The Doctors' Revolt

Doctors, the traditional advocates for the medical status quo, are increasingly in favor of major reforms to the U.S. health-care system.

ROGER BYBEE | July 1, 2008

http://www.prospect.org/cs/articles?article=the_doctors_revolt

Physicians like heart surgeon Dr. Dudley Johnson, a renowned pioneer in open-heart surgery, have concluded that only a single-payer system can restore patient care rather than profit as the core of the health-care system.

A poll published recently in the Annals of Health Research shows that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers.

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. 

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.

Where only 18 percent of AMA members favored single-payer reform in 1992, the figure had soared to 42 percent by 2004.

Single-payer proved more popular than more modest measures like public programs to cover the uninsured, an individual mandate to purchase insurance, or an employer mandate, according to the AMA's 2004 Advocacy Agenda Setting Survey. Among some subgroups of the AMA, support for single-payer was even stronger, reaching 58 percent among psychiatrists. (Pediatric cardiologists showed a 70 percent level of support for single-payer in a 2003 poll of physicians published in the Annals of Internal Medicine.)

Members of the American College of Physicians -- the nation's second-largest doctors' organization with 124,000 internal-medicine physicians and related specialists -- voted in December 2007 to endorse the single-payer idea.

Ironically, the commanding role of for-profit insurers and other corporate players has produced all the dire effects that doctors were warned about as the products of "socialized medicine," delivered instead by a system that generates immense profits. "When doctors were worried about the government looking over their shoulder, now they actually have insurers second-guessing everything we do," says Dr. Deborah Richter, past president of Physicians for a National Health Program.

Doctors' perceptions of the for-profit insurance industry -- which ranks about as low as Big Tobacco in the general public's eyes -- have declined as premiums soar, bureaucratic problems multiply, and the ranks of the uninsured grow. 

New York Times columnist Paul Krugman has noted, "Between 2000 and 2005, the number of Americans with private health insurance coverage fell by 1 percent. But over the same period, employment at health insurance companies rose a remarkable 32 percent. What are all those extra employees doing? ... They are working harder than ever at identifying people who really need medical care, and ensuring that they don't get it."

So, 59% of U.S./Oregon doctors support a "single payer" plan that essentially eliminates the central role of private insurers and  100% of the Oregon legislature and every candidate running for the Oregon legislature support resolving Oregon's moral and economic health care crisis by continuing to be enslaved by the failed private health insurance industry. There are no polls on how the million Oregonians who are uninsured each year, much less those with health insurance but not health care, would choose. However, it's a very safe bet that they all would overwhelmingly if not unanimously reject continued domination by the failed private health insurance industry.

The 2009 Oregon legislature will be at work trying to fund SB329 with a Billion dollars in new taxes destined mostly for the corporate masters of the failed private health insurance industry and their lobbyists before Barack Obama takes the oath of office. Unfortunately, Obama's national solution relies on the failed private health insurance industry model. It's chances of passage at the end of four years that Obama promises are dubious at best. If enlightenment comes to him in the oval office and he comes to embrace the federal single payer solution, HR 676, http://www.hr676.org/, then he will be on the right track.

If you are one of the 59% of Oregon doctors that want to restore patient care rather than profit as the core of the health-care system in our state then it's time for you to speak up for A. The Oregon Community Health Care Bill. THERE ARE NO OTHER VIABLE CHOICES ON THE PUBLIC TABLE IN OREGON.

A. The Oregon Community Health Care Bill (Which involves no new taxes, will reduce public institutional expenditures for health insurance by 20% and provides equality of health care for public employees and citizens without relying on the failed private health insurance industry and virtually no physician paperwork.)

B. Senate Bill 329 (Which, according to Representative Mitch Greenlick, will cost an additional Billion dollars in taxes and relies on the failed private health insurance industry model assuring continued unsustainable escalation of public institutional health insurance contributions. The complexity of this bill will assure that health care professionals will be spending even more time with paperwork than patients.)

C. Maintain the status quo.

Oregon doctors, if you don't write out a prescription for a new treatment very soon then your patients and your state will just keep getting sicker and sicker and sicker and ...

Primum non nocere, "First, do no harm." Your silent intervention in support of the failed private health insurance industry is doing harm.

Good luck and good health.


Richard Ellmyer