U.S. Physicians’ Views on Financing Options to Expand Health Insurance Coverage: A National Survey

Department of Medicine, Cambridge Hospital and Harvard Medical School, Cambridge, MA 02139, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 02/2009; 24(4):526-31. DOI: 10.1007/s11606-009-0916-x
Source: PubMed


Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States.
To assess physician views on financing options for expanding health care coverage and on access to health care.
Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care.
Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care.
1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance.
The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.

Download full-text


Available from: Danny Mccormick,
  • Source
    • "This may be a point to exercise pressure, by developing a system not paying the physician by the number of measures prescribed, but by the quality of care, reflecting his patients' health status. McCormick et al. [34] found that only 9.1% of US-physicians probed support the status quo, while reform proposals like adding tax credits or tax penalties (49.2%) or single payer NHI programs (41.6%) are favoured. When raising OOPP is necessary due to fiscal reasons, it should occur in relation to the patient's income. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In all OECD countries, there is a trend to increasing patients' copayments in order to balance rising overall health-care costs. This systematic review focuses on inequalities concerning the amount of out-of-pocket payments (OOPP) associated with income, education or gender in the Elderly aged 65+. Based on an online search (PubMed), 29 studies providing information on OOPP of 65+ beneficiaries in relation to income, education and gender were reviewed. Low-income individuals pay the highest OOPP in relation to their earnings. Prescription drugs account for the biggest share. A lower educational level is associated with higher OOPP for prescription drugs and a higher probability of insufficient insurance protection. Generally, women face higher OOPP due to their lower income and lower labour participation rate, as well as less employer-sponsored health-care. While most studies found educational and gender inequalities to be associated with income, there might also be effects induced solely by education; for example, an unhealthy lifestyle leading to higher payments for lower-educated people, or exclusively gender-induced effects, like sex-specific illnesses. Based on the considered studies, an explanation for inequalities in OOPP by these factors remains ambiguous.
    International Journal for Equity in Health 08/2010; 9(1):20. DOI:10.1186/1475-9276-9-20 · 1.71 Impact Factor
  • Source

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Promoting racial/ethnic diversity within the physician workforce is a national priority. However, the extent of racial/ethnic discrimination reported by physicians from diverse backgrounds in today's health-care workplace is unknown. To determine the prevalence of physician experiences of perceived racial/ethnic discrimination at work and to explore physician views about race and discussions regarding race/ethnicity in the workplace. Cross-sectional, national survey conducted in 2006-2007. Practicing physicians (total n = 529) from diverse racial/ethnic backgrounds in the United States. We examined physicians' experience of racial/ethnic discrimination over their career course, their experience of discrimination in their current work setting, and their views about race/ethnicity and discrimination at work. The proportion of physicians who reported that they had experienced racial/ethnic discrimination "sometimes, often, or very often" during their medical career was substantial among non-majority physicians (71% of black physicians, 45% of Asian physicians, 63% of "other" race physicians, and 27% of Hispanic/Latino(a) physicians, compared with 7% of white physicians, all p < 0.05). Similarly, the proportion of non-majority physicians who reported that they experienced discrimination in their current work setting was substantial (59% of black, 39% of Asian, 35% of "other" race, 24% of Hispanic/Latino(a) physicians, and 21% of white physicians). Physician views about the role of race/ethnicity at work varied significantly by respondent race/ethnicity. Many non-majority physicians report experiencing racial/ethnic discrimination in the workplace. Opportunities exist for health-care organizations and diverse physicians to work together to improve the climate of perceived discrimination where they work.
    Journal of General Internal Medicine 09/2009; 24(11):1198-204. DOI:10.1007/s11606-009-1103-9 · 3.42 Impact Factor
Show more