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A study published this afternoon in the New England Journal of Medicine finds that the vast majority of physicians practicing in Massachusetts support the State's health reform law and they report it has had a positive or neutral impact on their medical practice.

The paper, conducted by researchers at Harvard,  and funded by the Robert Wood Johnson Foundation, presents the results of a recent poll of 2,135 Massachusetts physicians (primary care and specialists) regarding their perceptions of the comprehensive health reform law  that was enacted three years ago. The poll was conducted between August 11 and September 15, 2009 and has a sampling error of +/-1.9.

The poll assessed Massachusetts’s physicians’ perceptions in three areas:

  1. Their overall support for the State’s health reform legislation,
  1. Their views of the law’s impact on their own practice of medicine, and
  1. Their views of the law’s impact on health care across Massachusetts.

NEJM article at RWJF website

Massachusetts's health reforms have been very successful in reducing the number of uninsured in the state. Three years after enactment of the law, Massachusetts now has the lowest proportion of uninsured residents (2.6%) in the U.S.  This is extraordinary.

But what impact have these reforms had on practicing physicians in Massachusetts?

Three years into the implementation of the law, nearly twice as many physicians give high overall ratings (excellent/good) to the Massachusetts system for providing medical care compared to the national system (63% vs. 33%).

In addition, the poll found that 70% of practicing physicians support the Massachusetts Health Reform Law, while only 13% oppose it.  Support for the reforms did not vary among primary care doctors, specialists, and safety net physicians.  

When asked about the law’s future, 75% of practicing physicians wanted to continue the law – 46% with some changes and 29% as is.  Only 7% of physicians favored repealing the legislation and this did not vary among specialists or primary care doctors.

The poll also asked about the impact the reform law had (positive, neutral or negative) on 22 different areas of physician practice.  

For 21 of these 22 areas, a majority of physicians said that the law either “did not have much of an impact or was having a positive impact on their practice. “

Some examples of the practice areas where the majority of Massachusetts physicians said the law had a positive or neutral impact were:

  1. the quality of care their patients receive (85%)
  1. their medical practice overall (79%)
  1. decreasing the number of patients in their practice who were uninsured (77%)
  1. your patients’ continuity of care (75%)
  1. your uninsured patients’ ability to pay for care (69%)
  1. your ability to order diagnostic tests or procedures for your patients (68%)
  1. the amount of time their patients wait to get an appointment (62%)
  1. the financial situation of their practice as a whole (56%).  

The practice area that elicited the most negative response (35%) was the law’s administrative burden on their practice.

The author’s conclude:

This suggests that it is possible to provide near-universal coverage of the population and have a resulting system that physicians believe improves care for the uninsured without undermining their ability to provide care to their patients.

This study bodes very well for likely physician response to national health care reform.  Many of the reform bills in the US Congress share similar features to the Massachusetts law including offering expanded private coverage through an insurance exchange, expanding coverage for existing public programs, and including an individual mandate to buy coverage.  

What is most interesting about physician reactions in Massachusetts is the overall positive impact they perceive the law has had on their practices, not just in reducing the number of uninsured but also in increasing their ability to pay for care, and in improving the quality of care they deliver to their patients.

The results of this study, combined with the previous RWJ survey of physician support for national health care reform, suggest that physicians will benefit from comprehensive reforms that will improve access to and the quality of care delivered in the US health care system.

One of the concerns of physicians is that the law did not do enough to control costs.  With a public option, it would achieve all the desired goals.

Originally posted to Helenann on Wed Oct 21, 2009 at 02:01 PM PDT.

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Comment Preferences

    •  here's your tip (0+ / 0-)

      Always take wooden nickels, they're collectibles.

      As for the pro-insurance industry scam you're supporting or more likely astroturfing for, while I'm sure private doctors favor anything that will get them paid, the rest of us know that the MA ExtortionCare plan with no cost controls is a major reason why MA is in major financial trouble and insurance companies doing business in that state are making record profits.

      The main difference between the RomneyCare and a Federalized version is that the US government can print money to cover the ballooning deficit that'll result. This does not solve the problem, it simply delays the crash and makes it bigger.

      I have been hearing about your precious program and what it does for the taxpayers of MA. From angry involuntary customers.

      You get nothing for your tip jar and ... I'll be recommending the diary so I can push the button a second time to unrecommend it.

      Looking for intelligent energy policy alternatives? Try here.

      by alizard on Wed Oct 21, 2009 at 03:44:48 PM PDT

      [ Parent ]

      •  Your rage (0+ / 0-)

        is palpable.  I am reporting on a NEJM study that was published today.  Calm down.

        Health care is a human right.

        by Helenann on Wed Oct 21, 2009 at 11:51:56 PM PDT

        [ Parent ]

        •  of course it is (0+ / 0-)

          I see no reason to be calm about being the notion that I should be forced to buy junk health insurance along the lines of the MA model if that's what gets signed by Congress.

          Yes, this idea does enrage me.

          What's your excuse for being OK with it?

          And if you aren't OK with it, why are you posting information which can only reasonably be used to support that kind of legislation?

          Looking for intelligent energy policy alternatives? Try here.

          by alizard on Thu Oct 22, 2009 at 12:47:50 AM PDT

          [ Parent ]

  •  Isnt the MA system a lot like (8+ / 0-)

    the Baucus plan though? Mandate to buy insurance, subsides for those who cant, and fines for those who dont? Or am I wrong about that?

    •  It is alot like Baucus (2+ / 0-)
      Recommended by:
      DBunn, papicek

      But there is a play or pay component for employers that the Baucus plan doesn't have, although the fees for employers who don't offer coverage aren't very high in MA.  But, yes, it is a lot like the Baucus bill.

      Health care is a human right.

      by Helenann on Wed Oct 21, 2009 at 02:16:26 PM PDT

      [ Parent ]

    •  The major concern is that it doesn't control cost (6+ / 0-)

      Most of the physicians who like the reform were concerned that it didn't control cost.  The public option in the House and Senate HELP bills, if added to the MA or Baucus bill, would help to accomplish the cost controls that are sorely needed.

      Health care is a human right.

      by Helenann on Wed Oct 21, 2009 at 02:18:20 PM PDT

      [ Parent ]

    •  ...and no "public option." (9+ / 0-)

      Result: insurance costs are the highest in the nation, three years after the law was passed.

      •  Exactly - it needs a public option (2+ / 0-)
        Recommended by:
        grrr, papicek

        But the good news is that it covered 97.4% of the population and made coverage affordable and had a positive or neutral impact on the practice of medicine with many feeling it had improved the quality of care.

        So I agree 100%.  With a public option - it could be close to perfect.

        Health care is a human right.

        by Helenann on Wed Oct 21, 2009 at 02:20:25 PM PDT

        [ Parent ]

        •  Far too simplistic (4+ / 0-)

          "Now, the Commonwealth Fund report projects that without significant cost reforms, an annual family premium in Massachusetts will soar to $26,730 by 2020."

          And we're not even touching on how many of that 97.4% has "junk" insurance.

          It's not "close to perfect" -- even if they fix the many things wrong w/ Mass. reform it becomes a big trade off. As it is, it is nothing but a big, fat wet-kiss to private insurers.

          •  Far too cynical (2+ / 0-)
            Recommended by:
            DBunn, Massconfusion

            It has insured 97.4% of the residents, it has lowered their costs, it has reduced the number of uninsured patients doctors see, it has made care more affordable for patients, it has enabled doctors to order the tests and procedures they deem necessary, it has reduced uncompensated care.

            It is a HUGE step forward.

            I am the biggest public option proponent there is.

            And Massachusetts at the moment is not perfect.

            But let's not let the perfect be the enemy of the good.

            This is a good reform, that has accomplished alot.  And docs like it.

            What they want is more cost control and a public option would do that.  It would also help reduce the administrative burden, which has increased under this reform.

            Health care is a human right.

            by Helenann on Wed Oct 21, 2009 at 02:28:10 PM PDT

            [ Parent ]

            •  What part of "highest insurance costs in the (1+ / 0-)
              Recommended by:

              nation" aren't you getting here?

              There's no need to try to defend Massachusetts' half-assed version of reform in order to convince people that HCR is a good idea. It would be highly unfortunate if Mass. becomes the model for the nation, and that's pretty much what the Baucus plan would leave us with.

              •  What part of "I support the public option" do you (0+ / 0-)

                not understand?

                Massachusetts gets us part of the way there.  A public option will help get us where we want to go - competition with private insurance and lower costs.

                Health care is a human right.

                by Helenann on Wed Oct 21, 2009 at 02:47:24 PM PDT

                [ Parent ]

              •  It also has one of the highest percentage of (0+ / 0-)

                Teaching Hospitals whose costs are notoriously higher. A recent Boston Globe expose has doctors performing procedurers at teaching hospitals like Mass general so they can make more money.

                Thay being said I have said that reform will look a lot like what we have here. The penelaties for non conforming employers need to be higher. Masss has always had a public option for low income people in the form of Free Care. It is subsidized by everyone else and that is another reason for the cost of care being what it is. In addition the demographic has been shifting here to older trained professionals and older populations and the more highly educated use medical services more often.

    •  that's pretty much it...n/t (1+ / 0-)
      Recommended by:

      Too many books, too little time. . . .

      by papicek on Wed Oct 21, 2009 at 02:39:20 PM PDT

      [ Parent ]

  •  The Massachusetts Experience (0+ / 0-)

    Helenann, your comments help to clarify the value of the information in this poll.  Every aspect of the Massachusetts success helps predict the success or problems that will be encountered in a new health care reform plan.  One of the top problems right now is the flurry of information, half truths and opinions.  It seems positive results are viewed more negatively by many than is justified.  Keep up the fight for health care for all.

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