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Here’s a new twist on the idea that the government wants to get between patients and their doctors. New polls out today show continuing strong support from the public for a public option. And a new poll of US doctors shows overwhelming support for a public option.
So both patients and their doctors want this choice. Where’s the government?
When polled, "nearly three-quarters of physicians supported some form of a public option, either alone or in combination with private insurance options," says Dr. Salomeh Keyhani. She and Dr. Alex Federman, both internists and researchers at Mount Sinai School of Medicine in New York, conducted a random survey, by mail and by phone, of 2,130 doctors. They surveyed them from June right up to early September.
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.
So folks like Olympia Snowe and those in the White House who think they can get away with just shining us on about how they like the public option but we just don’t have the votes better start thinking about Plan B, because their original sell out is looking like a public disaster.
59 Comments
Most excellent! Thanks so much, Scarecrow, for all of your hard work on the healthcare front.
Pfft, what do doctor’s know about health care?
Seriously. They should all just shuddap and listen to Mike Ross, who always tells it like it is.
Polls, schmolls. Ain’t gonna happen.
they’d like to see a single-payer health care system. Together, the two groups add up to 73 percent.
Astonishing.
Maybe we should compile a number of these polls and take them to the new gang of fifteen, the Blue Dogs, and the WH and ask for a comment? At least we should give them to Mike Stark to wave around and hand out.
Ask them, WTF? and If the Dems don’t do this isn’t our system is completely broken?
“Olympia Snowe”
Given her comments yesterday, I’m starting to suspect that we’re being taken for a ride, even on her own “trigger.” She basically said yesterday that, in the end, only diluted co-ops will be acceptable to Republicans and that “triggers” aren’t really on the table anymore, even though she had championed the “trigger” approach. Which means that if we give up the PO for a trigger to a PO, they’ll just demand a co-op, and if we give up on that and agree to the co-op, she’ll just vote against the final bill anyway. Does anyone else think that she’s negotiating in bad faith and that we (Dems) just shouldn’t bother with her?
Medicare For All!!!
Obama, the Democrats, and the Republicans could care less about the public or physicians think. The fix has been in from the beginning. There will be either no public option or a sham one.
True, but it’s time to make them say it in very plain words. Even the Tweety’s and CNN’s should be forced to ask these questions.
OK. So let me get this straight where is the strong support for private insurance, the system we more or less have today?
I would say that would be in the insurance industry, the pharma industry, and their lobbyist, their bankers, teabaggers, and for profit corporations in the “industry”…. Oh… and I forgot… and the critters they have bought off who say that there aren’t votes (support?) for public or single payer.
Aside from them it seems that seems that most other segments poll strongly FOR a public option or single payer system.
But big biz don’t like the smell of messing with the free market so that brings a bunch R’s who hare government because it’s there.
I’m so disgusted with all the politicos, top down. I know that I’m to communicate maturely, respectfully with the decision makers who are selling us all down toilet, but my anger is becoming way beyond that capability. So, Scarecrow, what can I say?
if the Dems don’t do this isn’t our system completely broken? Thanks EurekaSprings for pointing in the direction of truth
Seems to me like its been in major, major crisis for years and none of the politicos give a damn. There is not one righteous man (or woman), no not one, as one of the OT prophets once said.
I see the headlone below – 84% of Democrats approve of Obaman’s “performance” = well, I’m certainly not one of them. I despise his performance and have told him so in a quasi=nice way. But “nicety”
is flooding away by the minute.
I have no idea why we are listening to the republics. (and that includes the conservatards) They have ruined the country in the past 8 years. They will NEVER vote for healthcare reform of any kind. The whole mission for repukes is to bring down POTUS and the dems. Nothing more, nothing less.
Who are you going to believe, doctors or their mental health patients?
Speaking of which, who ever came up with this one might want to ask Cigna
for another 8 meetings with their psychiatrist.
Democrats use signs at demonstrations as extensions of their pen*ses,
and Republicans use them as replacements.
It would be interesting to see how the AMA member doctors responded -I think that currently they formally represent about 1/3 of all US doctors.
It is difficult to find any health care professionals who like the current system.
thanks for the detailed report.
Has anyone here ever been to a country with universal health coverage and all that it entails? I suspect most have not. There is some good to not having to worry about paying anything at a time of poor health or worse, however there is also a fair amount of bad. The assertion by Obama that costs will not increase is beyond ridiculous. In Canada, costs have done nothing but gone up while quality of care has slowly but surely gone down. Those are the facts.
Doctors must feel that the public option would make things easier for them. I imagine they are overwhelmed with paperwork under the present system and would like something as simple as Medicare.
Though, with that said, the US system absolutely needs serious revision. It cannot go on as is, however converting it all to government run, single payer is absurd.
why?
Simply untrue. Ian Welsh spelled this out in detail months ago.
All countries who have made the big switch reduced overall costs 20 to 30 percent from the get go. And they temper the rise in costs much better than we.
Oh you poor, poor dear.
Try spending some time here and report back to us:
http://www.pnhp.org/
And you realize many of the readers here live in these mysterious countries far, far away, that we all just wonder about.
Hey Nancy baby,
Whadda ya thinka them apples?
Also, would you please make public the amount of payoff money you received from profit health insurance bureaucracies during their payoff money fund fest for you?
You earned your pay for today?
many, if not most Doctors are also be in favor of Single Payer, but the polls keep that question ‘off the table’, and FDL hews closely to Democratic Party talking points, so you run misleading headlines as if Doctors would prefer some nebulous, undefined, in process “public option” which nobody knows the final details of.
from the PNHP site referenced above:
great message discipline though, Scarecrow. Its just like under Karl Rove – the White House draws the lines and frames the debate, and partisan advocacy groups play within them.
OK, here is the precise wording of the survey questions. This is not given in the NPR article or even in the main NEJM report; you have to go to the report’s supplemental online appendix to find it:
As is all too common, the description of the public option (bolded) is completely aspirational and bears no resemblance to the actual, hobbled program in HR 3200 and even less resemblance to the even more hobbled description of the public option given by Obama in his speech Wednesday. The notion that people under 65 would have a free choice of something like Medicare is as pie-in-the-sky in today’s Washington as full-frontal single payer. Even a single-payer nut like me would jump for joy and pound the pavement to preserve HR 3200 if that’s what it actually contained.
Oh, and while we’re at it, look at the wording of the single-payer choice. Eliminating all private insurance (even nonprofit Medigap-type plans of the sort available in France and most other nations providing universal health care) is a canard. Few knowledgeable single-payer proponents would consider this a necessary stipulation, and it is absolutely not a feature of HR 676, the single-payer bill most of us support. Other surveys showing much higher support for single payer, including that showing 59% support among US physicians, polled on a description of a Medicare-like program extended to all Americans. So it’s not surprising that only 10% of docs supported SP given this misleadingly radicalized description.
Had a friendly chat with my family physician during my last appointment. He stated he is in favor of single payer, and that the family physicians have “taken the hit already” – his words.
I have noticed that so many of the people on Medicare rail against “socialized health care”, evidently not aware that Medicare is a government administered program, since at the time they demand that nobody touch their Medicare. I have unfortunate news for the conservatives, i.e. teabaggers. If they listen carefully to their conservate Republican politicians they will realize their immediate goal is to kill the health care bill, but their ultimate prize is to dismantle Medicare and Social Security next. I hope all of these deluded seniors have contingency plans in place, especially if Social Security is their only income, and Medicare their only source of health care.
Forgot to drive home that NPR is full of shit in describing the public option polled in the NEJM study as “the position of President Obama”; the 63% of docs supporting the public/private option were saying yes to something much, much stronger than what Obama tepidly advocates.
Leave Joe a polite comment on his Video. You made a public accusation, now make a public apology to Congress for breaking House rules.
Thanks Ralph, Once again it’s all in the framing. If one’s frame leads the answer in a particular way one gets misleading results.
I mean, if the headline were “74% of doctors favor far more liberal ‘public option’ than Obama’s” I’d be happy.
touting of skewed results of polls with slanted questions, excluding by design opinions that the Party considers ‘off the table’ – doesn’t this remind anyone else of Republican message discipline under Karl Rove?
such an absurd binary system, where Democratic Party online outreach groups downplay their acquiescence to policies they deplored under Bush, and support stupid policies they would have had strenuously opposed had a Republican proposed them.
ralphbon made the kind of points that always stand unrefuted by supporters of the ‘public option’, but Scarecrow and whoever can just blithely ignore them and pretend Single Payer doesn’t exist. After all, the Leader has Decided, it is off the table, and if junior staff is good at anything, it is following orders.
Thanks, spork, but wrt scarecrow, I think he’s made some pretty rigorous arguments for SP within his extensive body of work; I consider him squarely in the “making the best of a bad situation” camp.
Speaking as a physician, I was happy to see this report. It is consistent with what I hear from my colleagues. The NPR report got it right on this point: Doctors understand that a Medicare-like plan would put downward pressure on their incomes. A generation ago, that was enough to have them unite in opposition. Now, most are so fed up with the aggravation of fighting with insurers that a public plan seems like a welcome alternative for both us and our patients. During the last attempt at reform during the Clinton administration, Arnold Relman (former editor of the New England Journal of Medicine) spoke to the opposition of “market-oriented” doctors, he said, basically, you guys imagine yourselves as savvy businessmen (and at that point it was mostly men he was talking to), but you are up against ruthless multi-billion dollar corporations filled with people who have nothing to do all day long but block you. You are going to get rolled.
And so it came to pass, and so at this point, most MD’s have no illusions about the insurance companies. We know that as long as for-profit insurers are in the driver’s seat, both doctors and patients are going to get screwed. My congresspeople are getting sick of hearing from me on this point. I hope you all are similarly annoying yours.
frankly what concerns me most is Max Baucus’ comfort level.
I think it’s orange these days.
allright, noted.
but isn’t the “making the best of a bad situation” camp about the only authentic constituency the Public Option, whatever it may be, has? outside of the Beltway and Democratic staffers?
this poll selectivity is just galling to me, but i should’ve damped my tone a bit.
Honestly, I have my doubts.
The WH is composed of so many parties and variables… how can we possibly know? And, I’m pretty sure that it’s mostly a moving target.
It may be orange on some scale. But on my favorite political indicator scale, I am sure it is GREEN, baby, all GREEN GREEN GREEN all the way to the bank.
My wife works as an RN in a major hospital (33 years), all the doctors and nurses she knows are adamantly against the PO mandate. The job is hard enough without government wage controls.
In response to the several inquiries and such from above; I am a physician in Canada and have trained, as well as worked in the US, specifically Ohio. I’ve been in practice for 15 years now with a total of 25 years if you include medical school and training.
I am not advocating that the US system as is, is better, however it allows for better quality of care when one receives it. The rich and poor receive the best, as does the middle class though that last group suffers the brunt of the costs if they need care and are uninsured. The US system, has tremendous costs, though health care in and of itself is quite costly and people need to understand that. I’m not surprised that many of my US colleagues want a change, because the hell they go through in receiving their pay is outlandish and has tremendous HR costs to their practices. Though they do not truly understand what it means to be under the thumb of the government and its whims when it comes time to “cut costs” and hence their desire to have a single payer system.
Americans and Canadians look alike, though they are two different people with two different mentalities toward life. Canadians wait, though may complain. Americans want things immediately and complain quite vocally. Patients wait hours, as in at times 5-8 hours in the ED and at times 1-2 in the doctors office depending on the specialty. That is more the norm than the exception. Another norm is for people to be lined up like cattle in the halls or stay in the ED once admitted due to lack of beds or lack of nursing care. There may be waits of 2-4 months to see a Cardiologist, 6-9 months for an Ophthalmologist, and over a year for an Orthopod. This is one of the Canadian governments ways of cutting costs, that being reducing the number of physicians in practice through variety of means. Some physicians also leave for the US after their training as well, which means less access to specialists for Canadians.
The Canadian system does an admiral job at the day to day care of patients, meaning that care is delivered to those in need and they “do not pay”. Though in reality, we pay heftily through our tax dollars that keep increasing with less to show for them. Where it fails is in the cases of emergency care or end of life issues. People slip through the cracks. Patients needlessly die on occasion, though ONCE is too many times. And believe it or not, people and their family members are gently nudged towards making a decision for a DNR orders or “no heroic measures” for patients that come in who may be long in the tooth, as they say. To me and my patients, age is not a determining factor if one should be treated heroically or not. I know 50 year olds who act as if they are 90 and 90 years old who out think 40-50 year olds. No one will ever admit to this if asked directly, though this is an ugly little secret in the medical community that may even be a subconscious process as it happens so often and is seen by all doctors in training where they learn to pick up the practice.
I’m not even touching on the issue of tort reform as Canada has a very strict tort system that does not reward damages anywhere near what the US does. Canadians are not litigious either in comparison to their American counterparts.
I’m an American who has lived in Canada and I consciously made the decision to move here for personal reasons. I know both systems and I am not advocating that the US keep its current system. I’m also not trashing the Canadian system, as I think it has positives as well. I just think, after speaking to colleagues, patients, expat Americans etc, most of the US has no clue on what is in store for you and what it means to have single payer health care. People should know all the pros and cons in order to make informed decisions and the gung-ho advocates of “Obamacare” do not. This will be the single most important decision of your lives for you and your progeny.
I had a chance to check the links, a majority of the AMA supports either public option or single payer, as well as most doctors in the survey. So this is very widespread support, and the survey questions indicate it is for much stronger programs than described by Obama.
If one commenter’s report above is accurate, then NPR is misreporting the results, and portraying them in a way that shades the debate towards the disgusting and corrupt ‘moderate’ center of the political debate.
I do not even think that public option or single payer is necessary for a good reform. I think you could have it all done by a heavily regulated private system and provide much better more reliable care at much lower cost.
But looks like we are not going to get a good and honest single payer, public option, or private insurance system out of reform. Prospects look like we will get weak ineffectual reform that will soak ordinary people. The best that can be hoped for is that insurance and healthplan industry, and Pharmaceuticals and providers will abide by their voluntary rules reduce corruption and poor performance just enuogh to prevent public outrage.
Obama may realy believe his weak proposals will work, and he has said he will be accountable. I hope he has not been mislead by his free market finance gurus and corporate advisors. Not that I care that much. Long past time to care much at all about what our leadership intends, but rather to press on with grassroots efforts.
I think this is the way to go and it may be the best of both worlds. In my opinion, of course.
With respect to discussion, I am puzzled by emphasis on Canadian single payer as a model. Many countries essentially have single payer. Australia has a single payer Medicare for all system that is more sensitive and respectful of public preferences than Canada. Some assert that the Netherlands has a single payer system that uses heavily regulated private insurance industry to adminster the finance.
I think that the Canadian system has some structural faults. It started as a provincial system, and retains some of the weakness of its origins in provincial governments. For example, in my view, it is too susceptable to provincial government interference for short run finanical and partisan reasons. I have no problem with single payer at all. I have a big problem with using Canada as the best example of how single payer could be adapted to US needs. I think Australia provides a better example.
Some of the bad stories are the results of provincial specific policies, that are dubious health policy, but polktically advantageous short run cheap budget tricks, or partisan game playing policies.
France, Australia, Canada, the Netherlands, how many of the people in those countries would exchange their system for ours? How many Americans would exchange our system for theirs?
This is so bogus and lovely how co-opted DNC sites like Daily Kos are promoting it. Doctors have long favored Medicare for All. We have just as much chance of passing Medicare for All, as we do passing an open choice of Medicare for All.
I spent about a decade as a litigator enforcing complex federal regulations against large corporations. It is difficult work. In the U.S., it can be made much more difficult by the political clout of those regulated. Regulation has a somewhat better chance, however, if powerful members of Congress have their own reasons to keep the money flowing to the regulators’ office. That was fortunately the case for my colleagues and me.
The imbalance of power as between the insurance companies and the rest of us, medical professionals and patients alike, favors the companies strongly. I see no counterweight in Congress to the companies’ political power.
Any U.S. health care system that would rely on heavy regulation for its efficacy will therefore, in my view, fail.
I have that concern too about lax regulation in the US. In order to work it would have to be much stronger than any other regulatory mechanism in the US that I know of. It would have to be Swiss-style health insurance regulation, with soft rate regulation.
The soft rate regulation would be feds set regional guidelines for maximum increases. A company that wants bigger increase would have to subject itself to a complete federal audit of company books, records, data, whole process of statistical analysis used to support company’s rate request. Results are made public. Under this system, the companies operations are essentially transparent to the feds.
Strong regulation would mean strict national guidelines for a single basic comprehensive policy, with definged benefits, and regulated reimbursement scheme.
Unless the US could get close to that very strong Swiss style regulatory regime, strong public option open to all might be safer approach.
What an informative view! Thanks! I suspect my congressfolk have a block-sender on my email address at this point. I still send little notes daily.
I’m thinking it might be interesting and possibly enlightening to list all the ways that Big Bidness and R’s Deny Jesus Healthcare (those among us who know their Bibles will see many additional ways, I suspect). Let’s see, he’s a single male adult, doesn’t work, he’s homeless, has no kids…
It can be in the present tense because didn’t he say something along the lines of “As you do unto the least of these, so do you unto me”?
If the Dems can’t pass a public option with this sort of polling numbers then they don’t deserve to be the party in power. Period.
I know.
Old news: Public option falls short 15 votes in the Senate. Do far left liberals care?
Olympia Snowe is the first Senator from Canada that serves in the Senate. She should move to Quebec where here wishy washy attitude would fit right in to the culture.
Please stop using Public opition, the word polls well but we are all members of the Public. The proper term is a Government Run Option.
I have a form of cancer that was not preventable,its origins were during embryonic development, it is called a germ cell tumor. Over 99% of the cases show up in people before that age of 25. I was detected with this form of cancer at 58. Do you really think that a Government Option would have paid for my treatment at MD Anderson. My health insurance did and paid for some diagnostic tests that Medicare does not pay for. Had I been 65 I may not have had the opportunity to have a PET scan which dictated my treatment, which I can assure you that chemo for 8 hours a day, five days a week times four treatments is neither fun nor inexpensive. I am still here and going to celebrate my 62 birthday next month and am a volunteer for a lot of community activities and other causes.
What if I was you Dad under the Government Opiton, would I be here of would I be a memory?
No one at the Texas medical center has been contacted by the government about health care. I am an MD Anderson patient but there are over 28 hospitals in the Complex in Houston. It is the largest medical complex in the World, forget about the US. Why hasn’t there been hearings conducted right there.
Every specialty and disease is represented there at the Med Center.
It falls 15 votes short because the President is not making it a make or break issue. If he did that, he could surely get the 50 votes he needs, along with Joe Biden’s to pass a Medicare for All option under reconciliation.
I think a better term would be Government Insurance Option, since it is an insurance organization we’re taking about, not a health care provider like the VA.
I think whether a Government Option would pay for it or not depends on how Congress creates that option. In other nations Government-funded insurance pays for all of the kind of thing you’re talking about. If Medicare doesn’t cover it here, it is because of politics and specifically the influence of Republicans and blue dog Democrats, bought by health insurance companies, in limiting and cutting back on the health care safety net the Government can offer. If you don’t like the limitations you should be a supporter of an enhanced Medicare for All like the Conyers/Kucinich HR 676 bill. In sum, the solution to the kinds of coverage problems you’re talking about is greater Government involvement, not greater reliance of for-profit private insurers.
3 out of 4 doctors choose the public option for their patients who choose health insurance.
Obama is not advocating for single-payer health care. As for what it means, does most of the US not have a clue about Medicare?