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HomeWeekly RoundupUS doctors overwhelmingly opposed to repealing Obamacare

US doctors overwhelmingly opposed to repealing Obamacare

A survey of doctors shows overwhelming opposition to the effort by President Donald Trump and the Republican Congress to repeal the Affordable Care Act (ACA), also known as Obamacare.

Reuters Health reports that the results show only 15% of 426 primary care physicians favour total repeal. Even among doctors who said they voted for Trump, only 38% said they wanted the Act eliminated in its entirety.

The report says Trump has promised to replace Obamacare with something better. Neither he nor Congress have released specifics. That might garner support from the physicians surveyed, depending on the provisions of a new plan; 74% favoured making improvements to Obamacare. But some improvements they want may not be popular with opponents of the law.

For example, more than 66% of the respondents said the government should create a public option similar to Medicare to compete with private insurance. Many opponents want the government out of the healthcare business altogether.

More than half (59%) of the physicians surveyed supported tax credits that would allow the purchase of private insurance by people eligible for Medicaid, the federally-financed but state-run health insurance programme for the poor. Nearly 69% favoured increasing the use of health savings accounts.

In contrast, only 29% supported increasing the use of high-deductible health plans, a proposal being floated around to keep down government costs, and fewer than half of the physicians (43%) said Medicare should be expanded to cover people aged 55 to 64. Some Republican proposals have called for deregulating the private insurance industry, a move that would allow companies to sell health plans across state lines. Only 42% of physicians supported that idea.

The primary care physicians were almost evenly split on the idea of requiring all states to expand Medicaid under the auspices of Obamacare, a controversial concept. Many states with Republican governors have refused to do so.

But, the report says, the provisions of the law that are most popular with the public are very popular with the first-line physicians as well. Just over 95% said it was somewhat or very important to prohibit insurance companies from denying coverage or charging more for people with pre-existing conditions, which companies were allowed to do before Obamacare.

Support levels among the physicians were nearly 88% for allowing children up to age 26 to be covered on their parents' insurance plan, 91% for providing tax credits to small businesses and 73 percent for expanding Medicaid for the poor.

"I do think it's striking that even among doctors who said they voted for Donald Trump for president, only about a third – 38% – supported repealing the ACA in its entirety," study co-author Dr Craig Pollack, an associate professor of general internal medicine at Johns Hopkins School of Medicine in Baltimore, is quoted in the report as saying. Only 32% of doctors who said they were Republicans favored complete repeal. The rate among Democrats was zero.

The survey was done by mail in December and January. The response rate was 45%. It focused on primary care physicians, a group that includes family practitioners, paediatricians and internal medicine specialists because "they're on the front line trying to advocate for their patients," Pollack said in the report.

In contrast, a survey done by The Kaiser Family Foundation and the Commonwealth Fund during the first quarter of 2015, a year and a half after the botched rollout of the Obamacare enrolment website, found that 52% of primary care physicians had an unfavourable view of the law while 48% viewed Obamacare favourably.

The report says political debate over the subject of physician support has been the subject of a lot of hype. For example, in 2012, Republican lawmakers were claiming that 83% of doctors were considering leaving the profession because of Obamacare. That claim was based on a survey by a group founded to oppose the law.

The report says that PolitiFact, the fact-checking website, ruled the claim false because the survey never directly asked doctors if Obamacare had sparked thoughts of quitting medicine.

[link url="http://www.reuters.com/article/us-health-obamacare-doctor-survey-idUSKBN15A2HJ"]Reuters Health report[/link]
[link url="http://www.nejm.org/doi/full/10.1056/NEJMp1700144"]New England Journal of Medicine perspective[/link]

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