February 21, 2018
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Doctors’ Orders

A common theme during this year’s health care reform debate has been that government shouldn’t come between doctors and patients. Implicit in this is the idea that doctors know what is best for patients. So, shouldn’t the fact that doctors strongly support the inclusion of a public option in health care reform be taken seriously?

A poll published in the current issue of the respected New England Journal of Medicine found that doctors preferred a mix of public and private options over a strictly private or public system. The survey, conducted this summer, found that 63 percent of physicians supported a combination of public and private options to expand health care coverage. Twenty-seven percent supported only private options and 10 percent supported only public options, according to the survey conducted by Salomeh Keyhani and Alex Federman, both of whom work at the Mount Sinai School of Medicine in New York. Dr. Keyhani also works for a Veterans Administration medical center in the Bronx.

“Support for the public option is consistent across physician specialties, practice settings and regions of the country and therefore should be carefully considered by lawmakers as they finalize legislation to reform health care and provide coverage for 47 million uninsured Americans,” the doctors wrote.

The Senate Finance Committee is expected to present its bill today. Its legislation is expected to be the template for further health care reform debate and negotiations in Congress. It is not expected to include a public option, even with a trigger mechanism long supported by Sen. Olympia Snowe.

Sen. Snowe, while saying that the president should take a public option “off the table,” offered a middle ground: a public option that would be triggered only if insurance companies didn’t offer affordable coverage.

Several senators, including both Republicans and Democrats, have said that a bill with a public option, with or without a trigger, cannot pass that chamber. A public option is included in the House bills.

Sen. Susan Collins said she opposes a trigger because it just delays a public option. She wants legislation to focus on reducing costs first.

Physicians deal daily with insurance companies. If any group understands that the current system is not working, it is doctors. Doctors report making phone calls to appeal insurance company denials of treatment that will help their patients. They report trying to find programs that will cover the high costs of some treatments.

So, when it comes to fixing the system, their endorsement of a public option should be valued, not ignored.

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