Malter A D, Emerson L L, Krieger J W
Department of Medicine, University of Washington School of Medicine, Seattle.
West J Med. 1994 Jul;161(1):29-33.
Attitudes of Washington State physicians about health care reform and about specific elements of managed competition and single-payer proposals were evaluated. Opinions about President Clinton's reform plan were also assessed. Washington physicians (n = 1,000) were surveyed from October to November 1993, and responses were collected through January 1994; responses were anonymous. The response rate was 80%. Practice characteristics of respondents did not differ from other physicians in the state. Of physicians responding, 80% favored substantial change in the current system, 43% favored managed competition, and 40% preferred a single-payer system. Of physicians responding, 64% thought President Clinton's proposal would not adequately address current problems. Reduced administrative burden, a central element of single-payer plans, was identified by 89% of respondents as likely to improve the current system. Other elements of reform plans enjoyed less support. More procedure-oriented specialists than primary care physicians favored leaving the current system unchanged (28% versus 8%, P < .001). While physicians favor health care reform, there is no consensus on any single plan. It seems unlikely that physicians will be able to speak with a single voice during the current debates on health care reform.
对华盛顿州医生关于医疗保健改革以及管理式竞争和单一支付者提案具体内容的态度进行了评估。同时也评估了他们对克林顿总统改革计划的看法。1993年10月至11月对1000名华盛顿州医生进行了调查，1994年1月前收集了回复；回复是匿名的。回复率为80%。受访者的执业特征与该州其他医生并无差异。在做出回复的医生中，80%赞成对当前体系进行重大变革，43%赞成管理式竞争，40%倾向于单一支付者体系。在做出回复的医生中，64%认为克林顿总统的提案无法充分解决当前问题。单一支付者计划的核心要素——减轻行政负担，89%的受访者认为这可能会改善当前体系。改革计划的其他要素得到的支持较少。比起初级保健医生，更多以手术为主的专科医生赞成维持当前体系不变（28%对8%，P<.001）。虽然医生们赞成医疗保健改革，但对于任何单一计划都没有达成共识。在当前关于医疗保健改革的辩论中，医生们似乎不太可能异口同声。
