Quality health care healthcare doctor
Quality health care healthcare doctor

By George

Two weeks ago, President of the Caribbean Cardiac Society, Dr. Richard Ishmael expressed support for the SLMDA’s vocal opposition to the healthcare policies of the UWP Administration and its statements denouncing the healthcare crisis in St. Lucia.

However, what has been widely missed in Dr. Ishmael’s words of support, was his own particular spin on this local issue: that being that he supports not just the SLMDA’s political advocacy, but also pushed for doctors in the region to have a right to lobby their respective governments, as their North American counterparts do.

He named in particular, the American Medical Association, the largest medical lobbying group in the United States; but contrary to what Dr. Ishmael claimed– that increased lobbying of governments by doctors, necessarily leads to an increase in the quality of care, and a decrease in mortality rates– the reality is far different.

The reality is that despite having very powerful medical lobbying groups and the most funded healthcare system in the world, the U.S. has seen far more growth in its political scandals and corruption surrounding healthcare, than it has in the overall quality of its health.

In other words, despite the large amounts of money attained by the U.S’ medical lobbying groups and the huge political influence that they wield, it simply has not translated into the quality of its overall healthcare.

Dr. Ishmael said this before restating his support for the SLMDA: “What we want to do is we want to be able to lobby the governments and the decision makers…” citing “the biggest health association” from the US, that being the American Medical Association, as an example of North American medical associations that “all lobby their governments to be able to get what they want, to bring the mortality [rates] down and it’s about time that the doctors in the Caribbean do that and I laud the Saint Lucia Medical and Dental Association for doing that.”

However, his romanticised view of the AMA and the general medical lobbying of Governments is a rather dangerous one, given the facts on the ground, inclusive of the fact that “The U.S. spends far more on healthcare than any other country in the world, often paying twice as much or more for the same drugs.” Despite being “far from the healthiest”; given that it’s the “only country on the top 10 list of the highest healthcare spending that has a life expectancy less than 80 years.”

So the question is, why hasn’t an increasingly powerful medical lobbying group in the U.S., brought about an increase in the quality of healthcare and what does this potentially mean for our own (future) medical lobbying groups?

The AMA, perhaps since its inception, has been more concerned with the political influence it wields, and the money that has secured for the medical bureaucracy, than it has been about improving the overall quality of healthcare for its patients at large. Why wouldn’t it? Given that a healthier society means less money generated for that very medical bureaucracy.

Together with the U.S. Food and Drug Administration, the AMA has helped secure billions of dollars in profits for the drug companies over there, mainly by creating a monopoly of FDA

approved treatments, while many diseases, including cancer remain without [FDA Approved] cure.

According to the Centre For Responsive Politics, “drug companies and their lobbying groups [including the AMA] spent $229 million to influence politics in 2014.” Buying the politicians in such a way, guarantees that laws are passed that are favourable to the medical bureaucracy and with such huge swathes of money being spent by groups that are supposed to mainly be concerned with healthcare, it means that they also help influence the outcome of elections, one way or the other.

Moreover, “The Tufts Centre for the Study of Drug Development estimates it costs $2.6 billion to get a drug [FDA] approved.” Absolutely crazy; except it’s not for the AMA and their ilk, who through their lobbying, have ensured the passing of such laws, under the guise of improving healthcare.

And this is nothing new. Hans Ruesch, medical editor and historian, in his 1978 book (Slaughter of the Innocent p 418), stated that “American special interest groups ‘showered a record $22.6 million on candidates in 1976 and that the top donors were the medical associations with $1,790,879.”

Going even further back, Eleanor McBean quoted this from a 1952 New York Times article which reads: “Some rather expert observations of the art of lobbying as practiced in Washington assert that the A. M. A. is the only organization in the country that could marshal 140 votes in Congress between sundown Friday night and noon on Monday. Performances of this sort have led some to describe the A. M. A. lobby as the most powerful in the country.”

What’s particularly curious about this, is that when one pays close attention to some of the actions and statements of the

SLMDA recently, it wouldn’t be a stretch to conclude, that this form of political lobbying is not far away from the St. Lucian political reality.

For instance, it’s been reported that the SLMDA has proposed a return to the original VAT rate of 15%, “with 2.5% of [the] same being specifically designated to cover predetermined healthcare costs.” [pg 15 of its Position Paper]

A move it claims will raise an extra $52 million, which in truth would mean 52 million more dollars out of the pockets of the St. Lucian citizen it purports to care so much about. But don’t forget that they [the medical bureaucrats] know what’s best for us, even better than we know ourselves.

And with the news that more taxes are being collected with the lower 12.5 % VAT rate, their argument that increasing funds will be garnered from reinstituting the 15% VAT, actually falls flat on its face. But I digress.

Another difficulty with the SLMDA’s position here, is that the reduction in the VAT was the politico-economic position and decision of the Allen Chastanet Administration and therefore the SLMDA’s public opposition to it, represents its entrance into the political arena.

With Dr. Ishmael’s recent statement supporting increased lobbying of governments by groups such as the SLMDA, it doesn’t take much to conclude that a significant portion of the reasoning behind its vehement opposition to the UWP’s healthcare policy is its own disagreement with the reduction in VAT rates.

This much was intimated in its Position Paper to the government, where the Association marked the “clear policy

shift (political and economic) articulated by the government” as being one of the factors that has prompted its now very vocal and public opposition to our current healthcare policy. [page 5 of Position Paper]

When that is juxtaposed against the non vocal and non public position of the SLMDA about the healthcare policy under the previous administration, when admittedly things were not much different than they are now, then it should raise concerns about the Association’s true [political] allegiances.

And as was pointed out in a Star Newspaper article months ago, this type of political advocacy from members of the SLMDA represents a major conflict of interest; this hyperthetical example solidifying the point, that if “say Allen Chastanet were to fall unconscious outside his Government Buildings office and had to be rushed to a local medical facility. And say he could not be revived. What would be the reaction of at least half of this politically polarized nation of ours…?” [from the article: Doctor’s Advice to Kenny & Company…]

Even though I would expect in that circumstance for each member of the SLMDA to do his/her job professionally, all of this political “lobbying” is going to cause the question to be asked, which is a terribly unfortunate thing.

The irony about all of this is that the Association seems completely oblivious to this reality. Take this statement of theirs from their Position Paper, for example, that the “SLMDA must never partner with those who seem to function as lobbyists against the greater good of our St. Lucian society.” [pg. 9 Position Paper]

The funny thing is, I completely agree with that statement. However, I’m afraid that it will (if not now) in the very near

future, be completely true of the SLMDA itself. The medical bureaucracy just doesn’t seem to get that it is doing the very lobbying “against the greater good of our St. Lucian society”, that it condemns in the above.

As demonstrated with the AMA’s own lobbying, such interference in government policy, healthcare or no, by the SLMDA, and other like groups, will eventually lead to open political and financial support of a party willing to acquiesce to its demands and a massive conflict of interest. Mind, Dr. Ishmael is already calling for this! How much longer before it reaches our shores?

Increased lobbying of governments by groups such as the SLMDA and other medical associations in the region, far from improving healthcare, will be a dangerous trail to blaze, one rife with corruption and millions of dollars being passed under the table.

As Jon Rappaport intimated in his book: Ownership of all Life, there is always a massive conflict of interest with such lobbying; using the AMA as an example he pointed out that “since 1975 [it] has channelled somewhere in the vicinity of $75 million into its own political action committee, the American Medical Political Action Committee (AMPAC).”; money that is “funnelled through to favoured candidates who run for office all over the US.”

He added that “The federal watchdog agency whose job it is to keep PACs like AMPAC honest is the Federal Election Commission…” which has its “Washington offices in a building at 999 E Street, NW…owned by the American Medical Association.”

This form of corruption is now and always has been rife in the AMA. As Eleanor McBrean quotes from The Tarnished Record of the American Medical Association: “The A. M. A. at its 1949 convention…urged its members to engage in political action to

defeat congressmen whom it could not control…”, advocacy not too distant from what Dr. Ishmael espoused recently and eerily similar to what the SLMDA has engaged in against an administration not willing to bow to its demands.


  1. First of all comparing the AMA to the SLMDA is asinine. Where are the large pharmaceutical companies in Saint Lucia to pay to lobby political parties. The SLMDA is just trying to get a seat the table because they one the most important stakeholders in health-care. So far they been stone-walled so they gave to get their position across.

  2. The slmda has never really cared about health in st Lucia. Only dr King and dr bird were vocal about our healthcare system and I don’t see them involved in the current mess the slmda is in. I have for the past few months questioned the motives of Dr Alphonse’s st rose. Should govt supporters even feel comfortable going to some of these doctors? What if our Pm gets sick should he go to any of these doctors that are so political now. I have never seen doctors so political. Are they doing their part to bring down the cost of health care instead they fighting Chastanet. By George! What you did about what’s in their position paper is quite revealing.

Comments are closed.