All-member survey demonstrates need for system change
by Benjamin Kupersmit
Featured in the November/December 2016 Colorado Medicine.
When Kupersmit Research conducted the Amendment 69 survey for the Colorado Medical Society in late August/early September, the vote among CMS member physicians showed 78% in opposition and 16% in support, with 6% unsure.
This survey was administered online by the Colorado Medical Society. The survey was in the field from Aug. 6-Sept. 2. A total of 795 Colorado Medical Society members (including 40 medical students) responded to the survey, for a margin of error of +3.5% at the 95% confidence level.
- Among the 78% of members voting no, 51% are opposed to single payer health care as a concept, while 40% of those voting no are open to the idea of single payer but oppose Amendment 69 specifically (while 9% say “neither” or “unsure”).
As per Table 1, satisfaction is very low with many aspects of the current health care delivery system. However, expectations were that Amendment 69 would make things worse almost across the board.
If Amendment 69 failed at the ballot box (which it did, with 79% of Coloradans rejecting the Amendment), 62% wanted to see CMS aggressively pursue incremental reforms to the current system, while 27% wanted to see CMS pursue sweeping health system reform.
Members’ top priorities for reform are:
- Addressing concerns about abusive commercial payer practices in contracting, authorizing and reimbursing for services, and
- Ensuring government payers provide predictable, adequate reimbursement while minimizing requirements (such as reporting and or technology) that require further time or investment by providers.
Looking to the future, a plurality (40%) want CMS to work to improve the Affordable Care Act, while 33% want to see a full repeal of the ACA and 15% want to see a single payer system.
The survey showed solid opposition to Amendment 69, driven by two core factors: The 31% of members who oppose single payer as a concept, not surprisingly, rejected the proposal on its face. The remainder – members who are open to or undecided on the issue of single payer as a concept – had deep, specific concerns about Amendment 69 that led a solid majority to conclude they should vote “no.”
At the same time, the message from this survey could not be more clear. Physicians want the Colorado Medical Society to continue fighting to improve the current system, regardless of the outcome for the Amendment. Bear in mind, there is very little appetite for major reform and a rehashing of 2008. Furthermore, a solid majority of members (including some who want full repeal of the ACA) reject allowing insurance companies to price coverage based on health condition.
Given this reality, CMS’ path forward is clear: Continue to pursue incremental reform to improve the ACA and make sure it works for patients and physicians in Colorado. Members want regulation and oversight that ensures commercial payers treat physicians and their patients with the highest level of respect by eliminating the hassles that interfere in care every day.
They also want ongoing advocacy among government payers and regulators, so that administrative and reporting requirements, technology and EHR systems, medical liability laws, and other aspects of the broader health care landscape are supporting, rather than impeding, the ability of physicians to care for their patients.
Amendment 69’s failure at the ballot box does not mean Colorado’s physicians are happy with the status quo. The survey demonstrates they feel tremendous frustration with the current health care system, just as their patients do, and that CMS should continue pushing for specific ideas and proposals to improve the health care delivery system in the months and years to come.