Utah Physician Recommends Staying Away from Hospitals

(This is a copy of my diary on Daily Kos.)

Utah state legislator Mike Kennedy (R) weighed in on the argument concerning extending Medicaid coverage. I first saw this content of Kennedy’s statements via a meme on Facebook. Knowing that false memes are a dime a dozen there, I had a look to see if I could independently corroborate it. And, indeed, I found a news site with video of his statement: Fox 13 Salt Lake City coverage

Text of Kennedy’s statement from that link:

Sometimes access to health care can be damaging and dangerous. And it’s a perspective for the [Legislative] body to consider is that, I’ve heard from National Institutes of Health and otherwise that we’re killing up to a million, a million and a half people every year in our hospitals. And it’s access to hospitals that’s killing those people.

It is not unusual to hear the “let them eat death” attitudes in Republicans talking smack about poor people and health care. It is somewhat more unusual that an M.D. in practice, who himself apparently is hospital staff at Timpanogos Regional Hospital, would say such a thing.

Now, we broadly protect legislators from being sued over their statements in the course of legislative sessions via legislative immunity. So the clearly defamatory nature of his statement regarding the competence of his medical colleagues in the performance of their duties will not result in legal action.

However, it is instructive to see just how contradictory Kennedy’s statements are to the clear opinion of the American Medical Association (AMA) on the topic, given in the AMA Code of Ethics, Opinion 2.095 – The Provision of Adequate Health Care.

Because society has an obligation to make access to an adequate level of health care available to all of its members regardless of ability to pay, physicians should contribute their expertise at a policy-making level to help achieve this goal. In determining whether particular procedures or treatments should be included in the adequate level of health care, the following ethical principles should be considered:

(1) degree of benefit (the difference in outcome between treatment and no treatment),

(2) likelihood of benefit,

(3) duration of benefit,

(4) cost, and

(5) number of people who will benefit (referring to the fact that a treatment may benefit the patient and others who come into contact with the patient, as with a vaccination or antimicrobial drug).

Ethical principles require that a just process be used to determine the adequate level of health care. To ensure justice, the process for determining the adequate level of health care should include the following considerations:

(1) democratic decision making with broad public input at both the developmental and final approval stages,

(2) monitoring for variations in care that cannot be explained on medical grounds with special attention to evidence of discriminatory impact on historically disadvantaged groups, and

(3) adjustment of the adequate level over time to ensure continued and broad public acceptance.

Because of the risk that inappropriate biases will influence the content of the basic benefits package, it may be desirable to avoid rigid or precise formulas to define the specific components of the basic benefits package. After applying the five ethical values listed above, it will be possible to designate some kinds of care as either clearly basic or clearly discretionary. However, for care that is not clearly basic or discretionary, seemingly objective formulas may result in choices that are inappropriately biased. For that care, therefore, it may be desirable to give equal consideration (eg, through a process of random selection) to the different kinds of care when deciding which will be included in the basic benefits package. The mechanism for providing an adequate level of health care should ensure that the health care benefits for the poor will not be eroded over time. (VII)

That opinion dates back to 1994; it isn’t like this suddenly popped up.

While Kennedy should be safe from legal action over his statements, it looks like he may well be in violation of the AMA Code of Ethics, and action on that score may not be covered by legislative immunity. I’d like to hear from anyone who could say with more definiteness what Kennedy’s responsibilities are in sticking to the AMA Code of Ethics, and how, if he is in violation, would that need to play out.