Poll finds Mass. doctors support health care overhaul law
Amid contentious congressional debate about health care, a new poll indicates that physicians on the front lines in Massachusetts overwhelmingly support the state’s closely watched 2006 overhaul, which is considered a national model.
Doctors supported the law by a 5-to-1 margin, and three-quarters of the 2,135 physicians surveyed said they wanted the law to continue. But nearly half said there should be changes, most notably to ensure more comprehensive coverage for their patients and to control costs.
The poll, by Harvard School of Public Health, Robert Wood Johnson Foundation, and Blue Cross and Blue Shield of Massachusetts Foundation, found just 7 percent favor repealing the law. The survey was published online yesterday by The New England Journal of Medicine.
Physicians were asked about 22 aspects of their practices that might have been affected by the law, from the quality of patient care to the amount of time patients wait to get an appointment, and a majority said the law either was not having much of an effect or was having a positive effect on their practice. However, a third said the law has increased their administrative burdens.
“The real question outside Massachusetts has been: are patients going to suffer if reform is passed?,’’ said Robert J. Blendon, health policy professor at the Harvard School of Public Health and the poll’s codirector.
“If you had a national law like the one in Massachusetts,’’ he said, “you would not expect that care for patients would be deteriorating as a result of the law.’’
When physicians were asked to assess the impact of the law on care in the state as a whole, more negative aspects emerged, particularly involving costs. Fifty-three percent said the law hurt the overall cost of care, and about a third said it had a negative effect on costs borne by patients.
The physicians were randomly selected and invited by mail to participate in the poll. It was conducted Aug. 11 to Sept. 15 and has a margin of error of plus or minus 1.9 percentage points.
Physicians interviewed yesterday said the poll’s findings basically jibed with their own experiences. But they also said the poll failed to capture a larger issue: the reason so many physicians indicated that the 2006 law had not had much of an effect on their practices is because many of them, particularly primary care doctors, are swamped and have been unable to accept new patients, the doctors said.
“There aren’t enough primary care doctors to meet the needs of all of our newly insured residents,’’ said Dr. Dennis Dimitri, president of the Massachusetts Academy of Family Physicians and a Worcester doctor who is not taking new patients.
The primary care shortage is worsening. A survey by the state’s medical society last month found 40 percent of family physicians were no longer accepting new patients, up from 30 percent in 2007. It also found long waiting times for new patients continues to be a problem.
In a separate article also published yesterday, Dr. JudyAnn Bigby, the state’s health and human services secretary, and Joel Weissman, one of her policy advisers, wrote that the 2006 law achieved near-universal coverage and that was the right first step, but “now, tackling costs has risen to the top of the agenda.’’
They said about half of the 400,000 newly insured have coverage subsidized by taxpayers, and that the law requiring most employers to offer coverage and most residents to buy insurance has provided “good value for Massachusetts taxpayers, costing about $1,060 in new state spending per newly covered state resident.’’ Much of the funding for the state’s landmark law comes from the federal government.
