45% of Doctors Would Quit Under ObamaCare

A new Investor’s Business Daily poll contends that nearly half the nation’s doctors would “Consider leaving [their] practice or taking an early retirement” if “Congress passes its health care plan.”

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost.

physician survey

I consider these numbers about as valid as those in the recent commuting pain survey claiming most people would pay $20 per 15 minutes saved on their commute. In reality, few of the doctors that are truly outraged at the proposed changes can either afford to give up their practices or would rather be doing something else. Further, this is a mail survey, so the results are particularly skewed because it’s essentially a self-selected sample.

My guess is that the 2/3 who oppose “the” plan is about right, despite the fact that there isn’t yet a single plan to oppose.  Moreover, I’m actually surprised that they found 25%  who believed “government can cover 47 million more people and it will cost less money and the quality of care will be better.”  Granted, it’s a ridiculously written triple-barreled question with no research validity whatsoever.   But anyone who’s not only schooled in how medical care works but did well enough in advanced math to get into medical school should know better.

FILED UNDER: Health Care, Public Opinion Polls, US Politics, ,
James Joyner
About James Joyner
James Joyner is a Security Studies professor at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Steve says:

    Kind of hard to take IBD seriously ever since they said the NHS would have killed Stephen Hawking if he was British?

  2. Marty says:

    Investors Business Daily?!?!? Gee, like they wouldn’t be biased, now would they?
    Read through the Robert Wood Johnson Foundation’s September 2009 Survey numbers:
    http://www.rwjf.org/files/research/48408physician.pdf

    They clearly document their methodology, and it’s quite sound. Nearly three quarters of physicians surveyed favor a public option – 10% favor only a public option.

  3. Dave Schuler says:

    Statistically, the AMA membership tends to run to run to specialists while internists tend not be members. That might account for a discrepancy between the AMA’s position and the position of significant numbers of physicians.

  4. Brett says:

    Further, this is a mail survey, so the results are particularly skewed because it’s essentially a self-selected sample.

    Big time. I’d argue it would only be more skewed if this were an Internet poll.

  5. So… wait… I guess I am behind the curve on conservative talking points. Last week, I was supposed to oppose the “plan” because it wouldn’t bend the cost curve enough to make a difference. This week, I am supposed to oppose it because the “lower pay” and “increased mandates” would force doctors to quit. But if the cost curve won’t be affected, why would doctors receive lower pay, and if they are required to do more work for the same pay shouldn’t it have some effect on the cost curve?

    It was all easier when I knew to oppose it because Obama wanted to kill my Grandma.

  6. Crust says:

    It’s worth noting that some doctors oppose this plan because they think it doesn’t go far enough. According to an NPR poll, fully 73% of doctors want to see either a public option or single payer.

  7. anjin-san says:

    Look, its a well known fact that 12% of doctors have decided to become hatchet murderers if the health care plan passes. The MSM is covering it up.

  8. James Joyner says:

    So… wait… I guess I am behind the curve on conservative talking points. Last week, I was supposed to oppose the “plan” because it wouldn’t bend the cost curve enough to make a difference. This week, I am supposed to oppose it because the “lower pay” and “increased mandates” would force doctors to quit. But if the cost curve won’t be affected, why would doctors receive lower pay, and if they are required to do more work for the same pay shouldn’t it have some effect on the cost curve?

    There’s a lot of FUD surrounding this issue since we’re debating a combination of politician’s fantasies about single payer and several draft pieces of legislation floating around. There isn’t a single bill.

    As for me, I’m posting this because it’s going around the blogs and I wanted to point out that 1) the methodology is complete BS but that 2) no bill is going to simultaneously do three contradictory things. You know: Faster, Better, Cheaper – Pick Two.

  9. Crust says:

    James Joyner:

    [N]o bill is going to simultaneously do three contradictory things. You know: Faster, Better, Cheaper – Pick Two.

    Can I pick Better and Cheaper? International comparisons suggest it’s possible. Unequivocally, the US has by far the most expensive system (measured either per capita or as a percentage of GDP); we pay around 2.5X what Japan or the UK pay per capita. On outcomes there’s more room for debate, but by most measures the US is middling at best among major countries; e.g. in terms of Potential Years of Life Lost for women we are third last in the OECD, ahead of only Mexico and Hungary.

  10. Rick Almeida says:

    James, sometimes it’s easy to forget about your academic background. From the linked article, emphasis mine:

    The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors’ positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.

    So, how many responses have they received? Doesn’t say. Mail survey? Awesome. I won’t snark about IBD, commenter Steve did that ably, but some of your recent posts really seem to be accepting blithely information that’s highly suspect on its face.

  11. hcantrall says:

    It’s amazing how differently these “outcomes” are reported depending on the person or opinion that is being either supported or dismissed.
    I’m thrilled though that there is yet another blog post that will get 100 comments of rehashed bs that no one agrees on.

  12. James Joyner says:

    Unequivocally, the US has by far the most expensive system (measured either per capita or as a percentage of GDP); we pay around 2.5X what Japan or the UK pay per capita. On outcomes there’s more room for debate, but by most measures the US is middling at best among major countries; e.g. in terms of Potential Years of Life Lost for women we are third last in the OECD, ahead of only Mexico and Hungary.

    International comparisons are incredibly difficult, as there are different reporting systems and varying levels of honesty in data collection. This particular comparison is complicated by violence, accidents, geographical dispersion, and other factors unrelated to “health care.”

    My guess, though, is that some sort of single payer system — not really on the table — or even universal insurance system would at least slightly improve the aggregate outcome, although I don’t think we’ll lower costs. Many of us will pay decidedly more in taxes with no return, however.

  13. Crust says:

    James, international comparisons of outcomes are difficult as you say (I’m not sure about your “honesty” point, but I’ll leave that to the side).

    But international comparisons of cost are easy. We pay way more per capita than other nations; that’s just indisputable. So if the US were to adopt a single payer system (not on the table as you say), why wouldn’t we expect to get some savings? What about if we adopted a robust public option? You’ve argued before that you oppose a robust public option because you fear it would outcompete insurance companies in some markets and put downwards pressure on doctors’ salaries. Now maybe that would have some bad impacts on quality of care (e.g. longer waiting lines) along with some good impacts, but how would that not save money?

  14. James Joyner says:

    Mail survey? Awesome. I won’t snark about IBD, commenter Steve did that ably, but some of your recent posts really seem to be accepting blithely information that’s highly suspect on its face.

    Dude, my post is only three paragraphs. Here’s the second paragraph:

    I consider these numbers about as valid as those in the recent commuting pain survey claiming most people would pay $20 per 15 minutes saved on their commute. In reality, few of the doctors that are truly outraged at the proposed changes can either afford to give up their practices or would rather be doing something else. Further, this is a mail survey, so the results are particularly skewed because it’s essentially a self-selected sample.

  15. Herb says:

    Paging Dr. Galt…paging Dr. Galt.

    Your skepticism about the integrity of this survey is warranted. You should throw up a question mark in the headline to highlight it, because ya know, it really needs one.

    But…assuming it’s somewhat accurate (and I don’t think it is…at all), isn’t this a great argument for reform? Obama just needs to start talking about hope and yes we can and “now we can build a new healthcare system from the ground up, with doctors who care about your health and your family’s health instead of their timeshares and luxury sportscars.” He’s not above playing the class card. That’s part of his appeal.

  16. Rick Almeida says:

    And from the third:

    My guess is that the 2/3 who oppose “the” plan is about right…

    You claim to agree with the results you assert are invalid. I think that’s legitimately a little confusing.

  17. James Joyner says:

    You claim to agree with the results you assert are invalid. I think that’s legitimately a little confusing.

    I think the survey methodology is useless — “it’s a ridiculously written triple-barreled question with no research validity whatsoever.” I merely offer conjecture that 2/3 of docs opposing is probably a good ballpark and that I don’t see how anybody could think that a plan would simultaneously do three contradictory things simultaneously.

    Thus, I use a bad poll that’s currently under discussion elsewhere as a vehicle to make points but I don’t rely on the questionable findings themselves to make those points.

  18. anjin-san says:

    Your skepticism about the integrity of this survey is warranted. You should throw up a question mark in the headline to highlight it, because ya know, it really needs one.

    Quite right. James has developed a bad habit of publishing headlines with a disclaimer somewhere in the copy saying “by the way, this is BS” Why grant the BS a level of attention that it does not merit?

  19. Dave Schuler says:

    So if the US were to adopt a single payer system (not on the table as you say), why wouldn’t we expect to get some savings?

    That’s post hoc propter hoc reasoning. Unless single payer is accompanied by cost cutting, once the the savings that could be realized through lower administrative costs (no more than about 15% IMO) cost increases would more than absorb the savings within about three years.

    I’ve been in favor of single payer for thirty years but only as part of a system of comprehensive systemic reforms in healthcare. Anything else would be a license to print money.

  20. Steve says:
  21. Brett says:

    Many of us will pay decidedly more in taxes with no return, however.

    You’d get financial security, and knowledge that if you ever suffer a crippling loss, you and your family won’t end up totally screwed and bankrupt from medical costs.

    That’s post hoc propter hoc reasoning. Unless single payer is accompanied by cost cutting, once the the savings that could be realized through lower administrative costs (no more than about 15% IMO) cost increases would more than absorb the savings within about three years.

    That’s more or less the assumption, Dave – that a single-payer system (like the Canadian and French systems) would be able to exert downward pressure on compensation rates for the supply side. It’s not like they’d just take the current compensation rates and simply pay whatever the doctors ask for in the future.

    In the long run, that would probably decrease the incentive to be a doctor and/or medical provider, although you’d have a greater volume of potential patients to choose from, and some degree of financial security (i.e., you don’t have to go chasing after deadbeats whether in terms of dilatory insurance payers or dilatory patient payers).

  22. Dave Schuler says:

    That’s more or less the assumption, Dave – that a single-payer system (like the Canadian and French systems) would be able to exert downward pressure on compensation rates for the supply side. It’s not like they’d just take the current compensation rates and simply pay whatever the doctors ask for in the future.

    I’m skeptical of the assumption. Indeed, I think that the French system is possible in France because of a consensus that allows government to control costs not the other way around.

    We manifestly don’t have such a consensus here. If we did Medicare costs wouldn’t be growing at the rate they are now.

  23. Jonathan says:

    Actually, 73% of doctors support the public option:

    http://www.reuters.com/article/topNews/idUSTRE58F3VJ20090916

    Let’s see, New England Journal of Medicine or IBD, which one am I going to believe?

  24. TangoMan says:

    Crust,

    But international comparisons of cost are easy. We pay way more per capita than other nations; that’s just indisputable. So if the US were to adopt a single payer system (not on the table as you say), why wouldn’t we expect to get some savings?

    You’re correct on this fact but your conclusion, I believe, is based on a false understanding of the processes at work.

    Medical care is what economists call a superior good. A superior good is a good that people are willing to spend more money on as their income increases. The US is one of the wealthiest nations in the world and so we should expect that we’d be devoting a greater share of our disposable income towards medical care. Similarly, housing is also a superior good. We’re a richer country today than we were in 1960. Take a look at the mean square footage of single detached homes over the years. As our national wealth has increased so too has the mean size of our homes. We take our “excess” income and spend it on superior goods.

    We’re richer than France, so it’s not a surprise that our homes are larger and that we spend more on medical care.

  25. TangoMan says:

    Take a look at this chart comparing international rates of growth in medical spending. You’ll see that nations with rapidly increasing economies are experiencing medical spending growth rates in excess of the US.

    Korea’s medical spending is growing at a 9.6% annual rate. The US medical spending is growing at 5.8%.

  26. Another Matt says:

    But anyone who’s not only schooled in how medical care works but did well enough in advanced math to get into medical school should know better.

    Having tutored pre-meds in physics, I’m not too impressed with the level of math they understood. Thankfully, my doctor doesn’t have to solve a second order equation to perform a differential diagnosis on me.

  27. anjin-san says:

    We’re richer than France, so it’s not a surprise that our homes are larger and that we spend more on medical care.

    Yep. Except the French, on the whole, live much better than we do. Eating fast food in a Mac Mansion in some crap suburb is not my idea of being #1.

  28. TangoMan says:

    Yep. Except the French, on the whole, live much better than we do. Eating fast food in a Mac Mansion in some crap suburb is not my idea of being #1.

    What’s stopping you from living like a Frenchman?

    “Americans, on average, spend 9.3 percent of their income on food, the lowest percentage in the world. India spends 53.1 percent, Venezuela spends 34.3 percent, Italy spends 25.7 percent, Japan spends 19.1 percent, France spends 16.3 percent and the United Kingdom spends 11.5 percent.”

    Sell your house, buy a small shack, and spend your savings on better quality food.