National health plan support up

4/1/2008
BY JULIE M. McKINNON
BLADE STAFF WRITER

Nearly 60 percent of U.S. doctors want government legislation to establish national health insurance, while another 14 percent instead support incremental reform, according to a study to be published today.

A 10 percent spike in the percentage of doctors supporting national insurance - to 59 percent last year from 49 percent five years earlier - shows more are ready for a system overhaul, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.

"What this means is the usual block of anti-reform is breaking up," he said. "These doctors are looking in the eyes of sick [uninsured] patients every day."

With an estimated 47 million Americans lacking health insurance, doctors realize it is increasingly difficult for patients to get coverage despite some efforts to improve the system, said Dr. Aaron Carroll, lead author of the study to be published today in the Annals of Internal Medicine.

"It's frightening, and it's getting worse. It's not getting better," said Dr. Carroll, director of Indiana University's Center for Health Policy and Professionalism Research.

He added: "It probably will take a big step to fix things, not these small incremental steps."

National health insurance typically involves having a federally administered fund guaranteeing health coverage for all, as Medicare does for those at least 65 years old and some disabled people. Incremental reform, meanwhile, involves taking steps such as mandating that consumers buy coverage from private insurance companies and offering tax incentives.

Health insurance has surfaced as a major concern among voters this election year. None of the three leading presidential candidates is proposing national health insurance, although they do offer up incremental reform to some degree.

Hillary Clinton and her Democratic rival, Barack Obama, would both give Americans the chance to buy guaranteed group insurance like that offered to federal employees, as well as expand eligibility for Medicaid and the State Children's Health Insurance Program.

Mrs. Clinton calls for mandated coverage for all, while Mr. Obama would require that children be insured but not adults.

Republican John McCain, meanwhile, opposes mandated coverage but has outlined various health-care reform measures. Insurance reforms, he maintains, would make health-care coverage more affordable by fostering competition and elimination.

The American Medical Association also proposes reforms that build on the existing system to provide coverage to the uninsured, including providing tax credits or vouchers to those who need financial help. Association officials declined to comment yesterday on the study's findings because they had not yet seen complete results, a spokesman for the nation's largest doctors group said.

Of 2,193 doctors surveyed by Indiana University researchers, 55 percent said they would support achieving universal coverage through incremental reform.

Fourteen percent of doctors who opposed national insurance instead were in favor of just incremental reform, according to the Indiana University survey.

Overall, 32 percent of doctors surveyed opposed national health insurance and 9 percent were neutral. Forty percent of doctors surveyed in 2002 opposed national health insurance, and 11 percent were neutral.

What was most surprising about survey results was that support for national health insurance was up among all groups of doctors except pediatric subspecialists, whose approval remained relatively high at 71 percent, said Dr. Carroll of Indiana University.

Support for national health insurance is particularly strong among psychiatrists at 83 percent. It was lowest among radiologists at 30 percent, according to the survey.

Contact Julie M. McKinnon at:

jmckinnon@theblade.com

or 419-724-6087.