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Sep 16, 2009 03:24 PM | 7
Despite the American Medical Association's (AMA) previously hearty lobby against public options for health insurance, only 27 percent of doctors are in favor of limiting coverage to private options.
More than half of doctors (about 63 percent of 2,130) in a recent survey preferred a public-private blend, which would allow for expansion of coverage both through tax credits to pay for private insurance and expanded public health plans. The survey results were published online in the New England Journal of Medicine earlier this week.
"The results of the study demonstrated that the majority of physicians support a public option," Dalomeh Keyhani told National Public Radio (NPR) on Monday. She is the lead author on the report and a researcher at Mount Sinai School of Medicine.
Given the survey findings, why has the AMA been largely opposed to public options? "It used to be that the AMA really did represent the view of most doctors because doctors were a pretty homogenous group," Julie Rovner, an NPR health policy correspondent said on the station's Morning Edition program on Monday. The demographics of doctors has changed over the years, she said, and an increased number of perspectives in the system has brought "a lot more differences of opinion about what the nation's health care system really ought to look like."
Earlier this year, the AMA had lobbied to keep public options out of the proposed health care bills. In July, however, the group issued a letter to the House of Representatives endorsing the America's Affordable Health Choices Act, which did include a public option. Today, with the announcement of Senator Max Baucus's (D-Mont.) proposal, which would cut the cost of reform but not include a public option, the AMA issued a statement that shied away from full support. "The AMA will continue to work with Chairman Baucus and his colleagues to strengthen this proposal," J. James Rohack, president of the AMA, said in a prepared statement. A linchpin of the organization's support is the revision of the current Medicaid formulas used to calculate payment to physicians.
Ensuring that more people had health insurance would also make it more likely that doctors and hospitals would be paid for their services. "A public option would sort of help guarantee that most people had coverage," Keyhani said on NPR. "Having a guarantee of reimbursement of some sort I think is very appealing to most physicians."
Working on the frontlines of health care doesn't appear to change doctors' viewpoint from that of the general population. More than half of the American public (52 to 69 percent, according to polls) favors public options for health insurance.
Even though specialists were less likely to favor any kind of public option than general practitioners—perhaps owing to concerns about decreased reimbursements—more than half of them still did, according to the survey, which was funded by the Robert Wood Johnson Foundation (a nonprofit organization that supports health care reform).
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7 Comments
Add Comment"More than half of the American public (52 to 69 percent, according to polls) favors public options for health insurance. "
Reply | Report Abuse | Link to thisOh really? When was this poll taken - last year? In August support for the Dem's health care plan was at 42%. And the public option is the main reason why so many oppose the plan.
And if doctors want expansion of public coverage, why do they incessantly gripe about Medicare and Medicaid reimbursement rates. Something seems not right with this article and its conclusions.
"Oh really? When was this poll taken - last year? In August support for the Dem's health care plan was at 42%. And the public option is the main reason why so many oppose the plan."
Reply | Report Abuse | Link to thisNo, it isn't. In August the support for the Dems' health care plan wasn't high, but it wasn't because of the public option. A CBS poll from early September found <a href="http://www.cbsnews.com/htdocs/pdf/poll_health_care_090109.pdf?tag=contentMain;contentBody">60% in support of the public option, and 34% opposed</a>. A Kaiser poll from mid-August found <a href="http://www.kff.org/kaiserpolls/upload/7964.pdf">59% in support of the public option, and 38% opposed</a>. A CNN poll from late August found <a href="http://i2.cdn.turner.com/cnn/2009/images/09/02/rel12d.pdf">55% in support of the public option, and 41% opposed</a>.
A few caveats. The public option is not quite as popular as it once was, as polling back in May and June found support breaking 70% easily. However, it seems to have leveled out, as polling from July and polling from September not significantly different; mid-to-high fifties in support, about forty opposed is fairly standard now. Also, there are outliers in either direction, showing May-level support numbers during the heat of August, and a couple even showing opposition in a very slight lead - off the top of my head, I remember an NBC poll I think it was, that had support in the mid-40's and opposition in the high 40's. This, however, seems to be the spectrum. Essentially even or a very slight lead for opposition is a "bad" result for the public option. Astronomical support upwards of two-thirds is a "good" result. Also, numbers vary depending on the sample used: those that survey all adults or registered voters generally provide more liberal results than those that apply likely voter screens, as is usual in most issues.
But the idea that the public option is the <i>reason</i> behind Democrats' troubles is ideological wishful thinking that's clearly not borne out by empirical studies. It has, unfortunately, gained some currency as a reflexive meme among mainstream outlets, but who says those are generally accurate?
What you'll notice is that the options for health care reform currently on the table seem to be less popular than the public option. How can this be, you may ask? Health care reform is looking contentious, and it's a LEFT WING proposal. The public option is the most LEFT WING component of it and should therefore be the most contentious of all! This is backwards!
Reply | Report Abuse | Link to thisThis is more ideological wishful thinking. Health care reform isn't in danger because it's a left wing proposal. It's in danger because of the alleged death panels, the alleged coverage that will be given to illegal immigrants, and the fear that it may take away spending from Medicare. (Which is why senior citizens are the least supportive group, and indeed, there's an inverse relationship between support for reform and age. Of the three listed, this last one is perhaps the most plausible concern.)
This is precisely the delusion that moderate right wingers, so-called libertarian conservatives, and the blue blooded WSJ laissez-faire crowd live under. They pretend to disapprove of the birther types, and during their stronger moments may actually do so - but they need those guys. Their policies and social vision - at least the economic parts - by themselves are dreadfully unpopular.
And perhaps I've wasted my time expounding on all this on an empty thread, but I see enough verbatim repetition of the same talking points - some of them by the same people, on a later thread when they think the person who debunked them is gone, so they churn out the same memes - that I'll just copy, paste, and save these two responses so I can re-use it later.
(SciAm doesn't support html script. I'd say that's not very scientific of you guys.)
Reply | Report Abuse | Link to thisI don't understand the right wing being against a public option? It's not like anyone is forced to use it. And it will cause health costs to go down for everyone, even those with private insurance.
Since it will help balance the budget is another thing rightwingers should like. The only thing I see is they hate people. They only seem to want things to go in businesses favor all the time and subsidize them.
Personally I'd like to see low cost public health care since they won't let us take care of ourselves. Why should we be forced to go to a doctor to get the medicine we know we need. Most people only have one or 2 problems which with a little education, they could take care of themselves most of the time. Why should I pay $65 to a doctor for the right to get the $4 blood pressure medicine I need? It's not like I can't measure my own blood pressure.
We expect our goverment to protect us from foreign invasion, protect us against criminals, protect our property, we have means thru our goverment to deal with violations for any of the above: war, justice system, police and I should include protection from fire too: fire department. Should goverment's duty include to make everything possible for a healthy population? Wouldn't a healthy population be a factor for a succesful country? Should we allow health coverage to happen only in an atmosphere of profit to insurance carriers and a portion of the population that could afford to share its hard earned money for the profit of insurance and pharmaceutical corporations? How is it possible to reconcile the basic profit motivation with the survival of fellow citizens? Is it morally acceptable for an insurance company executive to "earn" in a day's work more money than many hard working citizens "earn" in a lifetime? Our country is at a crossroads in its history and the health care debate will shape its course over the next century.
Reply | Report Abuse | Link to thisJerryd: your thinking: "Personally I'd like to see low cost public health care since they won't let us take care of ourselves. Why should we be forced to go to a doctor to get the medicine we know we need" makes sense BUT is inaccurate: you need the expertise of a doctor. I could be the healthiest person in the world and have just one disease: acute appendicitis; if I do not see a doctor, I could think I have just a stomach ache and die.
Reply | Report Abuse | Link to thisHealthcare the world over seems much more of an illusion, for far too many people that need it. My company http://www.smilemd.com is right now securing doctors and dentists for voluntary free clinics, for all those uninsureds throughout the USA, who still will not have insurance coverage, even after the dust settles on the great healthcare debate.
Reply | Report Abuse | Link to thisThe irony of the issue that's left out of these debates were fighting this very moment is that most people in this country die from viruses that are freely contracted. Whatever then will all your money buy you then?