U.S. physicians' views on financing options to expand health insurance coverage: a national survey.
BACKGROUND
Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States.


OBJECTIVE
To assess physician views on financing options for expanding health care coverage and on access to health care.


METHODS
Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care.


METHODS
Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care.


RESULTS
1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance.


CONCLUSIONS
The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.
McCormick
Danny
D
Department of Medicine, Cambridge Hospital and Harvard Medical School, Cambridge, MA 02139, USA. danny_mccormick@hms.harvard.edu
Woolhandler
Steffie
S
Bose-Kolanu
Anjali
A
Germann
Antonio
A
Bor
David H
DH
Himmelstein
David U
DU
D001291:Attitude of Health Personnel; D003625:Data Collection; D005260:Female; D018166:Health Care Reform; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D009313:National Health Programs; D010820:Physicians; D011795:Surveys and Questionnaires; D014481:United States