Most doctors in favor of national health insurance (ie: Medicare expansion), study finds

[gyroscope]

In all the endless debates over healthcare, no one seems to have bothered to find
what the doctors actually think about it. This study seems to dispell the argument that doctors
are opposed to Medicare because it doesn't pay enough. If a doctor doesn't want to accept Medicare under Medicare for all they don't have to, but most doctors will indeed choose to accept it going by the study. Private insurance will still be available to anyone that wants it, as it is in every other country with single payer.



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Most doctors support national health insurance, new study shows

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.

http://www.pnhp.org/news/2008/march/most_doctors_support.php

[NowSam]

1. Since the people have no money (Except the 1%) then Medicare ensures they will be paid

...for their services so of course they like it. Bernie's plan is a great plan because it ensures the patients get the care and ensures the doctors and nurses and all related professionals get paid. It eases the burdon(?) of employers to provide health plans for their workers and saves them and everyone thousands of dollars each year per family.

I see it as a win win. A healthier populace too which means more money to spend in other sectors of the economy. Now before y'all pile on and tell me how stupid I am - let me save you the trouble. I don't know anything about economics. I am just a regular working person with enough math skills not to bounce any checks. I am just looking at this from what seems to me to be a common sense (very common in fact) point of view.

[gyroscope]

2. Like Bernie said

it relieves businesses the overhead and burden of providing healthcare insurance,
and workers the burden of being stuck to a job they don't like because they need the healthcare benefit.

or when you get a new job have to go through the hassle of applying for and picking a new plan that may be totally different then the plan you had at your last job.

[NowSam]

4. Yes Sir!

President Sanders and all of us together can do this.

[polly7]

6. There was an article in the Vancouver Sun (I believe) a few years ago

where I read that physicians who'd moved here from the U.S. (not that many - about 30 in Vancouver that year I think) laid out their reasons why they preferred it. Not having to deal with the overhead and burden of collecting payment was one of the top issues. They are also able to incorporate, which enables them to get good tax breaks, we don't sue as much here - much, much less, and I can't remember the rest. But they were happier and could make their own decisions with regard to what dx and treatment were needed for their pts. with no worry about cost. Absolutely, we do have wait times - mostly for elective surgery, but also for access to CT's, MRI's, etc - and that is a huge issue that each province and territory work on improving.

[gyroscope]

8. Interesting, thanks for that

Question - are all doctors in Canada required by law to accept the national insurance plan, or can a doctor accept private insurance only if that's what they choose?

[polly7]

27. Sorry, I missed this.

The vast majority of physicians supplying insured services approved by Health Canada are compensated by medicare in accordance with the rules and at the rates established by the province that provided the services. Private health insurance plans are prohibited from duplicating coverage for health services provided in Canada which are insured under the Canada Health Act. There are some physicians - ie. in Québec, though very few, who choose to opt out - they cannot charge more than what they would receive under the health act for the same services, and must notify patients of their status. The main reason I've read of for opting out is discontent with the FFS method of reimbursement - they want more time than they're allotted to spend with each patient. Many physicians here want the FFS method revised, or even eliminated.

The methods of compensation for doctors varies from province to province and can be complicated -

FFS fee-for-service,

Primary care group payments such as family health teams, alongside other health professionals, including nurse practitioners, registered nurses, pharmacists and social workers,

Alternative payment programs which can include a mix of capitation (a physician or group of physicians is paid a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care), and salary. Doctors paid this way include emergency physicians, trauma team leads, academic physicians, geriatricians, oncologists and other specialists. Roughly half of specialists receive at least some pay through alternative funding arrangements. .

Blended capitation payment schemes are used in Family Health Networks, Family Health Teams and Family Health Organizations. These systems have a roster of registered patients and the main payment is via capitation: the physician receives a base payment for each enrolled patient; this payment is adjusted for age and sex. They get fee-for-service payments for treating non-enrolled patients, and also receive incentives and special payments for selected evidence-based health care services (diabetes care, smoking cessation counselling, etc).

Salary in which the unit is time - common in hospital settings and in some primary care settings, such as Community Health Centres, where accountability can be ensured. Few doctors get paid by salary alone.

[Matariki]

21. Yes. It sucks having to change the doctor you've been seeing for years

because they're not 'in network' in your new policy.

actually been there

[TheBlackAdder]

3. Every doctor I have spoken to, beween kids and myself, say insurance companies jerk them around.

.


They mention the delays in payments, wrong reimbursement amounts, follow-ups, all driving up their back-office costs.



Well, I used to work IT for a Non-Profit HMO years back. The claims people would often talk about stalling claims, by recording and shredding the first two claims submissions, and processing the third submission. The goal, besides the delay of payment, was the hopes that the doctor's office wouldn't be able to keep track of their accounts receivables and forget about resubmitting.



These were claims people who worked for many of the major insurance companies, and they would jump from company to company, since it's a relatively closed and specialized field. This wasn't just the tricks with the one firm, it was industry wide.



.

[gyroscope]

7. So they can just say

they never got the claim? wow.

From what I hear claims agents get paid commission or bonus for every claim they can delay and deny.
A massive headache for doctors and patients who have to deal with these sleazy insurance company tactics.

[Doctor_J]

16. read my reply 13 for my doctor's story

[hifiguy]

23. See my post below

The doctor Imention there had all these horror stories and more. He said dealing with private insurers was a nightmare and the worst part of his practice. They drive doctors nuts.

[Recursion]

5. Keep in mind that I “support government legislation to establish national health insurance”

So that doesn't necessarily mean much operationally in terms of the specific plan you want.

Also, per your article, 55% of physicians favor "incremental reform".

[gyroscope]

10. A doctor doesn't have to accept Medicare if he or she doesn't want to

private insurance is still available in every country with single payer.

I'm sure the well-off may prefer their private insurance plans, and there will always be doctors who prefer to deal exclusively with higher end clientele.

[Recursion]

11. No, private insurance in Canada cannot be used for a covered procedure. Period. You'll go to jail.

If private insurance can be used for it, as you yourself posted earlier, then it's not single payer.

Private insurance in Canada is for procedures that are not covered by their provincial Medicare systems.

[gyroscope]

12. Thanks for the correction

but, that doesn't mean it has to be done the same way in the states.

[Doctor_J]

14. I am pretty sure incremental reform does NOT include making more people buy for-profit insurance

[Recursion]

15. That's a pretty good example of incremental reform (nt)

[Doctor_J]

17. In the wrong direction

It's a really bad example of an increment toward single payer/Medicare for all. I really don't understand the BOG's insistence that "more people being forced to buy private insurance will lead to no private insurance". If you are in NYC and want to go to Boston, I suppose you can head toward Philly and hope for the best. However you probably won't make it on that route.

[99th_Monkey]

9. 20,000 Doctors Agree: A robust advocacy group of Doctors calling for single-payer healthcare now.

and ALSO calling for ONE of the Democratic Debates to be exclusively ON the issue of healthcare-for-all.

Check it out here:
http://www.pnhp.org/news/2016/january/doctors-group-welcomes-national-debate-on-‘medicare-for-all’

[Doctor_J]

13. It will never, ever happen!!!!

- recent quote from someone who wants to be president

Seriously, my doctor works on a draw from the insurance company that employs him. If he doesn't see enough patients during a given month, his paycheck is short. He has to work for the insurance company, and toe the line, lest the company, which has cornered the market in theses parts, drop him, making him "out of network", so no one can afford to go to him at all. then there is the paperwork, having to recommend in-network hacks instead of good doctors who are out of network, and so on.

I am not going to vote for anyone who believes we have to have profits in our healthcare system, any more. Period

[polly7]

18. The Fight for Medicare (just thought some might find this an interesting read)

Saskatchewan faces a bitter doctors' strike over Canada's first universal health care plan

The attempt to bring medicare to Saskatchewan was the latest in a series of measures adopted across Canada and throughout the western world in the years after the Second World War. The measures were based on the premise that governments owed their citizens a reasonable standard of living and access to basic services.

But Saskatchewan doctors complained that they would be turned into civil servants, unable to follow their own judgment about what was best for their patients. They argued that medicare was another step down a slippery socialistic slope

"This is like asking the doctors if they would like to try a hanging and if they didn't like it, it could be undone!," said a Saskatchewan doctor.

The Saskatchewan Liberals, led by Ross Thatcher, backed the doctors and attacked Douglas.

"The socialists say, elect us, even with a 35 per cent majority, and we will ram a scheme down your throat."

Douglas was bitterly opposed by the provinces physicians and private health-care insurers. Despite the $115,000 spent during the election on an anti--medicare campaign, Douglas and the CCF won a commanding majority and a clear mandate to proceed. Douglas would soon leave for Ottawa in 1961 to lead the newly formed New Democratic Party, but his provincial successor Woodrow Lloyd would continue the medicare fight.

The government brought doctors from Britain and encouraged others to come from the US and other parts of Canada to meet the emergency. Local citizens groups organized medical clinics and hired doctors to attend them.

By mid-July much of the KOD support had dissipated. Some doctors were returning to work; the force of the strike was spent. At the beginning of August, the government made some amendments to the Act; one amendment allowed doctors to practice outside the plan.

After 23 days on strike, the Saskatchewan doctors returned to work. But hostilities remained long afterwards; patients resented their doctors' desertion and doctors continued to object to government involvement in medical care. Nevertheless, a 1965 survey found that most doctors favoured continuing the plan.

The Saskatchewan government had opened the door to universal health care. Within ten years of the Saskatchewan strike, the entire country was covered by medicare.

http://www.cbc.ca/history/EPISCONTENTSE1EP15CH2PA4LE.html

Tommy Douglas was literally hated by politicians and doctors here during his fight to enact medicare. The newspapers were full of articles demeaning him. His family received death threats.

[Doctor_J]

19. If doctors don't like Medicare for all, McDonald's and Wal-Mart are hiring

[polly7]

20. Agree!

[hifiguy]

22. Years ago I was talking to the husband of a then work colleague.

A Republican doctor from a long line of same. He was ardently for single payer. His main beef was the enormous amount of doctor and staff time wasted arguing with insurers and the blizzard of different forma/plans/policies.

He said his radiology practice would more than make up for any revenue lost via single payer in efficiency gains alone, and then some. He also said that he and his colleagues could devote a lot more time to practicing better medicine for their patients.

[Uncle Joe]

24. Kicked and recommended.

Thanks for the thread, gyroscope.

[Ferd Berfel]

25. Good Article but it's from 2008 Here's one this year

http://www.democraticunderground.com/?com=view_post&forum=1251&pid=1131561

[Erich Bloodaxe BSN]

26. Most nurses, too. Which is why our unions are behind Bernie. nt