actual costs of healthcare and lost income. At the same time however, states without caps also experienced similar results, suggesting that other market factors may have contributed to the decreases. Some economic studies have found that caps have historically had an uncertain effect on premium rates.[84] Nevertheless, the AMA believes the caps may alleviate what is often perceived as an excessively litigious environment for many doctors.[citation needed] A recent report by the AMA found that, in a 12-month period, five percent of physicians had claims filed against them.[85]
The AMA sponsors the Specialty Society Relative Value Scale Update Committee, which is an influential group of 29 physicians, mostly specialists, who help determine the value of different physicians' labor in Medicare prices.
Collections of the association's papers dating from the late 1860s to the late 1960s are held at the National Library of Medicine.[86][87]
During the Civil Rights Movement, the American Medical Association's policy of allowing its constituent groups to be racially segregated in areas with widespread prejudice faced opposition from doctors as well as other healthcare professionals. Pressure from organizations such as the Medical Committee for Human Rights (MCHR) resulted in changed policies by the late 1960s.
Nobel Memorial Prize-winning economist Milton Friedman as well as his wife, Rose Friedman, have claimed that the organization acts as a guild and has attempted to increase physicians' wages and fees by influencing limitations on the supply of physicians and competition from non-physicians. In the book Free to Choose, the Friedmans stated that "the AMA has engaged in extensive litigation charging chiropractors and osteopathic physicians with the unlicensed practice
