Doctors Overwhelmingly Favor Public Option

Hippocrates courtesy Peter Paul Rubens

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A poll conducted by the New England Journal of Medicine found that nearly 80 percent of American doctors favor the public option in health care reform. The Journal mailed a confidential questionnaire to 2,000 practicing US physicians 65 or younger to explore whether they endorse a public role for the profession.

Respondents were asked to indicate their agreement or disagreement with the following statements:

 

  1. Addressing societal health policy issues, as important as that may be, falls outside the scope of my professional obligations as a physician
  2. Every physician is professionally obligated to care for the uninsured and underinsured
  3. I would favor limiting reimbursement for expensive drugs and procedures if that would help expand access to basic health care for those currently lacking such care

The Journal also asked physicians to indicate whether they objected to using cost-effectiveness data to determine which treatments will be offered to patients.More than half the doctors answered. The results:

 

  • A large majority (78%) agreed that physicians have a professional obligation to address societal health policy issues
  • Majorities agreed that every physician is professionally obligated to care for the uninsured or underinsured (73%)
  • Most doctors were willing to accept limits on reimbursement for expensive drugs and procedures for the sake of expanding access to basic health care (67%)

Physicians were divided almost equally about cost-effectiveness analysis. More than half (54%) reported having a moral objection to using such data “to determine which treatments will be offered to patients.”

Interestingly, age, race, and region didn’t seem to affect opinions. Female doctors were more likely than males to object to using cost-effectiveness data to guide treatment decisions but otherwise did not differ on other questions.

There were differences in opinion based on the doctor’s specialty. Surgeons, procedural specialists, and those in nonclinical specialties were all significantly less likely than primary care providers to favor reform that expands access to basic health care by reducing reimbursement for expensive drugs and procedures.

There were also consistent differences between self-described liberals and conservatives. The 28% of physicians who called themselves conservative were consistently less enthusiastic about professional responsibilities pertaining to health care reform.

The data suggest that some of the more controversial elements currently appearing in reform proposals will likely face serious opposition from segments of the medical profession, including:

 

  • Limiting reimbursement under Medicare (expanding the ranks of the underinsured)
  • Using cost-effectiveness data in treatment decisions
  • Limiting reimbursements for expensive drugs and procedures

The Journal concludes:

 

  • Most physicians see deliberations on health care reform as part of their professional responsibility
  • Conservative doctors need to be engaged for health care reform to succeed

 

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