Docs warm to sin­gle-payer health care

Wisconsin Gazette - - Opinion - From Kaiser Health News

A ma­jor­ity of physi­cians has come to sup­port sin­gle-payer health care, a new sur­vey finds.

Fifty-six per­cent of doc­tors reg­is­tered ei­ther strong sup­port or were some­what sup­port­ive of a sin­gle-payer health sys­tem, ac­cord­ing to the sur­vey by Mer­ritt Hawkins, a physi­cian re­cruit­ment firm.

In its 2008 sur­vey, opin­ions ran the op­po­site way — 58 per­cent op­posed sin­gle­payer.

What's changed?

More red tape, less di­rect own­er­ship, and a de­vel­op­ing sense of in­evitabil­ity, doc­tors tell Mer­ritt Hawkins.

Phillip Miller, the firm's vice pres­i­dent of com­mu­ni­ca­tions, said in the con­ver­sa­tions its em­ploy­ees have with doc­tors, physi­cians of­ten say they are tired of deal­ing with billing and pa­per­work, which takes time away from pa­tients.

“Physi­cians long for the rel­a­tive clar­ity and sim­plic­ity of sin­gle-payer. In their minds, it would cre­ate less dis­trac­tions, tak­ing care of pa­tients — not re­im­burse­ment,” Miller said.

In a sin­gle-payer sys­tem, a gov­ern­ment en­tity would pay all the med­i­cal bills for a cer­tain pop­u­la­tion, rather than in­sur­ance com­pa­nies do­ing that work.

A long-term trend away from physi­cians own­ing their prac­tices may be an­other rea­son sin­gle-payer is win­ning more over. Last year was the first in which fewer than half of prac­tic­ing physi­cians owned their prac­tice — 47.1 per­cent — ac­cord­ing to the Amer­i­can Med­i­cal As­so­ci­a­tion.

Many doc­tors today are em­ployed by hos­pi­tals or health care sys­tems, rather than work­ing for them­selves in tra­di­tional solo or small-group pri­vate prac­tices. Those doc­tors might be less in­vested in who pays the in­voices, Miller said.

There's also a grow­ing sense of in­evitabil­ity, Miller said, as more doc­tors as­sume sin­gle-payer is on the hori­zon.

“I would say there is a sense of frus­tra­tion, a sense of maybe res­ig­na­tion that we're mov­ing in that di­rec­tion, let's go there and get it over with,” he said.

Mer­ritt Hawkins emailed its sur­vey Aug. 3 and re­ceived re­sponses from 1,003 doc­tors. The mar­gin of sam­pling er­ror is plus or mi­nus 3.1 per­cent­age points.

PRO­VID­ING UNI­VER­SAL COV­ER­AGE

The Af­ford­able Care Act es­tab­lished the prin­ci­ple that ev­ery­one de­serves health cov­er­age, said Shawn Martin, se­nior vice pres­i­dent for ad­vo­cacy at the Amer­i­can Academy of Fam­ily Physi­cians. In­side the med­i­cal pro­fes­sion, the con­ver­sa­tion has changed to how best to pro­vide uni­ver­sal cov­er­age, he said.

“That's the de­bate we're mov­ing into, that's why you're see­ing a re­newed in­ter­est in sin­gle-payer,” Martin said.

Dr. Steven Schroeder, who chaired a na­tional com­mis­sion in 2013 that stud­ied how physi­cians are paid, said the at­ti­tude of med­i­cal stu­dents also is shift­ing.

Schroeder has taught medicine at the Univer­sity of Cal­i­for­nia-San Fran­cisco Med­i­cal Cen­ter since 1971 and has no­ticed stu­dents' in­creas­ing sup­port for a sin­gle-payer sys­tem, an at­ti­tude they likely carry into their pro­fes­sional ca­reers.

“Most of the med­i­cal stu­dents here don't un­der­stand why the rest of the coun­try doesn't sup­port it,” said Schroeder.

FUR­THER EV­I­DENCE

The Mer­ritt Hawkins' find­ings fol­low two sim­i­lar sur­veys this year.

In Fe­bru­ary, a LinkedIn sur­vey of 500 doc­tors found that 48 per­cent sup­ported a “Medi­care for all” type of sys­tem, and 32 per­cent op­posed the idea.

The sec­ond, re­leased by the Chicago Med­i­cal So­ci­ety in June, re­ported that 56 per­cent of doc­tors in that area picked sin­gle-payer as the “best care to the great­est num­ber of peo­ple.” More than 1,000 doc­tors were sur­veyed.

Since June 2016, more than 2,500 doc­tors have en­dorsed a pro­posal pub­lished in the Amer­i­can Jour­nal of Pub­lic Health call­ing for a sin­gle-payer plan to re­place the

Since June 2016, more than 2,500 doc­tors have en­dorsed a pro­posal pub­lished in the Amer­i­can Jour­nal of Pub­lic Health call­ing for a sin­gle-payer plan to re­place the Af­ford­able Care Act.

Af­ford­able Care Act. The plan was drafted by the Physi­cians for a Na­tional Health Pro­gram, which says it rep­re­sents 21,600 doc­tors, med­i­cal stu­dents and health pro­fes­sion­als who sup­port sin­gle-payer.

Clare Fauke, a com­mu­ni­ca­tions spe­cial­ist for the or­ga­ni­za­tion, said the group added 1,065 mem­bers in the past year and mem­ber­ship is now the high­est since PNHP be­gan in 1987.

Kaiser Health News is a na­tional health pol­icy news ser­vice. It is an ed­i­to­ri­ally in­de­pen­dent pro­gram of the Henry J. Kaiser Fam­ily Foun­da­tion.

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