I have received quite a few comments from ACP members who say that the College's positions on health reform are not representative of most internists' views. For instance, on Friday an internist posted the following comment in response to my blog about Obama's speech to Congress:
"You will be hard-pressed to find a physician outside of a university setting that supports this ridiculous bill . . ."
Lately, such criticisms have come mostly from the right of the political spectrum. Over the years, though, I have heard from many ACP members who support a single payer system; they also claim most internists agree with them and that ACP is out-of-step with its membership.
A new poll, funded by the non-partisan Robert Wood Johnson Foundation, found that a large majority of physicians - almost 63% - "support proposals to expand health care coverage that include both public and private insurance options - where people under the age of 65 would have the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans government." Fewer than one in ten of the physicians surveyed support a single government plan (Medicare for all) that replaces private insurance. Large majorities of physicians also support a Medicare buy-in option for people between the ages of 55 and 65. Primary care physicians - internists, pediatricians, and family physicians - were the most supportive of providing a public and private option, with 65.2% being in favor.
Physicians in all regions of the country supported a public-private option, with support ranging from a low of 58.9% in the south to a high of 69.7% in the northeast. 63.3% of physicians in urban areas and 59.6% in rural ones supported the public-private option. It wasn't just academic or salaried doctors who said they support a public plan option. Solid levels of support were found from physicians in private practices (59.7%), those who are involved in patient care more than 20 hours per week (62%), and those who get most of their income from direct billing rather than salary (58.9%). More than six out of ten AMA members expressed support for a public-private option.
Now, I have learned from experience that people tend to dismiss as being "biased" polls that do not agree with their own views. I also recognize that polls have their limitations, and some are more accurate than others. Some polls, especially those funded by advocacy organizations or political parties, should rightly be suspected of carrying bias. But there are a lot of highly respected researchers who are doing their best to capture accurate information about physicians' and the public's views, and I think this polls meets any reasonable standard of credibility.
Polls are snapshots of opinion, and opinions can change rapidly as circumstances change. Plus, complex issues like health reform aren't easily captured in a single poll. This poll did not ask the physicians about their specific views on President Obama's plan or the bills pending in Congress. Nor did it ask their views on financing health reform through higher taxes, or requiring that individuals buy insurance. Still, the poll suggests that there is broad and deep physician support for a larger federal government role in health care.
Now, just because physicians seem to agree on the need to provide the public with a choice of public and private plans doesn't make it the right policy prescription for America. A principled argument can be made against giving the government a bigger role in health care, just as a principled argument can be made for a single payer system. Still, physicians making such arguments should be aware that they seem to be at odds with where most of their colleagues stand.
Today's question: Do you agree with the poll's finding that most physicians support giving people the option of enrolling in a Medicare type program, along with private insurance? If you don't agree, are there alternative surveys or data on physicians' opinions that this blog's readers should know about?