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Health care reform: Doctors favor public-private mix as an insurance option

doctors favor public-private insurance optionDespite 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).

Image courtesy of iStockphoto/starfotograf

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