Health Care For America Now

See Jason's piece on the AMA's reversals and declining influence for further reading on how conservative doctors are out of step with mainstream Americans on health care.

Conservative opponents of health care reform often invoke personal experiences and anecdotal evidence when making their case. Conservative doctors serving in Congress, such as Sen. Tom Coburn (R-OK), are stepping forward as major critics of a public option and major proponents of attempting to address Americans' exploding health care costs with just a few tax credits. In the House, the GOP Doctors' Caucus, led by Reps. Phil Gingrey (R-GA) and Tim Murphy (R-PA), formed in March to coordinate efforts in promoting their vision of health care reform.

As remarks at a session in the House featuring the GOP Doctors' Caucus showed on Tuesday, though, Rep. Gingrey and his colleagues are more interested in sharing horror stories from other countries than they are in discussing real reform. Typical of the style was the following anecdote from Rep. Phil Roe (R-TN) (.pdf):

Two weeks ago, I was in Morristown, Tennessee, talking to a physician there who is Canadian. His father began to have chest pain. I won't go through all the details about how long it took him to get a treadmill, how long it took him to see a cardiologist. Anyway, 11 months later, the man got–his left anterior descending coronary artery was 90 percent blocked, and he finally survived and got a bypass operation. I do not believe the American people are going to put up with that type of health care system. We are not.

But as GOP doctors wax darkly about the dangers of "foreign" and "socialist" systems, they show themselves not only to misunderstand the public option and the economic ideas behind it, but also show themselves to be out of step with mainstream American physicians around the country.

Consider that in 2008, Indiana University's Center for Health Policy and Professionalism Research found that 59% of American doctors supported national health insurance. Moreover, support among doctors for national health insurance had risen dramatically just in the years since 2002, when only 49% of respondents supported national health insurance. This support undercuts the anecdotal evidence offered by pro-status quo conservatives:

"Many claim to speak for physicians and represent their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support national health insurance," said Dr. Aaron Carroll of the Indiana University School of Medicine, who led the study.

"As doctors, we find that our patients suffer because of increasing deductibles, co-payments, and restrictions on patient care," said Dr. Ronald Ackermann, who worked on the study with Carroll. "More and more, physicians are turning to national health insurance as a solution to this problem."

[...]

"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," Ackermann said in a statement.

The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan.

The researchers said they believe the survey was representative of the 800,000 U.S. medical doctors.

Roger Bybee, who wrote on the "doctors' revolt" last year, expands on the reasons doctors are changing their thinking on health insurance.

The poll results underscore mounting signs that doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine. And, increasingly, doctors seem to be showing support for a single-payer system that would essentially eliminate for-profit insurers and curb the power of big provider chains.

The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments.

Additionally, Bybee shows that the national poll results are not an anomaly:

State-level polls reinforce the just-released national survey from Indiana's Center for Health Policy. A remarkable 64 percent of the Minnesota doctors surveyed in 2006 expressed support for a Canadian-style single-payer system that would drive insurers from their commanding role in the health system, reported Minnesota Medicine. The Minnesota poll aligned closely with a Massachusetts survey of doctors in 2004, which reflected 61 percent backing for single-payer, according to the Archives of Internal Medicine. Doctors' views seem to be coming into closer alignment with those of the general public, of which 67 percent explicitly support a system like Canada's or Britain's.

As an aside, there's a healthy debate over the advantages of a single-payer system versus those of a robust public option. As Jason wrote earlier, single-payer is generally considered more radical than the President's plan, "so it's not unreasonable to assume a majority might support the reform we're talking about, which allows doctors and patients to preserve their relationships with their insurance companies if they want."

it certainly seems that advocates of reform have most American doctors in their corner. As Bybee shows, the mainstream opinion among American doctors has shifted and is continuing to shift. The ones left behind are the Coburns and the Gingreys of the world - and our Congress - who do not represent the desires of ordinary working Americans or the views of the majority of their peers in the medical profession.