Most U.S. doctors want public-private mix: poll

BOSTON (Reuters) - Most U.S. doctors favor having both public and private options in a reformed healthcare system, a survey published on Monday said.

Ernest Sass, 52, (L) winces as he is attended to by Girish Bobby Kapur, M.D. (R) in a room used to see patients who don't require treatment for trauma inside the emergency room at Ben Taub General Hospital in Houston, Texas July 27, 2009. REUTERS/Jessica Rinaldi

The possible inclusion of a public option -- a government-run insurance plan to compete with private insurers -- is one of the most divisive parts of the reform that is President Barack Obama’s top domestic legislative priority.

When given a three-way choice among private plans that use tax credits or subsidies to help the poor buy private insurance; a new public health insurance plan such as Medicare; or a mix of the two; 63 percent of doctors supported a mix, 27 percent said they only wanted private options, and just 10 percent said they exclusively wanted public options.

The survey of 2,130 U.S. doctors, published in the New England Journal of Medicine, also found that more 55 percent, regardless of their medical specialty, would favor expanding Medicare so it covered people aged 55 and older.

Medicare is the federal health insurance plan for people aged over 65 and some disabled people.

“The result shows that physicians see this system is broken and needs to be fixed,” Dr. John Lumpkin, senior vice president of the Robert Wood Johnson Foundation, which sponsored the survey, said in a telephone interview.

About half of doctors supported trying to save money by restricting care to treatments proven to be cost-effective, a separate survey of 991 doctors in the same journal said.


The polls have been published less than a week after Obama addressed Congress to outline the plan he says will overhaul the $2.5 trillion industry to cut costs, improve care and expand coverage to many of the 46 million Americans without any healthcare insurance.

The concept of a public option has drawn much controversy and the American Medical Association, which represents about 250,000 U.S. doctors, has opposed it.

Drs. Salomeh Keyhani and Alex Federman of Mount Sinai School of Medicine in New York, authors of the larger study, found broad physician support for a combination of private and public insurance, regardless of their region, medical specialty, how they earned their income, or how many hours they spent treating patients.

Similar results were seen when doctors were asked about extending Medicare to those aged 55 and above. Fifty-eight percent supported the idea, 23 percent were opposed and 19 percent were unsure.

In the smaller survey, 73 percent said every doctor ought to care for the uninsured and underinsured and 67 percent said they were willing to accept limits on payments for expensive drugs and procedures as a way to save money and make basic care available to more people.

“By contrast, physicians were divided almost equally about cost-effectiveness analysis; just over half (54 percent) reported having a moral objection to using such data ‘to determine which treatments will be offered to patients,’” said the survey team, led by Ryan Antiel of the Mayo Medical School in Rochester, Minnesota.

Family doctors were more likely to favor reform than surgeons and other specialists.

Editing by Maggie Fox and Alison Williams