Most doctors support national health insurance, new study shows

Reflecting a shift in thinking over the past five years among U.S. physicians, a new study shows a solid majority of doctors - 59 percent - now supports national health insurance.

Such plans typically involve a single, federally administered social insurance fund that that guarantees health care coverage for everyone, much like Medicare currently does for seniors. The plans typically eliminate or substantially reduce the role of private insurance companies in the health care financing system, but still allow patients to go the doctors of their choice.

A study published in today's Annals of Internal Medicine, a leading medical journal, reports that a survey conducted last year of 2,193 physicians across the United States showed 59 percent of them "support government legislation to establish national health insurance," while 32 percent oppose it and 9 percent are neutral.

The findings reflect a leap of 10 percentage points in physician support for national health insurance (NHI) since 2002, when a similar survey was conducted. At that time, 49 percent of all physician respondents said they supported NHI and 40 percent opposed it.

Support among doctors for NHI has increased across almost all medical specialties, said Dr. Ronald T. Ackermann, associate director of the Center for Health Policy and Professionalism Research at Indiana University 's School of Medicine and co-author of the study.

"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," he said.

Support for NHI is particularly strong among psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general pediatricians (65 percent), general internists (64 percent) and family physicians (60 percent). Fifty-five percent of general surgeons support NHI, roughly doubling their level of support since 2002.

Doctors have often expressed concern about lack of patient access to care due to rising costs and patients' insufficient levels of insurance. An estimated 47 million Americans currently lack health insurance coverage and another 50 million are believed to be underinsured. At the same time, health care costs in the United States are rising at the rate of about 7 percent a year, twice the rate of inflation.

The health care issue continues to rank high among voter concerns in the 2008 elections, placing third in a recent poll after the economy and Iraq .

The current study by the Indiana University researchers is the largest survey ever conducted among doctors on the issue of health care financing reform. It is based on a random sampling of names obtained from the American Medical Association's master list of physicians throughout the country.

In addition to measuring attitudes toward NHI, the survey also asked doctors about their views about "more incremental reform," often interpreted as state- or federal-based programs requiring or "mandating" that consumers buy health insurance from private insurance companies, legislative measures providing tax incentives to businesses to provide coverage for their employees, or similar steps.

Fewer physicians (55%) were in support of "incremental" reform.  Moreover, virtually all those opposed to national health insurance also opposed incremental reform to improve access to care.  In fact, only 14% of physicians overall oppose national health insurance but support more incremental reforms.  Ironically, many medical organizations and most politicians have endorsed only incremental changes.

Dr. Aaron E. Carroll, Director of Indiana University's Center for Health Policy and Professionalism Research and lead author of the study, commented: "Many claim to speak for physicians and reflect their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support the government creating national health insurance."

Other signs indicate that attitudes among doctors are changing.  The nation's largest medical specialty group, the 124,000-member American College of Physicians, endorsed a single-payer national health insurance program for the first time in December.