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Tilting at Windmills

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September 15, 2009

PHYSICIANS BACK PUBLIC OPTION.... Public opinion surveys have consistently shown strong national support for a public option as part of heath care reform. Nevertheless, the NYT noted over the weekend that the measure has drawn "all-out opposition" by "much of the health care industry."

Actual physicians, however, seem to agree more with their patients than with the industry. (via Dr. Ron Chusid, who has more)

A large majority of doctors say there should be a public option.

When polled, "nearly three-quarters of physicians supported some form of a public option, either alone or in combination with private insurance options," says Dr. Salomeh Keyhani. She and Dr. Alex Federman, both internists and researchers at Mount Sinai School of Medicine in New York, conducted a random survey, by mail and by phone, of 2,130 doctors. They surveyed them from June right up to early September.

Most doctors -- 63 percent -- say they favor giving patients a choice that would include both public and private insurance. That's the position of President Obama and of many congressional Democrats. In addition, another 10 percent of doctors say they favor a public option only; they'd like to see a single-payer health care system. Together, the two groups add up to 73 percent.

Dr. Keyhani added, "Whether they lived in southern regions of the United States or traditionally liberal parts of the country, we found that physicians, regardless -- whether they were salaried or they were practice owners, regardless of whether they were specialists or primary care providers, regardless of where they lived -- the support for the public option was broad and widespread."

Among primary care doctors, support for a public option was nearly three to one.

The conventional wisdom has been that medical doctors are skeptical about reform efforts, an idea bolstered by the AMA's decades-long opposition to system improvements. But this survey, published in the New England Journal of Medicine, suggests otherwise.

In terms of political salience, it's likely a report like this won't sway many votes in Congress. Indeed, a wide variety of polls point to strong support among Americans for a public option, and many conservative lawmakers simply pretend those results don't exist.

But when it comes to persuading the public, physicians' opinions on this may carry some weight with reform skeptics. Every little bit helps.

Steve Benen 8:00 AM Permalink | Trackbacks | Comments (21)

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Comments

Obviously these physicians polled are a bunch of communists bent on a eugenic based solution to future generations of registered Republicans.

Posted by: Can I haz a Glenn Beck? on September 15, 2009 at 8:07 AM | PERMALINK

This really shouldn't be that surprising. As I wrote somewhere else (I don't remember where), doctors don't like insurance companies anymore than anyone else, quite probably less. The most bizarre thing about this whole issue is that Republicans are essentially taking the side of protecting insurance company profits in this debate - entities which are universally reviled. If you can't easily win the crowd when the debate topic is how badly insurance companies suck, you are doing it wrong. But here we are, right?

Posted by: brent on September 15, 2009 at 8:13 AM | PERMALINK

Here's the thing. Sure, there are things doctors don't like about Medicare. But what they do like about it is that they get paid.

Despite the AMA's histrionics in 1965 about Medicare being "socialism" (hiring actor Ronald Reagan to make the video and all that), they quickly realized it was a steady source of income. One of Obama's accomplishments in Illinois was helping to pass the Healthy Kids Initiative, which guaranteed coverage for all Illinois children. Doctors in Illinois supported it because they got paid. (Although this year, with budget crunches, payments are behind, just like everywhere.)

It's true that the Medicare payment system has some problems. As last changed in 1998, it was set up by Congress as an SGR -- a sustainable growth rate -- that assumed any growth in the number of treatments by doctors to seniors had to be offset by lowered payment. Of course, with the growth in the number of people over 65, that just isn't happening. Right now, Congress just fixes the pay rate every year so that doctors don't get the pay cut. But the formula keeps going. Currently, doctors face a 21.5% pay cut next year unless Congress steps in again. Fixing this system is part of the health reform package, and one of the main reasons the AMA is on board.

Actually, when you think about it, so many parts of society give seniors a discount -- movie theaters, hotels, retail stores, restaurants. Why shouldn't doctors?

Posted by: Molly Weasley on September 15, 2009 at 8:17 AM | PERMALINK

Everyone supports the PO but the Insurance companies, the wingnuts, the congress (Ah. Good ol' "representative" democracy.) and probably the president.

Ever get the notion that he has been dangling it out there to trade it off for something, anything, from the Republicans?

One Republican vote is all it would take for him to completely ditch the notion. Problem is, bargaining chips only work if the other side actually thinks you really want that chip.

It has been obvious to me for some time that at least a third - and probably half - of the Democrats don't really want the PO and would love to see it killed - if only they could claim to have "fought the good fight" and lost.

Posted by: UnEasyOne on September 15, 2009 at 8:18 AM | PERMALINK

We have exactly the country that the Money Party wants us to have. Corporate monopolies rule. Corporate media is their mouthpiece. Don't expect any help from MSM.

And if that makes you sick, don't expect help from the health insurance companies.

Posted by: anonymous on September 15, 2009 at 8:25 AM | PERMALINK

Yeah, right. A so-called 'poll', conducted BY physicians OF physicians.

Who ya gonna believe, a bunch of skilled, educated doctors who deal every day with 'health care', or the 'Peeps'- a bunch of sign waving illiterate morons who are pissed of that a BLACK man is in 'their' White House?

We're a Democracy, America, and we Vote- when we remember to register. . .

Posted by: DAY on September 15, 2009 at 8:28 AM | PERMALINK

"Currently, doctors face a 21.5% pay cut next year unless Congress steps in again."

There goes the second boat.

Posted by: converse on September 15, 2009 at 8:44 AM | PERMALINK

It seems that the most common argument the right has had against the PO is that it will entail government bureaucrats getting between patients and their doctors.

This poll will make it hard for them to continue this argument. This is a gift, and there needs to be a concerted effort to contrast the results of this poll with the main Republican talking point of the last six months. This needs to be done RELENTLESSLY AND PITILESSLY.

Posted by: JD on September 15, 2009 at 8:44 AM | PERMALINK

so many parts of society give seniors a discount -- movie theaters, hotels, retail stores, restaurants. Why shouldn't doctors?

In most states, the current Medicare rate is a significant discount over not only the cash charge but the prevailing private insurer rate. Also, the entities that give the discounts above are those that face low marginal costs for providing additional units of service. Physician offices have a relatively high marginal cost structure and their patient load is already skewed towards those on Medicare.

Posted by: sj on September 15, 2009 at 8:55 AM | PERMALINK

To the crazies in the streets of America: Trust your doctors! -Kevo

Posted by: kevo on September 15, 2009 at 9:02 AM | PERMALINK

Real health care reform is dead already. It died the second that UHC was passed over in favor of hodgepodge of nebulous alternatives. It's impossible to believe at this point that neither Obama nor the Democrats in Congress didn't know that the Republicans would fight their first proposal to the death so the only sensible conclusion is that the Dems (Other than the late Ted Kennedy) weren't actually invested in substantial health care reform.
A bill that's acceptable to the health care industry will be passed and Obama will sign it into law. Health care costs will continue to soar, tens of millions still won't have coverage, politicians will pause to pat themselves on the back before tackling the Potemkin reform of the financial sector.

Posted by: Dennis-SGMM on September 15, 2009 at 9:09 AM | PERMALINK

when it comes to persuading the public, physicians' opinions on this may carry some weight with reform skeptics. Every little bit helps.

This isn't some little bit, this is a shout-it-from-the-rooftops, incredible piece of rhetoric that a useful, mobilized and energized party could use to run roughshod over a minority-party resistance based on lies and fear mongering. These are DOCTORS, and people notoriously trust their doctors.

But, you know, Dems aren't that party.

Posted by: eadie on September 15, 2009 at 9:17 AM | PERMALINK

The Teabaggers are hitting the streets to demonstrate their right to be victims of our healthcare system, for the right of insurance CEOs to make millions by denying them coverage.

Are they the dumbest people in the world?

Posted by: bob h on September 15, 2009 at 9:57 AM | PERMALINK

Saw a teabagger clip. Lady confronted by Max Blumenthal about her personal health insurance situation. She said she didn't have insurance but when pressed wasn't concerned because "I have close family members that are doctors". She didn't want health care to be more affordable or more available for other people but was openly smug that she would be taken care of if she had issues. No mention of whether these physician/relatives/friends are neurosurgeons, cardiac specialists, orthopedic surgeons, oral surgeons, gastro-intestinal specialists and every one of 100 other different disciplines this woman may need to call upon depending on her malady. She just knows she'll be taken care of, no need for health insurance on her part, no sir, my uncle is a doctor! This is the opposition to Obama's reform. In a nutshell. Along with blithering idiots spitting into the wind about Hitler and Nazis and communists under their beds. What a pathetic lot of fools. WTF do people in other nations think when they see the lunacy that passes for political debate in this nation? Republicans not only make you ashamed to be an American, they amp it up all they way to questioning the value of your species.

Posted by: steve duncan on September 15, 2009 at 10:32 AM | PERMALINK

The difference isn't so much that "these people are doctors dammit!" but that they actually happen to understand what's involved in the public option, and that it serves conservative ideals as much as liberal ones.

Posted by: Christopher on September 15, 2009 at 10:41 AM | PERMALINK

Rethuglicans don't care what their constituents think about health insurance reform, why should they care what doctors think?

Posted by: Cal Gal on September 15, 2009 at 5:36 PM | PERMALINK

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Posted by: Dietroly on November 21, 2009 at 3:51 AM | PERMALINK

This is the welcome page for the dietguidance.us Association web site.

Posted by: Dietroly on November 21, 2009 at 3:52 AM | PERMALINK
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