without first getting the patient’s address and checking on hisrnfinancial status.rnThen there was the problem of pharmacists selling drugsrnwithout a doctor’s prescription. I’his was denounced as “therapeuticrnnihilism,” and the American Pharmaceutical Association,rncontrolled by the AMA, tried to stamp out the low-cost,rnin-demand practice. In nearly every state, the AMA securedrnlaws that made it illegal for patients to seek treatment from arnpharmacist. But still common were pharmacists who refilledrnprescriptions at customer request. The AMA lobbied to makernthis illegal, too, but most state legislatures wouldn’t go alongrnwith this because of constituent pressure. The AMA got its wayrnthrough the federal government, of course.rnThere were other threats that also had to be put down:rn”nostrums,” treatments that did not require a visit to the doctor,rnand midwives, who had better results than doctors. Also arndanger was “contracting out,” a company practice of employingrnphysicians to provide care for its workers. This was “unethical,”rnsaid the AMA, and should be illegal. Fraternal organizationsrnthat contracted out for their members were put outrnof business with legislated price controls, and hospitals—whosernaccreditation the AMA controlled—were pressured to refusernadmittance to patients of contracting-out doctors.rnBy the end of the Progressive Era, the orthodox profession asrnled by the AMA had triumphed over all of its competitors.rnThrough the use of government power, it had come to controlrneducation, licensure, treatment, and price. Later it outeompetedrnfraternal medical insurance with the state-privilegedrnand -subsidized Blue Cross and Blue Shield. The AMAdominatedrnBlues, in addition to other benefits, gave us thernegalitarian notion of “community rating,” under which everyonernpays the same price no matter what his condition.rnAMA control remains much the same, and as a result, evenrnincompetent doctors are guaranteed high incomes. In law, arnprofession with much freer entry, some lawyers get rich, othersrnmake middle incomes, and others have to go into another linernof work. But thanks to almost a century and a half of AMArnstatism, even terrible doctors get lavish incomes.rnThe monopoly also allows anti-customer practices to go unpunished.rnFor example, doctors routinely schedule appointmentsrntoo closelv together so as to keep their waiting rooms full,rnfor prestige and marketing reasons. With little competition,rnthey can get away with it, and advertising on-time servicernwould be “unethical.” The next time you have to wait 45 minutesrnamid six-month-old People magazines, thank the AMA.rnNow, if Hillary gets her way, licensing will become evenrnmore abusive. Iler Health Security Act mandates racial quotasrnfor medical students and faculties, as well as for practicingrnphysicians in the health alliances. This is the wits’ end of licensing,rnwhich began as an effort by the regulars to weed outrnthe competition and will now force on us the spectacularly inept,rnscalpels in hand.rnReal reform would remove the AMA’s grip on the marketplacernand subject the entire industry to competition. Untilrnthen, stock up on home medical books.rn’Iwclvc-Stcppinj; Ibvvards Hetlilclieiiirnhi K:ithcn’iic Mc. Mpi’ncrnDssfiinclional, abu.M-d or ccidc’j)endenl”rnSpeak np with pniic! |•.p^•rl^ in viciologxrnispoHinga h i i i t l i i l trend on ihe ascendcnDrnurgeou to whine away withoiil ajiolog}.rnI (irgcl old saws like •sell-rcliancc.” then.rnand “tlignitN.”‘ I nk-.i^li your Miner Victim!rnill this iii-u woild where ever eili/eiirnvie- lor the liglit tocr how late lias kicked l i i n i ,rnwi- honor, not the brigiitc’Nt and tiie best,rnbut tho.-iC who claim l t i e ‘ v been the most op|^rc^^edrn20/CHRONICLESrnrnrn