Survey: Most Docs Back Single Payer

John Commins, August 14, 2017

Fifty-six percent of physicians in a Merritt Hawkins survey support a single-payer healthcare model, while 41% oppose it. The results are a direct inversion of the same question posed by the physician recruiting firm in a 2008 survey.

A plurality of physicians strongly supports a single payer healthcare system, according to a survey by physician recruiters Merritt Hawkins.

The survey of 1,033 physicians indicates that 42% strongly support a single payer healthcare system while 14% are somewhat supportive. Thirty-five percent strongly oppose a single payer system while 6% are somewhat against it. The remaining 3% are neutral on the issue.  

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The results are a near-exact inversion of a national survey of physicians Merritt Hawkins conducted in 2008, which found that 58% of physicians opposed single payer and 42% supported it.

Jack Ende, MD, MACP, president of the American College of Physicians, said he was not surprised to see the shift in physicians’ attitudes toward single payer, and said that “several factors are in play here.”

“First, the proportion of physicians in private practice vs. employed-salaried positions has decreased, so there is less concern with direct reimbursement,” Ende said in an email exchange with HealthLeaders Media. “Second, the average age of physicians has decreased, and along with that there has been a generational decrease in concern about physician autonomy and economic independence.”

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“And third, the recent ‘sturm und drang’ of the healthcare imbroglio over the ACA has made physicians somewhat distrustful of leaving healthcare to the whims of politicians, and more aligned with settling this issue once and for all with a system that will provide universal access to healthcare, and enable us to move forward, i.e. with a single payer system,” Ende said. “And so we find a more egalitarian, socially committed physician community that is more comfortable with a government controlled system of payment than was the case in 2008.”

Merritt Hawkins Vice President of Communications Phil Miller, responded by email to a query from HealthLeaders Media, and offered a handful of theories for the inversion.

  • Doctors want clarity and stability. The fits and starts of health reform and the complexity of our current hybrid system are a daily strain. Many believe single payer will reduce the distractions and allow them to focus on what they have paid a fairly high price to do: care for patients.
     
  • It's generational. The surveys we have conducted for the Physicians Foundation show that younger doctors are more accepting of Obamacare, ACOs, EHR, and change in general than are older physicians. As the new generation of physicians comes up, there is less stigma among doctors about single payer.
     
  • Part of it is resignation rather than enthusiasm about single payer. Doctors see the writing on the wall and want to get it over with. The 14% of physicians who said they "somewhat" support single payer are probably in this group.   
     
  • There is a philosophical change among physicians that I think the public and many politicians now share, which is that as a society we should cover everybody. That wasn't always the case and is one area where Obamacare should gain some credit. It established that as a society we need to do better when it comes to providing care for our citizens.

The survey was emailed to 70,000 physicians nationwide on Aug. 3, and has a margin of error of +/- 3.1%.  Miller said the response rate to the question “is not the only factor to consider.”

“Net number of responses also is significant,” Miller said. “If you got 1,000 doctors in a room and asked them a question, their answers would have some significance: 50 doctors, not as much. We submit our surveys to a Ph.D. in statistical response analysis at the University of Tennessee to determine margin of error rate. He put the survey at +/- 3.1% -- well within the accepted range for credibility.”

Miller says the Merritt Hawkins survey findings are consistent with a survey from LinkedIn that came out earlier this year showing 48% of physicians support single payer, and 32% oppose it. 

John Commins

John Commins is a senior editor at HealthLeaders Media.

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