Research Question – Won't American doctors hate single payer?

I was on Stand Up! with Pete Dominick this afternoon, and a caller asked a question I get asked all the time.  Basically, he was citing the “fact” that doctors would quit being doctors if there was major health care reform because they won’t make as much money.  Or something.  But it all gets down to the same thing – doctors hate single payer, right?

I can’t even count the ways this is untrue.

Let’s start with my own research showing that doctors in the United States would support national health insurance:

Methods: We randomly sampled 5000 physicians from the American Medical Association Masterfile. We sent each physician a survey asking 2 questions: 1) In principle, do you support or oppose government legislation to establish national health insurance? and 2) do you support achieving universal coverage through more incre- mental reform? Question 1 was identical to the one we used in our 2002 study (3). Respondents answered using a 5-point Likert scale. We also gathered data on physician membership organizations and demographic, personal, and practice characteristics.

This was the largest mail survey of physicians ever done on health care reform.  It was a follow up study of work we had done five years earlier.  And what did we find?

Look at that.  59% of all physicians supported government legislation to establish national health insurance.  A majority of every specialty except three supported national health insurance.  Every specialty we measured in both 2002 and 2007 increased support for national health insurance (except pediatric subspecialists which stayed the same at 71%).  Almost twice as many physicians support national health insurance as oppose it.

That’s 59% for national health insurance.  Remember that when people start saying physicians oppose reform.

Another popular form of this argument is that “doctors are flocking to the US from Canada”.  You can’t imagine how many people I meet who claim to know such a doctor.

Well, it’s true that years ago there was a net influx of docs into the US from Canada.  No longer:

What you are looking at is data from the Canadian Institute for Health Information.  The important line is the yellow one, which is the net loss of docs to Canada.  Even in the worst year, fewer than 700 more docs moved to the US than moved to Canada.  But, since 2003, there has been a net movement of docs into Canada from the US.

It’s not that docs are fed up with Canada and moving to the US.  If anything, it’s the opposite!

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