{"id":830,"date":"2008-01-30T17:11:00","date_gmt":"2008-01-30T21:11:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=830"},"modified":"2008-01-30T17:11:00","modified_gmt":"2008-01-30T21:11:00","slug":"physicians-views-on-single-payer","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=830","title":{"rendered":"Physicians views on Single Payer"},"content":{"rendered":"

This is not new data, but I am just trying to get as much information into this blog as I can. So here we go, first from Archives of Internal Medicine in 2004, by Himmelstein and Woolhandler of PNHP:
<\/em><\/span><\/strong>
Single-Payer<\/span> National Health Insurance: <\/span><\/strong>Physicians’ Views<\/span> <\/strong><\/span><\/p>\n

Danny McCormick, MD, MPH<\/nobr>; David U. Himmelstein, MD<\/nobr>; Steffie Woolhandler, MD, MPH<\/nobr>; David H. Bor, MD<\/nobr> <\/span><\/p>\n

Arch Intern Med.<\/em> 2004;164:300-304. <\/a><\/span><\/p>\n

<\/p>\n

Results <\/b>Of 1787 physicians, 904 (50.6%) responded to our <\/sup>survey. When asked which structure would provide the best care <\/sup>for the most people for a fixed amount of money, 63.5% of physicians <\/sup>chose a single<\/span><\/strong>–payer<\/span><\/strong> system; 10.7%, managed care; and 25.8%, <\/sup>a fee-for-service system. Only 51.9% believed that most physician <\/sup>colleagues would support a single<\/span><\/strong>–payer<\/span><\/strong> system. Most respondents <\/sup>would give up income to reduce paperwork, agree that it is government’s <\/sup>responsibility to ensure the provision of medical care, believe <\/sup>that insurance firms should not play a major role in health <\/sup>care delivery, and would prefer to work under a salary system. <\/sup><\/p>\n

Conclusions <\/b>Most physicians in Massachusetts, a state <\/sup>with a high managed care penetration, believe that single<\/span><\/strong>–payer<\/span><\/strong> <\/sup>financing of health care with universal coverage would provide <\/sup>the best care for the most people, compared with a managed care <\/sup>or fee-for-service system. Physicians’ advocacy of single<\/span><\/strong>–payer<\/span><\/strong> <\/sup>national health insurance could catalyze a renewed push for <\/sup>its adoption. <\/sup><\/p>\n\n\n\n
\"<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

A response from Dr. Palmisano of the AMA<\/em><\/p>\n

The Danger of Single-Payer Health Insurance<\/strong>
Donald J. Palmisano
Arch Intern Med.<\/em> 2004;164(20):2281-2282.
EXTRACT<\/span><\/a> FULL TEXT<\/span><\/a> <\/nobr><\/p>\n

Dr. Palmisano cites Dr. Ian Bogle in his “Outgoing speech as Chairman of the British Medical Association Council.” Available at: <\/em>http:\/\/www.bma.org.uk\/ap.nsf\/Content\/ARM03chcouncil<\/em><\/span><\/a>. <\/em><\/p>\n

and a survey published a year earlier to make his case: “Support for national health insurance among US physicians: a national survey.” <\/em>Ann Intern Med. 2003;139:795-801.<\/em><\/a><\/p>\n

Regarding the former, England has a National Health Service, not a single payer system, though I always urge us to learn from the faults of other systems. We are not doomed to repeat the mistakes of others (unless we’re stupid).<\/em><\/p>\n

Regarding the second study, which Dr. P argues “found that only 26% <\/sup>supported a single-payer system,” here is the results section of the abstract:<\/em><\/p>\n

Results: <\/b>Sixty percent of eligible participants returned a <\/sup>survey. Forty-nine percent of physicians supported governmental <\/sup>legislation to establish national health insurance, and 40% <\/sup>opposed it. Only 26% of all physicians supported a national <\/sup>health insurance plan in which all health care is paid for by <\/sup>the federal government. In analyses adjusting for differences <\/sup>in personal and practice characteristics, physicians in a primary <\/sup>care specialty, physicians reporting that at least 20% of their <\/sup>patients had Medicaid, and physicians practicing in a nonprivate <\/sup>setting or in an inner-city location were statistically significantly <\/sup>more likely to support governmental legislation to establish <\/sup>national health insurance. <\/sup><\/p>\n

The editors’ notes from the journal:<\/em><\/p>\n

With the exception of family practitioners, <\/sup>anesthesiologists, and surgical subspecialists, more than half <\/sup>of physicians in major specialties supported national health <\/sup>insurance. Support was highest among pediatricians, psychiatrists, <\/sup>and general internists.<\/p>\n

With all due respect to the authors, <\/em>these questions were as clear as mud.<\/em><\/a> I am very engaged and strongly favor single payer, but I don’t know how I would have answered these questions. I’d suggest: “Would you favor expanding Medicare to all citizens?” for instance.<\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

This is not new data, but I am just trying to get as much information into this blog as I can. So here we go, first from Archives of Internal … Continue reading “Physicians views on Single Payer”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[62,115],"tags":[],"class_list":["post-830","post","type-post","status-publish","format-standard","hentry","category-physician-surveys","category-single-payer-health-care-physicians-opinions"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/830","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=830"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/830\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=830"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=830"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=830"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}