opinion

A voice for medicine before the nation’s high court

The AMA, and the Litigation Center it runs with the state medical societies, has had a major presence at the U.S. Supreme Court this term.

Posted March 4, 2013.

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Sometimes what physicians need is a good lawyer or two — especially when those attorneys are representing their interests before the highest court in the land.

The significance of the health care legal cases that reach the U.S. Supreme Court cannot be denied. The court’s decision in June 2012 to uphold the Affordable Care Act, for instance, will deeply impact the lives of tens of millions of Americans and their doctors for decades.

And court cases do not need to rise to that historic level for physicians to have a major stake in the outcomes. Several considered by the Supreme Court this term have the capacity to affect fundamentally the way doctors treat their patients, run their businesses and live their lives.

The American Medical Association and the state physician organizations know this well. That’s why the AMA — often through the Litigation Center of the American Medical Association and the State Medical Societies — regularly files friend-of-the court briefs with the Supreme Court, making sure justices hear doctors’ voices loud and clear.

For the court term that started in October 2012, this level of commitment reached a striking level. Between them, the AMA and the Litigation Center filed or had plans to file amicus curiae briefs on more than a half-dozen pending Supreme Court cases.

The cases that have merited AMA and Litigation Center involvement are a diverse group that touch on multiple aspects of the medical-legal landscape. After all, physicians are not interested solely in one very specific area of jurisprudence, and the work and life of physicians touch a wide-ranging array of legal, professional, economic and social issues.

One cutting-edge case involving the Litigation Center has the Supreme Court considering a huge question: Are human genes patentable? To physicians, the clear answer is that allowing a patent on such a product of nature would impede scientific progress, erect a barrier to patient access and approve a business practice that is ethically questionable.

The Litigation Center sometimes must go to court to preserve the ability of doctors to secure relief for a legal grievance. A friend-of-the-court brief, soon to be filed, will back a physician pursuing a class-action arbitration against a health plan he says has systematically downcoded and bundled doctor payments.

The Litigation Center had submitted a brief on one case recently decided by the Supreme Court that concerned hospital competition and federal antitrust powers. The center argued — with some success — that ensuring healthy competition among health care facilities was a good thing for patients, but it counseled the justices not to go too far in asserting federal power as to impede the ability of state medical boards to do their jobs well.

The AMA itself has been busy before the high court this term. The Association recently filed a brief urging a ruling against the practice known as “pay for delay,” in which brand-name pharmaceutical companies compensate generic drugmakers to slow-walk less-costly medication equivalents to the market. Physicians want patients to have access to affordable drugs they need, and pay-for-delay deals undermine that access.

Not every court case of great interest to physicians is an economic one at its heart; social issues also are worthy of their contributions to the debate. That’s why the AMA gave its support in a case to a university that — like many — uses applicants’ race as one of many factors it considers. Diversity of all kinds is a vital component to a good education.

Denying the ability of two people to enter into civil marriage based on their sexual orientation is discriminatory, harms individuals and families, and fosters health care disparities. That’s why when two major cases challenging statutes banning same-sex marriage come before the Supreme Court, the AMA will be ready to file briefs on those cases as well.

Some advocacy organizations may go years without having the cause or opportunity to file a single high court brief on behalf of their members’ interests. Having such an unusually large number of briefs before the court in one term reflects the vigor with which the Association and the Litigation Center advocate for their constituents.

When physician advocacy entails taking a fight to the highest level — Congress, the White House or the Supreme Court — experience, resources and the ability to work collectively count. This busy year for the AMA and the Litigation Center is a compelling example of what it takes to make the voice of medicine heard by all of the branches of government.

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