NEJM: Most AMA docs support expanding healthcare coveragewith choice

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A survey, published in the Sept. 14 online edition of the New England Journal of Medicine, showed that 62.9 percent of physicians nationwide support proposals to expand healthcare coverage that include both public and private insurance options—where people under the age of 65 would have the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans. About 27 percent supported offering private options only.

In April, Salomeh Keyhani, MD, and Alex Federman, MD, from Mount Sinai School of Medicine in New York City, obtained data on a random sample of 6,000 physicians from the American Medical Association (AMA) Physician Masterfile. The authors noted that the association has a history of opposing healthcare reforms.

The Robert Wood Johnson Foundation survey was conducted between June 25 and Sept. 3. Although the survey was conducted in several “waves” over a summer in which healthcare reform was vigorously debated, according to the authors, no statistically significant differences were identified in physician responses during this time period.

They excluded certain physicians due various criteria, and eventually received surveys from 2,130 physicians.

The researchers found that only 9.6 percent of doctors nationwide support a system where a Medicare-like public program is created in lieu of any private insurance. A majority of physicians (58 percent) also support expanding Medicare eligibility to those between the ages of 55 and 64.

According to the authors, respondents across all demographic subgroups, specialties, practice locations, and practice types showed majority support (more than 57.4 percent) for the inclusion of a public option. Primary care providers were the most likely to support a public option (65.2 percent); among the other specialty groups—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 percent did so.

Also, physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9 percent in the South to 69.7 percent in the Northeast.

Keyhani and Federman wrote that on one of the “most critical elements,” specifically the expansion of coverage, the survey showed that a clear majority support a combined public–private approach to expanding health insurance.

“We found that physicians' support for including a public option in the reform package largely mirrors the support revealed in national public polls conducted throughout the spring and summer of this year,” they wrote.

They also found that a similar proportion of physicians also supported the expansion of Medicare to help cover the near-elderly population.

“Support of public and private options was consistent across a wide range of physicians, including those from the traditionally conservative southern regions of the United States, those with a financial stake in their practice, and members of the AMA,” the authors noted.