Well it is that time of year again, no not Christmas, Hanukkah, Kwansaa, or New Years, it is open enrollment time for the Affordable Care Act, until February 15, 2015. There are many that oppose this law and many that support it, but since it has been upheld by our Supreme Court, it is the current law of the land. But how was it passed despite years of controversy? Well a huge proponent of passage was the AARP, which stands to benefit with billions in income, and the wholehearted support by the American Medical Association. But who is the American Medical Association really? Well the story goes back to when I was at UCLA Dental School in the early 70's. At that time the AMA and the ADA had a participation rate of their doctors of approximately 70%. Our dental society decided to undergo a huge transformation to increase its recruitment efforts. We began aggressively sponsoring continuing education classes, having annual meetings, and then at the National, State and local levels began insurance companies, like The Dentists Insurance Company (TDIC) in California to represent us for malpractice issues and the multiple needs for myriad of other insurance issues. In addition to working closely with state boards and legislatures to pass laws and regulations that help dentists, staff and patients overall well being. What did the AMA do in that same time frame? Nothing. It was apparently way too much trouble for those involved to increase participants and it has been doing nothing for recruitment efforts since the 70's. Therefore, currently the ADA has a membership participation rate of approximately 85% of all dentists and its is even higher in the Sacramento District Dental Society. The AMA participation rate is somewhere between 14 and 17% depending on the report you read. Who are the AMA members? I would almost guarantee it is not your primary care physician at Kaiser, he or she is as upset with the ACA as any of it's most ardent detractors. The AMA is made up primarily of academics and administrators (like our congress person (Ami Bera) and other “bean counters.” I only hope that we can fix the problems of the ACA before they are unsolvable. Interestingly enough, I am starting on Medicare this year and therefore I will not be a participant for long.