As Massachusetts enters its fourth year under a sweeping law that aims to get nearly everybody health insurance, there's new evidence on what one crucial constituency thinks about it: doctors.
The first broad-based survey of how physicians feel about the Massachusetts experiment shows strong and deep support: 70 percent favor the law; three-quarters want to keep it.
Only 7 percent would repeal the law, and it's hard to find a doctor to say so publicly, says a spokesman for the Massachusetts Medical Society.
The thing doctors like most about the Massachusetts law is, perhaps not surprisingly, that fewer of their patients are uninsured, says Robert Blendon of the Harvard School of Public Health. He and his colleagues conducted the poll for the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation.
"They were just quite impressed, both in their own practice and statewide, that the uninsured problem has essentially disappeared from their lives," Blendon says.
Support among Massachusetts physicians is slightly higher than in the public at large, according to the most recent general poll.
The most telling results come from a series of 22 questions the pollsters asked doctors about how the law is playing out in their own daily practice. For instance:
That's not to say that Massachusetts doctors have no problems. Half say things at their practice have gotten worse over the past three years. But only 11 percent say the health law was to blame.
Blendon says the poll provides a rejoinder to critics who have claimed that the Massachusetts health care system is bulging at the seams under the pressure of newly insured patients.
For instance, there have been reports that it's hard for newly insured patients to find a primary care doctor, and that some physicians have long waiting lists for an appointment. While Medical Society officials say that is the case in some areas of the state, such as Cape Cod and rural western Massachusetts, the new poll finds that 62 percent of doctors say it's not a problem in their practice.
"Doctors do see shortage of primary care services as a problem in the state," Blendon says. "But two-thirds did not think it was a problem brought on by the legislation."
Asked what they would change about the law, 34 percent of doctors put "expand coverage" at the top of their list.
The second most-mentioned course correction, with 23 percent mentioning it, is "address costs." This parallels a more general consensus in Massachusetts that something serious needs to be done about the cost of health care. The new program is heavily subsidized by the state.
Dr. Philip Triffletti, a primary care physician in Chelsea, just north of Boston, says he's happy to know that most Massachusetts doctors feel the way he does about how things are going.
"I'm glad it's popular, and I think it has worked well," Triffletti says. "And I fully agree that having doctors' support is a good thing. And I hope that has some political clout in Washington."
But Triffletti says what's really going to count is whether Massachusetts can continue funding its popular new health care program in the face of the state's whopping budget deficits and impending new round of budget cuts.
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