If you study a little in economics, you learn (if you're open to learning) that the Invisible Hand of Adam Smith has many pathological off-shoots. One of those led to the Great Depression that followed the stock market crash in October 1929.
Another one, is when one group is successful in creating a monopoly as has brilliantly succeeded the AMA.
In all the discussion that led up to ObamaCare, the "third rail" of the system was a nut they could never crack (how's that for a tortured analogy and mixed metaphors) - to get the doctors to agree to cost curbs.
So in the end, the government forced limited movement of resources around, to help 20,000,000 people pay for a system that is broken and unsustainable, and there wasn't (and still isn't, and unlikely to ever be if nothing else changes) enough to go around, with the inevitable result seen is the last year of premiums going up, and companies pulling out of the healthcare exchanges.
Fundamentally, the AMA has been highly effective at controlling the supply of medical care, so costs are driven up by demand *totally removed from outcomes* (whether people get better or not, how long it takes us to get well, and how often and soon we go back).
Fundamentally, for US healthcare to deliver its promise,
we need to examine costs at a more granular level at which clinical outcomes are matched with the business and administrative processes.
There are pockets in the US where this has been achieved. And the AMA was successful in resisting policies being incorporated in Obamacare that would have replicated those success stories around the country and truly made a difference.
Arguing care is a right or not a right is a moot point in practical terms. The "compact" that the AMA has in return for the highest paid segment of society, is that no one (in theory) is turned away. This leads to much care delivered through emergency rooms - a highly inefficient (and expensive) mechanism, and this was the sole element the politicians could get through in the Affordable Healthcare Act (that is, providing insurance to all so people could schedule their doctor visits), because reform touches several rice bowls of powerful special interests.
The election of President Trump pales compared to the forces in support of the status quo, and this is NOT a Democrat/Republican thing liberal/conservative thing, despite all the noise on the line currently. What both parties are dancing around, is how to bring the AMA in line, and be able to stand the onslaught that would be unleashed which is the AMA's trump card: [advertising - fake news - alternative facts - whatever you want to call it: "This change will drive doctors out of business, and people will die waiting for treatment. Will it be you? A loved one ? Don't say we didn't warn you."
