Would Doctors Still Make A Lot Of Money Under Universal Healthcare

Why Do So Many Doctors Oppose Single-Payer Health Care?

Jan 26

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Doctor opposition to unmarried-payer wellness care in California may seem counterintuitive — but information technology's nothing new. Dr. Micah Johnson, author of 'Medicare for All: A Citizen'south Guide,' says doctors have been 'double agents' in the debate, and are about concerned with changes to their pay and autonomy.  (Getty Images)

Legislation that would help create a single-payer wellness care arrangement in California, the first of its kind in the nation, faces a crucial test in the side by side week. The nib — AB 1400 — must pass the full Assembly past Jan. 31, or information technology's dead.

The California Nurses Association, the state's nurses spousal relationship, is leading the endeavour to pass AB 1400. Merely the state's largest association of doctors, the California Medical Association, opposes the bill.

"It will disrupt people's health care at the worst possible time," said Ned Wigglesworth, a spokesperson for Protect California Wellness Care, a coalition formed to oppose AB 1400. The coalition includes the California Medical Association equally a member.

"Information technology will force all twoscore meg Californians into a new untested state government program and will prohibit them from being able to choose private coverage fifty-fifty if they want it," he said.

In nearly all previous attempts to create a single-payer health organisation in the U.s., the fiercest objections have come from doctors, said Dr. Micah Johnson, co-author of the book "Medicare for All: A Citizen's Guide" and a practicing internal medicine dr. in Boston.

Doctor opposition to unmarried-payer may seem counterintuitive — merely Johnson said doctors cannot help but view health reform through the lens of what's best for them as well as what's best for their patients. To the extent they're most concerned with changes to their own pay and autonomy, Johnson called doctors "double agents in the health reform argue for the terminal century."

Johnson spoke with KQED's April Dembosky about the history of doctor opposition to single-payer.

The post-obit interview has been edited for length and clarity.

Apr Dembosky: In your book, you phone call doctors the "perennial opponents of health reform." What events led you to draw that determination?

Dr. Micah Johnson: Doctors have had a century-long history in the health reform debate, ordinarily as the opponents. That started dorsum in the 1910s during the progressive era of reforms. This is after Federal republic of germany, in 1883, had passed health insurance. In 1911, U.k. had passed health insurance. It seemed clear that the U.S. would be following suit. And initially, it looked like doctors and the American Medical Clan were going to be supporters of the bill. Just as the discussions unfolded, doctors turned.

What were their concerns?

The superlative i is really their own pay. And the second ane is their autonomy in the practise of medicine. Going back to the 1910s and also in the 1940s, there'due south this fright that if in that location is a universal public insurance plan, doctors are going to get paid less.

The most hitting case is Harry Truman's wellness intendance proposal in the 1940s. This is the first and really but time a sitting U.S. president gave a full-throated endorsement of a single-payer-way, truly universal national wellness insurance plan.

The American Medical Association were the elevation opponents of the plan. They hired a PR house chosen Campaigns Inc. that rose to fame in California, helping to defeat a statewide universal health insurance plan. The American Medical Association put an incredible corporeality of money behind this at the fourth dimension: $3.5 million. In today's dollars, that's about $twoscore million. It was the largest lobbying entrada the nation had ever seen — and it worked.

So at the beginning, the public was in support of this national health insurance plan. But then support dwindled over the years — and the vast majority of people had heard of the AMA's opposition to the program.

When I talk to doctors who are opposed to the single-payer proposals correct at present, they say their top concerns are their patients.

I think doctors have been double agents in the wellness reform debate for the terminal century.

Nosotros wear 2 hats in these conversations. We wear the chapeau of medical experts, people who know a lot nearly what's best for patients, and we too wear a hat that's just our own personal financial interest. I recall these things can often get confused and, you know, can be leveraged against each other.

In the early on '60s, there was an early attempt to create a Medicare program for seniors, and back and so, doctors hired player Ronald Reagan to speak out confronting the thought. He said, "One of the traditional methods of imposing land-ism or socialism on a people, has been past manner of medicine. Information technology's very easy to disguise a medical programme as a humanitarian project."

Definitely a remarkable moment in the history of health reform, and even though Medicare passed, Ronald Reagan was likewise elected in a landslide in 1980 and concluded up presiding over the Medicare programme. So we have all these ironies in wellness reform.

How has doctors' thinking evolved from the early 20th century to the Medicare days, to at present?

I think we're really seeing an development.

Showtime, in seeing doctors back up the Affordable Care Act in 2008, 2009. And then over the last 10 years, we've seen a lot of very interesting developments.

For i, a majority of doctors in most polls now support single-payer health care. Secondly, we've seen at the American Medical Association that there's some internal debate about what the opinion is going to be. In recent years, at one of the AMA'due south big meetings, it was really the medical student chapter that brought upward a resolution to effort to remove the AMA's opposition to single-payer health care — and information technology very narrowly failed.

Information technology got 47% back up. So the AMA still opposes single-payer, but we can see signs that things are changing.

Source: https://www.kqed.org/news/11902591/why-do-so-many-doctors-oppose-single-payer-health-care

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