Primary care doctors show support for keeping ‘Obamacare’
JAMM AQUINO / JAQUINO@STARADVETISER.COM
UH Medical School faculty member David Horio, right, holds a sign along Ala Moana Boulevard with fellow faculty and students during an organized protest demonstration in support of #ProtectOurPatients on Jan. 9 near University of Hawaii’s John A. Burns School of Medicine facility in Kakaako. #ProtectOurPatients is a nationwide, grassroots movement organized by medical students to raise awareness about the potential repeal of the Patient Protection and Affordable Care Act , frequently referred to as Obamacare.
A postelection survey of primary care physicians reveals that majorities of the doctors that first treat most Americans do not support some of the GOP’s most widely circulated plans to repeal and replace the Affordable Care Act.
Conducted in December and January and published online Wednesday in the New England Journal of Medicine, the new survey shows that nearly three-quarters of general practitioners favored making changes to the Obama administration’s signature health care reform measure.
But in this nationally representative sample of primary care doctors, only 15 percent favored the law’s repeal. Among responding physicians who voted for Donald Trump, only 38 percent favored the law’s repeal.
That makes the repeal of the Affordable Care Act, also known as Obamacare, far less popular among the physicians on the front lines of medicine than it is in the American body politic. A Kaiser Family Foundation poll taken after the November 2016 election found that 26 percent of Americans wanted to see Obamacare repealed.
Like President Donald Trump, primary care doctors were aligned solidly behind a continued guarantee of access to insurance irrespective of patients’ pre-existing conditions (95.1 percent approved). And a broad majority (87.6 percent) said they supported a provision of the health care law that allows young adults up to 26 to stay on their parents’ insurance plans.
Beyond that, however, the survey uncovers scant support for many proposals that have emerged as leading Republican alternatives to the health care law’s provisions. As lawmakers debate the details, many of their proposals would shift health care costs toward patients, pare some benefits and extend less financial help for many who could struggle to afford insurance coverage.
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But among primary care docs, just 29 percent expressed support for measures that would expand the use of health insurance plans with high deductibles.
Some 42 percent of respondents said they oppose further deregulation of private insurance markets. Among the most visible GOP deregulation proposals now circulating is a plan to allow insurance companies to sell policies across state lines.
And 58.6 percent expressed support for tax credits to help Medicaid-eligible people purchase private insurance policies.
Among the survey’s most striking findings was strong support for an extension of the Affordable Care Act that is absent from any GOP proposals: Two-thirds of primary care physicians endorsed the idea that any health care reform should include a public insurance option resembling Medicare that would compete with private plans.
Study co-author Dr. Craig Evan Pollack, an internal medicine specialist at Johns Hopkins University School of Medicine, said he was struck by the strength of physicians’ opposition to measures that increased complexity and shifted costs toward patients. He suggested it was a direct result of doctors’ experience in caring for patients.
“As physicians, we see people struggle with out-of-pocket costs, deciding which types of care they’re able to afford and making very challenging decisions,” said Pollack. Primary care physicians, he added, “try to advocate for their patients.”
The new survey reflects the answers of 426 physicians drawn from a master file of the American Medical Association and is considered a nationally representative sample. Its findings appear to mark a significant shift in physicians’ opinions about the Affordable Care Act. In the opening months of 2015, 48 percent of primary care physicians had a favorable opinion of the Affordable Care Act and 52 percent viewed it unfavorably.
Dr. David Grande, an internal medicine physician at the University of Pennsylvania’s Perelman School of Medicine, said that as the Affordable Care Act got up and running, virtually all of his colleagues have treated new patients who had previously been uninsured or who struggled to hold on to insurance.
The possibility of the ACA’s repeal in 2015 “was hypothetical — it was political rhetoric,” said Grande. “This is no longer hypothetical; the threat is quite real. And the idea of repeal is something that makes primary care physicians nervous,” he added.
The Congressional Budget Office has estimated that if the law is not replaced, 18 million Americans would lose or drop their health insurance in the first year after the ACA is repealed, and as many as 32 million more would drop off the rolls over the next 10 years.
The survey did reveal one respect in which primary care physicians mirror many Americans’ distrust of the Affordable Care Act. Just under half — 49.5 percent of the physicians surveyed — expressed support for tax penalties for individuals who do not purchase health insurance.
That “universal mandate” is the mechanism the ACA used to ensure that young and healthy people join the insurance pool and help offset the costs of the pool’s sickest participants, spreading the costs of care. The finding that fewer than half of doctors support the mandate underscores the “important need to educate health care providers and the public about the fundamental inseparability of these provisions,” the authors wrote.
Grande said that physicians’ tepid support for a universal mandate is stronger than that in the general public, indicating that “they probably understand that connection” a little more than some. “But health insurance and policy is very complex for consumers and for physicians as well. So I’m not terribly surprised,” he added.
50 responses to “Primary care doctors show support for keeping ‘Obamacare’”
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What a crock.
Yeah, about 10 doctors waving a few signs warrants a front-page story?
Read the story, don’t just look at the pictures.
Actually, I did. Polls and statistics can be twisted to get the results you want. That was the takeaway.
These are medical teachers and medical students … they’re not doctors working in the real world. Think about it
Bucky, You mean like Trump misinterpreting the study he claims supports voter fraud? I do agree that polls and stats can be manipulated. But, your comment was related to 10 doctors in a picture…so please tell me how your takeaway relates to anything.
Jean, who cares about who is in the picture. The study was published in the New England Journal of Medicine, and the respondents were primary care physicians…think about that.
My comment is awaiting moderation.
@ peanutgallery
“What a crock” of ________.
(Fill in the Blank)
The study was published in the New England Journal of Medicine, one of, if not the top medical journal.
agree
Doctors want to get paid. Can’t blame them.
I don’t know what to believe in California and why they want ACA. My doctor in Hawaii who is a PPP participant was adamantly against ACA before it took effect. Maybe he changed his mind on this matter?
@ Pocho
No.
Go ask your doctor. He didn’t vote trumpf.
Im willing to bet you that if we did away with all medical insurance except “catastrophic insurance ” the cost of medical care would plummet. And allowing selling across State lines will make it even better. Right now the players in medical insurance have no competition.
Exactly. The GOP doesn’t need a “comprehensive” plan. Repeal O’Care, let the insurance companies offer plans without mandates for coverage of every possible conceivable modality and pass a few smaller laws enabling sales across state lines, eliminating state mandates for certain types of coverage but still require a mandate for catastrophic care. Make a few tort reforms and the market will handle the rest.
Except that didn’t happen before Obamacare, did it?
I believe there will be option(s) to select the extent of coverage. For some the basic bronze (copper :))where you can get just what you need. Then those who want more can opt in but will pay for what they get. Details to follow. 🙂
Are these the same studies and polls that said Hillary was going to win the POTUS by a landslide?
See my comment. I’ve been very wary of how these are being used and interpreted. 🙂
New England Journal of Medicine.
Thank you for the reply. The article appeared in the New England Medical Journal which I am familiar, however…”Study co-author Dr. Craig Evan Pollack, an internal medicine specialist at Johns Hopkins University School of Medicine,” in addition those survey were pulled from “…answers of 426 physicians drawn from a master file of the American Medical Association and is considered a nationally representative sample.” Key word “considered” however, what was the population, was it statistically significant and how were the survey questions posed to participants? I am skeptical on how surveys and studies are employed, interpreted and distributed to the public.
Wn, I think you bring up a good points (thank you because the rest of these fools just ramble). Unfortunately, I don’t have the answers and have not read the study…so…I guess, we can just wait and see of those that did respond, as well as those not sampled comment on the findings.
wn, answers for your questions can be obtained by reviewing the article at – http://www.nejm.org/doi/full/10.1056/NEJMp1700144?query=featured_home.
took me about 20 seconds to locate it, I’m certain the methodology is described & is sufficiently robust to withstand peer review. otherwise such research doesn’t get published in the journal.
if you’ve attended grad school you’ll be familiar w/ these concepts.
Paragraphs 7 and 8 highlight the core issues. Essentially, without forcing healthy participation, the cost of providing coverage for sick consumers will quickly become unsustainable. Also, a very large majority of PCP’s disapprove of the so called “high deductible” plans, which have effectively eliminated insurance reimbursement for “normal” health costs.
My take on this article is that many doctors are against a repeal of the ACA without an effective alternative in place which addresses these significant issues.
I’ll replace “forcing” with “encouraging and obtaining”….
MrMusubi. Thank sharing the link. Interesting read however, I still question the veracity of the article and survey. By the way, one does not necessarily have to have attended (?) graduate school, nor does it guarantee grasping the nuances of the article. In my humble opinion, your reply seems to have a condescending tone, something that I’ve come across from some (not all) physicians who failed the course on “proper bedside manner”. Just saying… 🙂
Trumpf said” Plan? I don’t need no stinking plan. I just sign what PAUL is passing to me”.
Are these University of Hawaii employees getting paid by the State while they are protesting? Hopefully they took official personal vacation while protesting. If not
it appears that theft of government time may apply here.
According to the survey 75% of the physicians want changes to Obamadon’tcare, they disagree about how it will be change because now they are unsure about how changes will affect the way they practice, essentially the fear of the unknown. Liberal LA Times chose to take a part of the article to imply than MD’s support Obamadon’tcare, in reality, it has caused a number of MDs to retire prematurely and it favored primary care MDs over specialists, where there are terrible shortages. So it’s not terribly surprising that primary care MDs would be supporting this terrible plan by a failed administration, the Obama Administration.
I’m glad you read the news feed…LA Times…and commented on same. I believe you and many more are becoming aware of where the news feed originates can be of bias reporting. In addition questioning surveys (who did the survey [have they been cited for bias?], statistical significance [Confidence Interval]) and how survey questions worded..it may predispose a bias reply…just saying. 🙂
They had better have a real working plan before considering repealing Obama care. Don’t care for it but millions may have any coverage. Have had health care insurance since 1971 and as a federal retiree has the same coverage.
This is a survey representing 426 physicians. 1)Is this of statistical significance (sampling representative of targeted physician population) who by the way have themselves cover with appropriate medical coverage.
2) Perhaps a site to access and review the actual survey. Regardless, opinion noted. On the other hand, we the people (patients) have been saddled with increased premiums (personally 52% in 2016), ridiculous coverage requirements and if you don’t sign up there are penalties that will show up as a penalty when filing your taxes. I believe tweaking the has been brought up as an option. In my opinion, not the best option. Congress would end up bickering on what to tweak. Simply repeal and replace with a palatable plan that should have been passed initially. Just saying… 🙂
I hope these people are protesting on their lunch break..
My comment is awaiting comment.
@ lespark
Shame on you K_LLJOY.
lol
“OBAMACARE” IS THE WORST PIECE OF…….LEGISLATION ever in American history that TOOK 2 WHOLE YEARS and passed with ONLY DEMS VOTING FOR IT!
What do these people in fake white coats & students don’t understand?
The white coats and stethoscopes are used to separate themselves from the non-elites. Just saying. 🙂
The shorter the white coat, the more it has been drawn up into the nether parts of the anatomy.
With the intent of Probing hard, real Hard.
If the ACA was such a magnificent invention then premiums wouldn’t be skyrocketing.
And you wouldn’t have deductibles like 3-5K$, which by the way most people in Hawaii or California cannot afford. Odumbo-care is and will simply collapse on its own. At least the new WH will replace it with a new plan. In the last 8 years the repubs actually ,in the house put forth over 40 different plans,,,all blocked by Dictator Reid.
Trumpf doesn’t know how to work to.make people’s lives better. He’s been working all his life for the God $. That and his own bank account.
How do they even know what a new plan would encompass? Seems they may be a bit shortsighted.
Today episode: “Democrats scaring Democrats”.
Professors alone scare the living daylights out of me, but “Protesting Professors”? That really scares me!…..let me borrow Allie’s fav word “Scary”.Haaaaaaaaa!
Maybe the Professors at UH should have offered to pay us for the Extremely High Medical costs under The Un-ACA?
Repeal & Replace is about making it affordable for everyone. Under the Trump Admin and the Republicans…..No one will lose their benefits.
Don’t fall for this nonsense! Be Smart
Man all these years I thought professors were really smart…….guess not.
Title is so deceiving.
Did Obamacare improve medical care? Who enrolled? Remember the small numbers but the 100 of millions of dollars spent in Hawaii and people who were paid big bucks to set it up and left?
“The Plan you say?” I’ll let the repugs handle the finAL draft” It’s huge and great! It will be “simultaneously” release. Don’t complain after.
You want to see what government healthcare looks like, just look at the VA.
Too little, too late. They should have spoken up in support of the ACA all along. Instead, many doctors complained about it and blamed their increased costs on it. Don’t know what you’ve got till it’s gone.
LA Times really asked only Cali doctors
I don’t believe the survey. All, except for a few who are terrible in managing the business aspect of a practice, and doctors who are very young and recent graduates, doctors I know do not support the ACA. Furthermore, I would guess 99% have not read the entire law and don’t understand whats in it. The media only talks about the uninsured, staying on the parents insurance, and pre-existing conditions, all important, but the bill represents total Government control of healthcare. The inefficiencies of government alone is one reason why it should be repealed. The ACA should be 100% repealed. A new bill should be written in language everyone can understand. It can contain all the “good” aspects, if desired, but everything else eliminated. To this day I doubt you can find more than a few Congressman who have any clue as to what is in the bill. The media should investigate and list some of the details of the bill. The public would be shocked.