Poll Finds Most Doctors Support Public Option

[Elphaba]

Poll Finds Most Doctors Support Public Option : NPR

Most doctors — 63 percent — say they favor giving patients a choice that would include both public and private insurance. That's the position of President Obama and of many congressional Democrats. In addition, another 10 percent of doctors say they favor a public option only; they'd like to see a single-payer health care system. Together, the two groups add up to 73 percent.

When the American public is polled, anywhere from 50 to 70 percent favor a public option. So that means that when compared to their patients, doctors are bigger supporters of a public option.

Elphaba

[bytebear]

Doesn't that make you just a little nervous? Wouldn't they want the plan that is going to give THEM the most money? That gives them the MOST security? Could their opinion be somewhat self serving?

[Elphaba]

Doesn't that make you just a little nervous? Wouldn't they want the plan that is going to give THEM the most money? That gives them the MOST security? Could their opinion be somewhat self serving?

Or, since they're the ones who provide the care, and know who is and who isn't getting treated, could it be they want the chance to help everyone?

Elphaba

[Guest]

Or, since they're the ones who provide the care, and know who is and who isn't getting treated, could it be they want the chance to help everyone?

Elphaba

Normally, doctors don't spend 10 years of their lives and hundreds of thousands of dollars in student loans just for the "chance to help everyone". Sure, lots of doctors like my brother are very idealistic - they donate tons of their time at public clinics, accept bananas as payment for services rendered, etc. etc. But, they can't do the philantrophic things without making a decent living after paying off loans and malpractice insurance.

[HEthePrimate]

They probably want the public option because it would make it possible for more people to be covered by insurance. That way, they could catch problems before they became too serious. Believe it or not, there are people who go into medicine because they want to help people.

HEP

[Elphaba]

Normally, doctors don't spend 10 years of their lives and hundreds of thousands of dollars in student loans just for the "chance to help everyone". Sure, lots of doctors like my brother are very idealistic - they donate tons of their time at public clinics, accept bananas as payment for services rendered, etc. etc. But, they can't do the philantrophic things without making a decent living after paying off loans and malpractice insurance.

I'm not talking about philanthropy.

I'm not sure, but I think you're saying doctors will take advantage of their patients because they spent 10 years of the lives to become a doctor, and are in thousands of dollars in debt.

I know there are disreputable doctors who do scam their patients, and the government. But I don't think they're the majority of doctors.

Your scenario actually tells me they do go through all of those unbelievably difficult experiences because they want to help people, and I trust their on-the-ground experiences.

Elphaba

PS: Your brother sounds amazing.

[bytor2112]

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

Major findings included:

• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration's claims that doctors are part of an "unprecedented coalition" supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

Edited September 22, 2009 by bytor2112

[jadams_4040]

Doesn't that make you just a little nervous? Wouldn't they want the plan that is going to give THEM the most money? That gives them the MOST security? Could their opinion be somewhat self serving?

actually this will give them more profit because they wont be doing anymore free service to emergency patients and those whom for whatever reason cant pay the bill. And all the {billions} of dollars going out the window from the doctors ,hospitals, and the tax payers for emergency room patients e;t;c....will now be going "into" the health industry instead of flowing "out" of it. Also preventative treatment will cause a whole lot of "last minute" hospital visits. :)

[bytor2112]

actually this will give them more profit because they wont be doing anymore free service to emergency patients and those whom for whatever reason cant pay the bill. And all the {billions} of dollars going out the window from the doctors ,hospitals, and the tax payers for emergency room patients e;t;c....will now be going "into" the health industry instead of flowing "out" of it. Also preventative treatment will cause a whole lot of "last minute" hospital visits. :)

Spoken like a true Captain of Industry to be sure:huh:

Edited September 22, 2009 by bytor2112

[Gatorman]

I asked my mom and step dad, both current or retired hospital presidents, when the problems with the health care system really kicked in. Both of them believe the government has to do something. Both of them understand medicare/medicaid, etc, and the pay system very well. Both of them had the same answer.

The problems with our health care system began when the government created Medicare originally. When our government got into the insurance and health care business, the model changed for the worse. I am flabbergasted that, with that knowledge, they think that the government is the solution. But, they believe the problem has gotten too big for anyone but government to fix it. I fear this fix as much as I fear the previous fix. I truly believe we are looking at the definition of insanity. To keep doing the same thing that has failed or caused the problem <Asking government to fix it> and expecting a different result.

[bytor2112]

They probably want the public option because it would make it possible for more people to be covered by insurance. That way, they could catch problems before they became too serious. Believe it or not, there are people who go into medicine because they want to help people.

HEP

Too bad the poll Elph posted is baloney:eek:

[bytebear]

actually this will give them more profit because they wont be doing anymore free service to emergency patients and those whom for whatever reason cant pay the bill. And all the {billions} of dollars going out the window from the doctors ,hospitals, and the tax payers for emergency room patients e;t;c....will now be going "into" the health industry instead of flowing "out" of it. Also preventative treatment will cause a whole lot of "last minute" hospital visits. :)

I don't buy that for a minute. If I make a law that requires all people to buy toasters, do you think toasters will go down in price? The solution is simple. Get more doctors. Create more medical schools, and open more neighborhood clinics that will charge for basic care rather than get the big dollar payoffs from insurance companies. Then, let them just do their jobs without having to worry about lawsuits or government regulations. Suddenly you will see prices drop to reasonable rates where anyone can see a doctor without insurance at all.

Edited September 22, 2009 by bytebear

[Guest]

I'm not talking about philanthropy.

I'm not sure, but I think you're saying doctors will take advantage of their patients because they spent 10 years of the lives to become a doctor, and are in thousands of dollars in debt.

I know there are disreputable doctors who do scam their patients, and the government. But I don't think they're the majority of doctors.

Your scenario actually tells me they do go through all of those unbelievably difficult experiences because they want to help people, and I trust their on-the-ground experiences.

Elphaba

PS: Your brother sounds amazing.

No, you're not getting what I said. Because, I don't believe doctors (except for the very few) "take advantage of their patients". What I'm saying is, doctors do not go into medicine incurring hundreds of thousands of debt just so they can practice medicine without a profit. Even my very idealistic brother is for-profit. He has to - if we wants to keep practicing medicine. The "helping people" does not come from insurance - as a matter of fact - it is the anti-thesis of helping people.

I have mentioned this story before - when my brother got interviewed in Savannah for residency spot. He was given a chart and asked for his diagnosis. My brother gave it and the doctor told him no, he needs lab. My brother said, no the patient doesn't need lab because the symptoms are very obvious. The doctor said, nope - have to send to lab in case of malpractice lawsuit - it is called defensive medicine which my brother abhors - it incurs unnecessary cost for care. And insurance puts mandates on care - the doctor's hands are tied - they cannot order what they feel is the proper treatment because the insurance company disagrees.

Okay, I'm going to share here why my brother does not practice medicine in America besides the "defensive medicine" reason. So, most people carry insurance right. So then, a patient comes in and my brother (a very very good doctor - I'm not just saying that because he's blood-relative, he truly has a gift for it!) wants to administer treatment - say at least 7 days in the hospital. The insurance companies do not like that - no no no (have you ever been pregnant? they shoo you out of there at the earliest possible moment!). So, they tell my brother to discharge at 3 days. The doctor has no option - otherwise, the patient will have to pay the extra 4 days. So, the doctor signs the discharge papers after 3 days. Of course, the patient does not get better, say, he dies instead. What is a doctor gonna do? Sue the insurance company? The insurance company just comes back with - hey d00de, you signed the discharge papers! So then, of course, the patient's family sues the doctor - double whammy.

Nope, my brother refuses to practice medicine in America. Everytime we talk about this healthcare insurance business here, he laughs! In the Philippines, it is rare to have health insurance. And it is rare to get malpractice lawsuit. It's funny when Terri Hatcher made fun of Filipino doctors in Desperate Houswives. Filipino doctors can run circles around their American counterpart. Except Filipino doctors do not have the means to fund innovations and advancement in medicine. They still do things the old-fashioned way there. They are awesome in diagnostic medicine!

[Maxel]

Wait... Doctors are there to help people? I thought they just wanted to amputate limbs for profit....

I don't see how the poll Elphaba's posted is "baloney". I understand that the article bytor linked is critical of it and has different results but the sampling method seems to be the same (randomly chosen doctors surveyed by mail and phone), and the sampling size for Elphaba's poll is larger (2,130, as opposed to 1,376). Did I miss fine print in the article Elphaba linked...?

[Elphaba]

Wait... Doctors are there to help people? I thought they just wanted to amputate limbs for profit....

I don't see how the poll Elphaba's posted is "baloney". I understand that the article bytor linked is critical of it and has different results but the sampling method seems to be the same (randomly chosen doctors surveyed by mail and phone), and the sampling size for Elphaba's poll is larger (2,130, as opposed to 1,376). Did I miss fine print in the article Elphaba linked...?

Max, I'm responding to your post. I mean for this to go to both you and Bytor.

Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion

New England Journal of Medicine

Posted by NEJM • September 14th, 2009 • Printer-friendly

Salomeh Keyhani, M.D., M.P.H., and Alex Federman, M.D., M.P.H.

In the past few months, a key point of contention in the health care reform debate has been whether a public health insurance option should be included in the final legislation. Although polls have shown that 52 to 69% of Americans support such an option,1 the views of physicians are unclear. Physicians are critical stakeholders in health care reform and have been influential in shaping health policy throughout the history of organized medicine in the United States.2

. . . .

Overall, a majority of physicians (62.9%) supported public and private options (see Panel A of graph). Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option (see Table 1). Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001), but a majority still supported it. Finally, there was also majority support for a public option among AMA members (62.2%).

~~~~~~~~~~~~~~~~~

Elphaba

[bytebear]

I think the point of contention was that the sampling was from AMA doctors. This would essentially be the same as asking Union workers if they like unionization?

[Maxel]

So, out of ~5000 doctors polled who belonged to the AMA- which on its website proudly declares it supports health care reform, only 63% actually support a public option?

That seems to be a shockingly low number of doctors who are committed to their organization's goals.

Thanks for linking the original study, Elphaba.

[Elphaba]

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

Major findings included:

• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration's claims that doctors are part of an "unprecedented coalition" supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

Bytor,

Would you please provide a link to theTimes article? I Icouldn't find it..

Thanks,

Elphab

[NeuroTypical]

Poll Finds Most Doctors Support Public Option : NPR

Anyone who knows doctors can tell you that most of them are good doctors, but absolutely lousy business administrators. The more specialized one gets, the more handlers one needs to function in the real world.

It's an easy assumption to make that the most highly-educated folks make the best decisions. But if you think about it, it really does depend on what the education is in, doesn't it?

Go ask your nearest PhD "Do you have enough sense to come in out of the rain?" I've asked a handful that I know, and if they have a sense of humor, they've always admitted that's why they have a spouse or an office manager.

In other words, it's not surprising that "most doctors" are wrong on matters of government entanglement in their practices.

LM

[Just_A_Guy]

Anyone who knows doctors can tell you that most of them are good doctors, but absolutely lousy business administrators. The more specialized one gets, the more handlers one needs to function in the real world.

It's an easy assumption to make that the most highly-educated folks make the best decisions. But if you think about it, it really does depend on what the education is in, doesn't it?

Go ask your nearest PhD "Do you have enough sense to come in out of the rain?" I've asked a handful that I know, and if they have a sense of humor, they've always admitted that's why they have a spouse or an office manager.

In other words, it's not surprising that "most doctors" are wrong on matters of government entanglement in their practices.

LM

On the other hand, we don't want to exclude doctors from the process entirely. There has to be a happy medium somewhere; otherwise we may as well go whole hog on this idea that "professionals are not the best ones to reform their own industries" and do things like this.

[Guest]

JAG, thanks so much for the link! I immediately sent it to my brother for his daily dose of comics.

[goofball]

In the OR yesterday I asked which of the doctors there would favor a public option. None of them did because they see it like Medicare and Medicaid which overall is a low payer. I know a number of them do not belong to the AMA due to reasons such as this. The only docs I know in favor of the reform is ER docs because many of them are on an "eat what you kill" (not literally of course). If everyone they saw had some level of insurance they would make more money. There is the big fear though that those near the "end stage" of life would be forgotten because they are the ones that cost the most.

One doc, an anestheologist proceeded to bash polls because he said it is all about how you ask the question. You can get a favorable poll if you word your question right.

Defensive medicine is an unfortunate side affect of so many lawyers suing everyone. Doctors CYA all the time now. Tort reform is huge and thankfully the President finally mentioned that need. We will see if any of that happens

I wonder what the private insurance companies are going to do if there is a public option. Many business people I know say they would stop paying for private insurances for their employees if there was a public option.

Bottom line the health care industry is a mess. I would be for little changes over time. Not one massive overhaul by a gov that is so confused and caught up in a power struggle. They have their own health care for crying out loud.

And that is my rant!

[Elphaba]

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

TIPPOnline is the EXCLUSIVE polling partner of IBD (Investors Business Daily), Famous for the ludicrous claim the Stephen Hawking would be dead without the HIS, and the that poll showed McCain had the youth vote 74/22.

This poll is essentially useless when all of the following are combined:

1. The survey was conducted by mail over a two-week period. This is much too short a period to create an objective survey (which this one is not). It would take a survey the scope of this one at least a month to get enough responses to pull together a true sampling.

As it is, the only people likely to read, respond and mail back the surveys are those who have very strong feelings on either extreme. Thus; those whose opinions are better represented by the middle might not show up in the poll. That doesn’t necessarily mean a mail survey is wrong, just that you have to be very careful how you implement it. If all of your mail sample is bad, then your research is going to be flawed. If nothing else, this survey needed more prep work.

2.. There is a question so blatantly biased it’s difficult to assume IBD’s survey was designed to be objective:

Do you believe the government can cover 47 million more people and it will cost less money and the quality of care will be better?

I actually had to read that three times to make sure I really was reading what I thought I was reading. I’m still stunned that this is actually three sentences in one, which for many people, means it’s impossible to answer.

Unless your answer is the same for all three, you can‘t answer the question without skewing the results. For example, if you believe that [yes]. the government can cover 47 million more people, but [no] that it will not cost less money,“ you can’t answer the question. However, since most people who will choose to complete the survey are motivated to do so, s/he will probably answer that question with one “yes” to all of the questions even if that is not accurate, or vice versa.

3. This baffles me, but they say they are still receiving responses to the survey. At the least this is highly unorthodox, since that means the survey period is not over. Why in the world would they print a survey’s results in a poll when they haven’t received all of the surveys?

4. There is virtually no disclosure about IBD’s methodology, whatsoever. Compare this to the “Methods” Section of Physician View on the Public Health Care Options and Medicare Expansions,” below:

In April 2009, we obtained data on a random sample of 6000 physicians from the American Medical Association (AMA) Physician Masterfile, which includes current data on all U.S. physicians. We excluded physicians from U.S. territories because health care reform may not be as relevant to them, and we excluded physicians in training because of their limited experience with insurance; a sample of 5157 physicians remained.

We categorized physicians into four groups: primary care physicians (in internal medicine, pediatrics, or family practice); medical subspecialists, neurologists, and psychiatrists; surgical specialists and subspecialists; and other specialties. The survey instrument we used was developed with the input of an expert panel, and we conducted cognitive testing and pilot testing to ensure its clarity and relevance. (More detailed information about our methods can be found in the Supplementary Appendix, available with the full text of this article at NEJM.org.)

If IBD wanted to be credible, it should have provided the same information as the NEJM.THIS is what you look for in a survey’s methodology. IBD may well have such a methodology available for anyone to look at, but I think it should have been included in the article.

5. I’m no mathematician, but this confuses me: “Four of nine doctors, or 45%, said they "would consider leaving their practice or taking an early retirement" if Congress passes the plan the Democratic majority and White House have in mind.” Does that mean literally only four doctors said that?

If so, where is the “half” a doctor in the five and a half doctors? Can someone help me out on this one?

6. Last, as you pointed out the IBD’s survey’s conclusions differ from that of the NEJM, it also differs from the AMA story in the Los Angeles Times.

The IBD poll does, like you say, differ with the findings of a poll released Monday by National Public Radio (the New England Journal of Medicine) that suggest a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Personally, I don’t think the NEJM report differs all that much from the AMA story--it’s just that the Times story was specifically about members of the AMA, whereas the NEJM story encompasses all physicians.

Regarding the Times‘ article, I agree it reads exactly as you said it did, and only addresses members of the AMA, I’ll go ahead and post what you had written for those who missed it,

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

This is true; however, the survey in the NEJM covers all doctors, both members of the AMA and non.

The bottom line is: we know we have a good survey methodology from the Robert Wood Jones Foundation, which has been completed, and printed in the New England Journal of Medicine: Physician Views on the Public Health Insurance Option and Medicare expansions.

We do not know if we have a good survey methodology from IBD or not. We do have an excellent one from The Robert Woods Foundation.

Obviously, the Foundation’s result are not baloney. You don’t have to agree with it, but when you look at the information the Robert Woods Foundation has put out, including methodologies, which are a huge help, you are able to better see exactly what the “questions” are worth asking, and I think we all can contribute to that, regardless of our political prersuasion.

Elphaba

[Gatorman]

Elphaba - I have to disagree with one of your points. The question IS answerable. However, it is written to make it difficult to get anything but one answer. Standard polling technique. Since it uses ANDs instead of ORs, it is answerable. Look at it like a flow chart.

Cover 47 Million - If No - End. If Yes - Continue

Cheaper - If No - End. If Yes - Continue

Better - If No - End. If Yes - End

So, a no on ANY one point results in a no. It is asking if the government is capable of doing all three, which, is a no.

[Elphaba]

Elphaba - I have to disagree with one of your points. The question IS answerable. However, it is written to make it difficult to get anything but one answer. Standard polling technique. Since it uses ANDs instead of ORs, it is answerable. Look at it like a flow chart.

Cover 47 Million - If No - End. If Yes - Continue

Cheaper - If No - End. If Yes - Continue

Better - If No - End. If Yes - End

So, a no on ANY one point results in a no. It is asking if the government is capable of doing all three, which, is a no.

Yes you're right Gator. Thanks for that.

Elphaba