An IBD/TIPP Poll released earlier this week showed overwhelming opposition among physicians to proposed health care reforms. But that doesn't mean no doctors support them.
Of the 1,376 physicians who answered our survey, 65% said "no" to proposed reforms. But that leaves 454, or 33%, who do support them.
How do they feel about reform? And why do they support it?
On Thursday, we let those who oppose Congress' health reforms sound off. Today, it's the supporters' turn. All of the quotes in this story were taken from written responses to our poll.
For those who haven't read the first two installments, the IBD/TIPP Poll was conducted by mail, with questionnaires sent out Aug. 28 to 25,600 doctors nationwide.
The doctor sample was purchased from a list broker. One hundred of those responding were retired, and their answers were excluded from the final results.
Coverage For All
Those in our poll who expressed support for proposed health care reforms cited a number of reasons, ranging from cost control to fairness. Others expressed a deep resentment of insurance companies.
But perhaps the most common sentiment of supporters in favor of a government plan is that it would presumably cover all 46.3 million of those who currently lack insurance.
"We are all one serious illness away from losing our current standard of living," warned one physician. "If people are too ill to work or are laid off, they lose their employer-based benefits."
"Millions of Americans are uninsured and do not have access to health care," added another doctor.
Others were far more blunt in saying what they wanted. "I believe in socialized medicine," one doctor simply said.
A Right, Not A Privilege
Many in the group of supporters suggested that health insurance coverage not be purchased like other goods and services, but rather that it should be accepted as a fundamental right of citizenship.
"Health care is a right," said one doctor, echoing the simple sentiment of many, "not just a privilege." Added another: "The cost of health care is bankrupting our economy. People deserve health care. It is a right!"
"Health care is a basic social service, like fire, police," said still another. "It makes our country stronger to have a strong community."
A related reason given by some was fairness - especially for those who are poor or lack insurance. "The poor half of the population gets poor treatment," said one doctor, "and the lower fourth of the population gets very poor treatment."
"It's a way out of poverty for the poor," agreed another. "It's a way to better health for the nation."
"The number of uninsured is a disgrace" is how another physician put it. "The future of the world is related to healthy, well-educated children."
Still others couched their support in anti-corporate terms. Many of these expressed deep anger at insurance companies, which often refuse certain medical procedures or drugs to patients - even when they might be helped by them.
That said, in our current health care system, for better or for worse, private insurance companies are the main way that costs are controlled.
Doctors' ire over insurers was almost palpable - especially on the issue of rationing care. Asked why they support health insurance reform, many doctors took the opportunity to unload on insurers.
"Insurance companies already ration care and limit access," one of the doctor respondents said. "A private payer option will provide a 'transparent' bureaucracy that at least the doctors and patients will have a chance of dealing with."
One physician railed: "I prefer to accept government inefficiency rather than corporate thievery. We should rid the country of greedy insurance CEOs and all other branches of organized crime."
"Health care for all - stop insurance companies from denying care for pre-existing diagnoses," said another.
"The current health system is not patient-oriented - it is big business and HMOs that run the show and tell doctors what to do," noted a medical professional. "Their profits paint the picture."
"Private insurance companies interfere with medical care by denying coverage," yet another doctor said. "Their goal is to increase profits, and they do this by low payments to doctors and hospitals and by denying claims and by refusing to authorize procedures."
"Someone has to break the power of big insurance," another respondent said. "Twenty cents out of every dollar goes to health care, (with) 47 million uninsured and (mortality and morbidity) rates similar to nations spending half as much."
On a related note, "rising health care costs" were cited frequently as a main reason for supporting reform - even though most estimates put the cost of a federally funded health care program over 10 years at $1 trillion or more.
Even the pared-down version released by Sen. Max Baucus, D-Mont., this week carried a hefty $856 billion price tag.
Today the U.S. spends roughly $2.3 trillion on health care. Roughly 47% of that is already controlled by the government, which runs the Medicare, Medicaid, Veterans Administration and S-Chip programs.
Yet, with costs rising much faster than inflation, some doctors felt only government could control spending.
"Ethically, I support universal coverage," said one caregiver. "We need to get some constraints on runaway use of technology, referrals (and) waste. (We need) priorities in spending."
"It will cover the 45 million Americans who are uninsured and will bring down costs and the national deficit in the long term," was how one doctor saw it.
"Private insurers/administrative costs are 30% of health care costs," one reform supporter said. "(We) need a unified, nationalized complete overhaul of the entire system. . . . Our current system violates the civil rights of the poor and the sick."
For some, the deficiencies of the current mixed system far outweigh the uncertainties of letting the government take over the remainder of the private health care system.
"Nobody knows what the play will be," said one doctor. "But we absolutely need to do something."
Others noted that cost controls were inevitable and necessary, no matter what the system. That means rationing is inevitable.
"The current system of rationing health care is arbitrary and irrational," said one respondent. "(It) leads to greater morbidity and mortality, negatively affects productivity and GDP, (and) handicaps U.S. companies in global markets."
"The current system is imploding on itself," groused another doctor. "Thirty years of cost shifting to cover noncompensated care has resulted in no one knowing what any given service actually costs."
Another cited "too many uninsured people, pre-existing-conditions limits, lack of portability and too much insurance company profits" as signs that "private industry has failed."
Others, in effect, just threw up their hands over the current system.
"Any change has to be better than what we have now," said one in this camp.
IBD systematically went through all 1,295 written responses to our survey. We were struck by the sincerity of both sides of the physicians' debate. But the differences between the two camps were wide.
Monday: How doctors think seniors will fare under health care reform.