By Livia Gershon
Worcester Business Journal, November 7, 2011
Presumably, doctors are more familiar than the general public with the pressures driving up health care costs, and an overwhelming majority of them also say there needs to be some government involvement in the health care system. A survey by the Massachusetts Medical Society this fall found that 41 percent of doctors thought the best option for health care reform in the U.S. would be to adopt a single-payer system like Canada’s. That number was up from 34 percent in 2010.
(Another survey by the Blue Cross Blue Shield of Massachusetts Foundation) found that 88 percent of Massachusetts residents think it’s important for the state government to take major action on health care costs.
Physician Workforce Study
Massachusetts Medical Society
September 28, 2011
6.1. Practicing Physicians Opinions on U.S. Health Care System Reform
A question was added to the Practicing Physician Survey in 2010 to document how physicians view upcoming system changes in national health care reform. The following question was asked again this year of each of the respondents:
Which of the following would you choose as the best option for the U.S. health care system?
The percent of practicing physicians choosing each response is outlined below:
1. Both public and private plans with a public buy-in option (allow businesses and individuals to enroll in a public Medicare-like health insurance plan that would compete with private plans) — 23%
2. Keep the existing mix of public and private plans, but allow insurers to sell plans with limited benefits and high deductibles to keep premiums low. State subsidies would help low-income individuals buy insurance. Individuals could choose to buy a less expensive catastrophic plan, more expensive comprehensive coverage, or no insurance at all — 15%
3. The recent national plan (Patient Protection and Affordable Care Act) passed by Congress in 2010 (modeled after the Massachusetts health reform law of 2006). This plan includes an individual mandate, expansion of public programs, American Health Benefit Exchanges, changes to private insurance including prohibiting the denial of coverage for preexisting conditions, and employer requirements —- 17%
4. Single-payer national health care system offering universal health care to all U.S. residents — 41%
5. Other (please specify) — 4%
While more physicians prefer single payer as the best option for U.S. heath care reform compared to last year’s survey results (41% in 2011 and 34% in 2010), the majority of physicians prefer other options (59% in 2011 and 66% in 2010).
By Don McCanne, MD
Of five options for the U.S. health care system presented to Massachusetts physicians, far more – 41 percent – preferred single payer to any other option. That was almost twice as many as those who preferred the second choice option. The single payer choice jumped from 34 percent last year, likely representing further dissatisfaction with their current system based on a design very similar to that of the Affordable Care Act.
The leadership of the Massachusetts Medical Society is not very supportive of single payer, pointing out in this report that 59 percent of Massachusetts physicians prefer other options to single payer. But if they were more objective, they would have pointed out that when offered a choice of “The recent national plan (Patient Protection and Affordable Care Act) passed by Congress in 2010 (modeled after the Massachusetts health reform law of 2006),” 83 percent of physicians prefer other options.
Presenting the remaining data in the same manner, 85 percent of physicians prefer other options to high deductible plans, 77 percent prefer other options to a “public option,” and 96 percent prefer one of the listed options (including single payer) to any other undefined option that they might otherwise prefer.
From this we can conclude that a clear plurality of Massachusetts physicians, who have direct experience with the Affordable Care Act model, would prefer single payer, and that support is increasing. By a large majority, they reject any other option, including their current system based on the model of the Affordable Care Act.