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Tags: clinical observations, degree type, doctoral degree, health care, health insurance, insurance, legislation, national health insurance, physicians, respondents, response rate, sex age, surance, surveys, universal coverage,Pages: 2
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Created: Mon Mar 24 09:31:13 2008
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Letters
Results: Of 5000 mailed surveys, 509 were returned as undeliv-
erable and 197 were returned by physicians who were no longer
practicing. We received 2193 surveys from the 4294 eligible partic-
ipants, for a response rate of 51%. Respondents did not differ sig-
nificantly from nonrespondents in sex, age, doctoral degree type, or
specialty. A total of 59% supported legislation to establish national
CLINICAL OBSERVATIONS health insurance (28% "strongly" and 31% "generally" supported),
9% were neutral on the topic, and 32% opposed it (17% "strongly"
Support for National Health Insurance among and 15% "generally" opposed). A total of 55% supported achieving
U.S. Physicians: 5 Years Later universal coverage through more incremental reform (14%
Background: The increasing costs of health care and health in- "strongly" and 41% "generally" supported), 21% were neutral on the
surance have concerned Americans for some time (1). The number topic, and 25% opposed incremental reform (14% "strongly" and
of uninsured Americans increased by 2.2 million to 47 million in the 10% "generally" opposed). A total of 14% of physicians were op-
most recent census. This is the largest increase reported by the U.S. posed to national health insurance but supported more incremental
Census Bureau since 1992 (2). In a 2002 survey of physicians, we reforms. More than one half of the respondents from every medical
reported that 49% supported government legislation to establish na- specialty supported national health insurance legislation, with the
tional health insurance (3). exception of respondents in surgical subspecialties, anesthesiologists,
Objective: To determine whether physician opinion has changed and radiologists. Current overall support (59%) increased by 10 per-
in the 5 years since the 2002 survey and assess physicians' support for centage points since 2002 (49%). Support increased in every subspe-
government legislation to establish national health insurance and cialty since 2002, with the exception of pediatric subspecialists, who
their support for achieving universal coverage through more incre- were highly supportive in both surveys (Figure).
mental reform. Conclusion: Most physicians in the United States support gov-
Methods: We randomly sampled 5000 physicians from the ernment legislation to establish national health insurance. Support is
American Medical Association Masterfile. We sent each physician a high among physicians in all but some of the procedural specialties.
survey asking 2 questions: 1) In principle, do you support or oppose
government legislation to establish national health insurance? and 2) Aaron E. Carroll, MD, MS
do you support achieving universal coverage through more incre- Ronald T. Ackerman, MD, MPH
mental reform? Question 1 was identical to the one we used in our Indiana University School of Medicine
2002 study (3). Respondents answered using a 5-point Likert scale. Indianapolis, IN 46202
We also gathered data on physician membership organizations and
demographic, personal, and practice characteristics. Potential Financial Conflicts of Interest: None disclosed.
Figure. Support for government legislation to establish National Health Insurance in 2007 and 2002, by specialty.
Psychiatry
Pediatric subspecialties
Emergency medicine
General pediatrics
General internal medicine
Medical Specialty
Medical subspecialties
2007
Pathology
2002
Family medicine
OB-GYN
General surgery
Surgical subspecialties
Anesthesiology
Radiology
0 10 20 30 40 50 60 70 80 90 100
Support National Health Insurance, %
2002 data are not available for pathology and radiology because of lack of response in those categories. OB-GYN obstetrics and gynecology.
566 1 April 2008 Annals of Internal Medicine Volume 148 · Number 7 www.annals.org
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References
1. Kaiser Health Tracking Poll: Election 2008, Conducted October 2007. vol. 4.
Menlo Park, CA: The Henry J. Kaiser Family Foundation; 2007. Accessed at www.kff
.org org/kaiserpolls/pomr032907pkg_v2.cfm on 6 March 2008.
2. DeNavas-Walt C, Proctor BD, Smith J. U.S. Census Bureau. Income, Poverty, and
Health Insurance Coverage in the United States: 2006. Washington, D.C: U.S. Gov
Printing Office; 2007. Accessed at www.census.gov/prod/2007pubs/p60-233.pdf on 6
March 2008.
3. Ackermann RT, Carroll AE. Support for national health insurance among U.S.
physicians: a national survey. Ann Intern Med. 2003;139:795-801. [PMID:
14623616]
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