COMPRENSIVE HEALTH COVERAGE

Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.



The latest sign is a poll published recently in the Annals of Health Research showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.

The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.



"What this means is the usual bloc of anti-reform is breaking up," he told The Toledo Blade. "These doctors are looking in the eyes of sick [uninsured] patients every day."



The poll results underscore mounting signs that doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine. And, increasingly, doctors seem to be showing support for a single-payer system that would essentially eliminate for-profit insurers and curb the power of big provider chains.



The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments…



The statistics indeed suggest a major breakdown: Premiums have climbed 87 percent since 2000, and workers' meager pay raises have been far outstripped by major increases in their share of the premiums. While the U.S. ranks 37th on a variety of quality measurements used by the World Health Organization, per-capita spending in the U.S. is twice as high as any other nation. For example, the U.S. spent $6,697 per person in 2005 compared with $3,326 in Canada. Meanwhile, the sharply escalating costs in the U.S. are leading to shrinkage of insurance coverage provided by employers. Some 47 million Americans are uninsured, with the present economic downturn certain to significantly increase those numbers…



State-level polls reinforce the just-released national survey from Indiana's Center for Health Policy. A remarkable 64 percent of the Minnesota doctors surveyed in 2006 expressed support for a Canadian-style single-payer system that would drive insurers from their commanding role in the health system, reported Minnesota Medicine. The Minnesota poll aligned closely with a Massachusetts survey of doctors in 2004, which reflected 61 percent backing for single-payer, according to the Archives of Internal Medicine. Doctors' views seem to be coming into closer alignment with those of the general public, of which 67 percent explicitly support a system like Canada's or Britain's…



Meanwhile, members of the American College of Physicians -- the nation's second-largest doctors' organization with 124,000 internal-medicine physicians and related specialists -- voted in December 2007 to endorse the single-payer idea. The vote followed an analysis of health care in the United States and 12 other industrialized countries, after which the ACP concluded that universal coverage had been successfully attained elsewhere through single-payer or mixed public/private systems...



Roger Bybee is a Milwaukee-based writer and progressive activist, who formerly edited the official labor weekly Racine Labor. He has written for a number of state and national publications and websites on issues such as health care reform and corporate globalization.



http://www.prospect.org/cs/articles?article=the_doctors_revolt