State medical societies are conservative bastions of physician self-interest. So this scientific and non-partisan non-activist survey is quite revealing, even, or perhaps especially, if it is Massachussetts:
Massachusetts doctors snub state’s health reform as model for country, pick single-payer system instead
For the first time the Massachusetts Medical Society has asked doctors what they think about health reform in its annual "Physician Workforce Survey" of 1,000 practicing physicians in the state, and the results may strike some as surprising.
A plurality of the physician respondents, 34%, picked single-payer health reform as their preferred model of reform, followed by 32% who favored a private-public insurance mix with a public option buy-in. 17% voted for the pre-reform status quo, including the permissibility of insurers offering low-premium, high-deductible health plans.
Remarkably, only 14% of Massachusetts doctors would recommend their own state’s model as a model for the nation. A small number of respondents, 3%, voted for an unspeciified "other."
In other words, the doctors with the most on-the-ground experience with the Massachusetts plan, after which the Obama administration’s new health law is patterned, regard it as one of the least desirable alternatives for financing care.
Now you may be thinking: "Who cares what doctors think."
But it is worth remembering that, with or without the AMA, doctors are an important consituency and interest group in any health reform battle.
And while this may be supposedly liberal Massachussetts, these are also the only doctors who have expereience something like the health reform we got, which is to say forced expansion of and dependency on for-profit health insurance compnies.
And let us not forget that similarly non-advocate, non-partisan polling prior to the recent health reform debate consistently showed a significant majority (55% to 65% depending on the exact wordin) also supported single payer.
Interstingly, the findings of this survey contrast with an earlier survey of Massachusetts physicians’ opinions on health reform funded by the Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation. That survey, published in the New England Journal of Medicine in October 2009, found that three-fourths of doctors in the state support the Massachusetts reform law.
Why the difference?
One difference is of course time. Over a year's worth of real world experience and revelations about the reality of Massachussetts reform separate the two surveys.
But probably the biggest difference is that the prior survey did not allow respondents to express their preference for alternative models of health reform. The new survey offers a range of alternatives, including going back to what there was before, the sort of health reform we thought we were going to get with both private insurance and a public option, or full blown Single Payer. Given multiple options, physicians chose single payer which edged out the private-public mix. Everything else -- inlcuding both the status quo prior system, and the reform they and we got -- came in far behind.
Indeed this new survey in Massachussetts echoes a survey published in the Annals of Internal Medicine in April 2008 showed that 59 percent of U.S. physicians support government action to establish national health insurance, an increase of 10 percentage points over similar findings five years before.
Single Payer activists in Massashcussetts comment on this poll (which it is important to again emphasize, was not conducted by them or on their behalf):
Dr. Rachel Nardin, chair of neurology at Cambridge Hospital and president of the Massachusetts chapter of Physicians for a National Health Program, said: "Massachusetts physicians realize that the state's health reform has failed to make health care affordable and accessible, and won't work for the nation. These findings show the high support for single-payer Medicare for all by physicians on the front lines of reform."
While many in the country look to Massachusetts as a role model for the country, Dr. Patricia Downs Berger, co-chair of Mass-Care, the single-payer advocacy coalition in Massachusetts, and a member of the Massachusetts Medical Society, notes, "Physicians in Massachusetts, particularly after health reform, know from experience that the current health care system is not sustainable and is not addressing the deep inequalities and high costs faced by patients, and they are calling for a more fundamental change."
Remember that regardless of this year's well funded Tea Party screeching, and all the claims of how America is majority conservative or libertarian. There is a well known disconnect between claimed general philosphy, ad actual support for specific and clearly defined liberal progressive policies, including single payer.
Remember that independent non-partisan and non-activist (Washington Post, CNN, AP, ABC, Yahoo, Harris, etc) polls in 2003-2008 showing 55-66% public support for universal government health insurance, single payer, "expanded and improved Medicare for all."
And indeed, recent polls show strong public support for the fact the reform we got does not go far enough.
The fact remains that for-profit private insurance cannot work. You cannot make a profit insuring sick people. The fight will continue, and we wil be there.