A majority of physicians in the U.S. support health care reform that includes adding a public insurance option, according to a poll conducted by the Robert Wood Johnson Foundation. Approximately 63 percent of physicians surveyed by the foundation said they favor a health care system that offers both a Medicare-like public option and private insurance options. About 27 percent of doctors in the survey said they think the system should include only private insurance carriers.
The public option has become a centerpiece of the health care debate as supporters and opponents argue over whether it represents too much government involvement in health care or is the only way to improve competition in the market and offer affordable coverage to millions who currently do not have it.
Among physicians, "support for the inclusion of a public option was demonstrated across all demographic characteristics, specialties, practice locations and practice types," the foundation wrote in its report on the survey, which polled 4,936 doctors between June 25 and Sept. 4. About four out of 10 doctors in the survey group responded.
CHA has not taken a position on the inclusion or exclusion of a public insurance option but has emphasized the importance of adequate payment rates for providers should a public plan be included. On Sept. 29, the Senate Finance Committee rejected two amendments that would have added a public insurance plan to legislation proposed by Committee Chairman Max Baucus, D-Mont. Proposed legislation in the House includes a public plan, but it is not clear whether that provision will survive the legislative process.
Dr. P. Terrence O'Rourke, executive vice president and chief clinical officer at Trinity Health in Novi, Mich., said that without knowing crucial details of the public plan, such as how it would reimburse hospitals and doctors, it would be premature for him to say whether he supports it.
"In the physician community at large, there is a huge frustration and disappointment with the current system," O'Rourke said. "The current system is just untenable going forward with lack of coordination and disparities around reimbursement and malpractice and all the other problems doctors deal with on a daily basis."
O'Rourke said it is likely that the Robert Wood Johnson Foundation's finding of physician support for the public plan is based more on the physicians' desire for change than it is support of a specific policy. "If (the public plan) would expand access and at the same time (include) a sustainable reimbursement rate and have objectives that would improve quality of care and coordination and evidence-based care, then I would be supportive of it," he said.
One alternative under consideration would "trigger" the creation of a public plan in a set number of years in the event that private insurers do not meet benchmark goals. Those goals likely would be aimed at expanding the number of insured by making meaningful coverage accessible and affordable.
"There's a good chance there will be a trigger," said Ed Howard, executive vice president of the Alliance for Health Reform, a nonpartisan think tank based in Washington, D.C.
In the Robert Wood Johnson Foundation survey, primary care physicians were the most likely to support a public option. Support declines among physician specialists and those who do not have regular patient contact, such as radiologists, and physicians in nuclear medicine or anesthesiology.
Doctors who reported that they own their own practice were less likely to support a public option than their non-owner counterparts — 60 percent of owners said they support it while 67 percent of non-owners said so.
Results of the foundation's survey "reflect the kind of frustration that you hear from individual doctors when you talk to them about their struggles with the private insurance industry and the hope that maybe at least if you had a public option there would be some responsiveness through the political process," Howard said.
Among the broader public, August was a rough month for support of health reform but recent polls show some improvement. According to a September survey by the Kaiser Family Foundation, 57 percent of Americans believe that health care reform is more important than ever — up from 53 percent in August.
Forty-two percent, meanwhile, said they think their families would be better off with the passage of health reform, up six percentage points from August. Fifty-three percent surveyed by Kaiser said the nation would be better off, up eight points from August.
With regard to the public option specifically, Kaiser found that nearly 60 percent of the general public favors including it as part of health reform.
Younger people, meanwhile, support the public option in greater numbers than any other age group. According to a Wall Street Journal/NBC News poll, some 50 percent of people between the ages of 18 to 34 said they support a public option, while 43 percent oppose it.