March, 1999
Study in New England Journal of Medicine Finds Medical School Deans, Faculty, Residents and Students Favor Single-Payer 3 to 1 Over Managed Care
Managed care is bad for your health, according to the first comprehensive survey of physicians involved in research and teaching published in this week’s New England Journal of Medicine. But the nation’s best and brightest physicians don’t want to return to the old fee-for-service system, either.
So what does this prestigious group think would make a good health system? According to the study, “all groups [Deans, department chairs, residency training directors, physician faculty at medical schools, resident physicians, and medical students] expressed a preference for a single-payer health care system over both managed-care and fee-for-service systems. Overall, 57.1 percent thought that a single-payer system with universal coverage was the best health care system…. A total of 21.7 percent favored managed care, and 18.7 percent preferred a fee-for-service system.”
“I’m not surprised at all by these findings,” said Dr. Douglas Robins, Chair of the D.C. chapter of Physicians for a National Health Program. “A survey of all physicians members of the D.C. medical society found that 69 percent support single payer. The academic medicine physicians are just the tip of the iceberg.”
In an accompanying editorial in the Journal, Dr. Robert Michels strongly disagreed with the view that the purpose of medical education should be to “prepare students to fit into the new world of health care, to work in it effectively and presumably happily.” Dr. Michels noted that “the unhappiness of academic physicians…reflects the recognition that managed care threatens medicine’s core values,” and that “medical education is working well…by underlining the urgent need to change managed care [emphasis added].” He also noted that physicians support single payer national health insurance even though physicians know that “a single-payer system would be unlikely to increase the financial rewards of medical practice.”
“We know physicians support single-payer national health insurance because of the increasing numbers of medical associations and prominent physicians that are endorsing it,” said Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard.
They include: The D.C. branch of the American Medical Association (AMA), the American Medical Women’s Association (AMWA), the National Medical Association (NMA), the Gay and Lesbian Medical Association (GLMA), the American Medical Student Association (AMSA), the American Public Health Association (APHA), the Islamic Medical Association (IMA), the American Association of Community Psychiatrists (AACP), the American Family Therapy Association, and others. The Maryland and Massachusetts branches of the AMA are studying single payer, and the American College of Surgeons’ Dr. David Murray testified before Congress in 1994 that single payer would “probably provide the best assurance that patients would be able to seek care from any doctor of their choice.”
Dr. Christine Cassel, the first woman president of the American College of Physicians, the nation’s second-largest medical association, is a strong advocate of single payer and a founding member of Physicians for a National Health Program.