Most Minnesota doctors like single-payer health care, academic study finds


The Minnesota Health Plan would move health insurance out of the private sector and create a system where one payer — Minnesota — would cover everyone in the state based on his or her ability to pay. The bill, authored by Sen. John Marty, DFL-Roseville, is an example of a single-payer health care system and it has the support of a majority of physicians in Minnesota, according to the latest survey.

For more on Minnesota health care legislation, see Minnesota Health Plan draws citizen support, passes committee by Andy Birkey, Minnesota Monitor.

Dr. Dick Adair, a 65-year-old physician, said that the current system is not only having an impact on patients, but also on physicians. “The financial burden of caring for uninsured people is driving some doctors out of primary care and into better-paying specialties, at a time when we need more primary care doctors,” he said.

In his years as a physician, he has seen a sharp change in how physicians look at health care. “Having lunch with other doctors used to mean listening to conservatives griping about the government. Now lunchroom talk is that single-payer would be a good idea,” said Adair.

A recent survey through the University of Minnesota and St. Olaf College found that 64 percent of Minnesota’s physicians support a single-payer system much like the Minnesota Health Plan. Another 25 percent said that health savings accounts were the way to go, and only 12 percent thought that the current system of managed care was adequate.

“I personally feel very angry and frustrated when I know my patients are not getting the care that they deserve,” said Dr. Elizabeth Frost, a supporter of the Minnesota Health Plan. “I hate saying to people, ‘you need this test or this study,’ all the while knowing they don’t have insurance and likely don’t have a lot of savings either.”

Of the reasons that a single-payer system is so attractive to the majority of physicians in Minnesota is that the current multi-payer, managed-care system often gets in the way of physicians’ ability to provide the care that they swore an oath to provide.

Most Minnesota doctors like single-payer health care, academic study finds

Dr. Ann Settgast explained the problems trying to provide care under the current system. “When we are limited by the lack of insurance or under-insurance, it becomes frustrating, and we are not able to do our jobs properly.” Settgast provides a typical example of caring for a patient with high blood pressure. “We know that with proper monitoring and follow-up, we can control this with ease and prevent devastating complications such as strokes and heart attacks,” she said. “However, we take care of patients who cannot come to appointments with us or cannot afford to take the medications we prescribe because their co-pay is too high, and these are patients with insurance,” she said.

Because of these barriers people often under-use the system, “as opposed to the overuse that people erroneously cite as a significant problem in the current system,” said Settgast. “This under-use leads to unnecessary human suffering and also financial waste because the cost of caring for a patient with a stroke far exceeds the cost of effectively managing someone’s high blood pressure.”

That example is one of hundreds that testify to the importance of a single-payer system to many physicians, a system that many have come around to in recent years.

On a national level, Frost said that a single-payer system would be ideal. “I support a single-payer system specifically, instead of a universal insurance patchwork like [Sen. Hillary Clinton] and [Sen. Barack Obama], because it makes so much more sense,” she said. “The problem with the bureaucracy of the myriad insurance companies is that each differs from each other, and their ultimate goal is to deny claims and save money. There is a reason why my insured patient with post-polio syndrome never got his electric wheelchair even after a year-and-a-half of trying, and it is not related to lack of medical need,” she argues. In a single-payer system, “the ultimate goal would be to provide not deny.”

Settgast agreed. “As a physician, my job would become simpler as I could make medical decisions based on my expertise and the patients’ best interests — not based on regulations [from insurance companies] that often do not have these interests in mind,” she said. “The single-payer solution is the only choice that makes sense given my motivation to provide the highest-quality care to each of my patients.”