Sharfstein J M, Sharfstein S S
Harvard Medical School, Boston.
N Engl J Med. 1994 Jan 6;330(1):32-7. doi: 10.1056/NEJM199401063300107.
The American Medical Political Action Committee (AMPAC), the political arm of the American Medical Association (AMA), contributed $2.4 million to candidates for Congress during the 1989-1990 campaign and $2.9 million during the 1991-1992 campaign. It is not known whether these funds preferentially benefited representatives who supported the AMA's positions on public health issues.
We analyzed AMPAC contributions to members of the House of Representatives during the 1989-1990 and 1991-1992 campaigns according to their votes on three health-related issues: the promotion of tobacco exports, the institution of a mandatory waiting period before a handgun purchase, and the so-called gag rule, which limited physicians' speech on abortion in federally funded clinics. For each issue, we determined whether AMPAC had contributed more on average to opponents or to supporters of the official AMA position.
AMPAC contributed more on average to opponents of the AMA positions on all three public health issues. From 1989 to 1992, AMPAC gave significantly larger average contributions to House members who favored tobacco-export promotion than to those opposed it ($11,549 vs. $9,842, P = 0.04) and contributed significantly less on average to supporters of handgun control than to their opponents ($9,022 vs. $11,250, P = 0.001). During the same period, AMPAC's contributions revealed a marked preference for House members who supported the gag rule over those who opposed it ($10,961 vs. $9,611, P = 0.05). House members who supported the AMA positions on all three votes received an average of $8,800 from AMPAC from 1989 through 1992, whereas members who opposed all three positions received an average of $13,270 (correlation between the number of votes for AMA positions and AMPAC contributions, -0.21; P < 0.001).
AMPAC's contributions to members of the House of Representatives belie the AMA positions on some important public health issues.
美国医学政治行动委员会（AMPAC）是美国医学协会（AMA）的政治分支，在1989 - 1990年竞选期间向国会候选人捐款240万美元，在1991 - 1992年竞选期间捐款290万美元。尚不清楚这些资金是否优先惠及支持AMA在公共卫生问题上立场的众议员。
我们根据众议员在三个与健康相关问题上的投票情况，分析了AMPAC在1989 - 1990年和1991 - 1992年竞选期间对众议院议员的捐款情况：促进烟草出口、实行购买手枪前的强制等待期以及所谓的“禁言规则”（该规则限制医生在联邦资助诊所就堕胎问题发表言论）。对于每个问题，我们确定AMPAC平均是向AMA官方立场的反对者还是支持者捐款更多。
在所有三个公共卫生问题上，AMPAC平均向AMA立场的反对者捐款更多。1989年至1992年期间，AMPAC向支持促进烟草出口的众议院议员提供的平均捐款显著高于反对者（11,549美元对9,842美元，P = 0.04），而向支持手枪管制的议员提供的平均捐款显著低于反对者（9,022美元对11,250美元，P = 0.001）。在同一时期，AMPAC的捐款显示出明显倾向于支持“禁言规则”的众议院议员而非反对者（10,961美元对9,611美元，P = 0.05）。在1989年至1992年期间，在所有三项投票中支持AMA立场的众议院议员平均从AMPAC获得8,800美元，而反对所有三项立场的议员平均获得13,270美元（支持AMA立场的票数与AMPAC捐款之间的相关性为 - 0.21；P < 0.001）。
AMPAC对众议院议员的捐款与AMA在一些重要公共卫生问题上的立场不符。
