Let’s look instead at the “study” itself. This is not as easy as it sounds. Yes, it was published in the Annals of Internal Medicine, but the content is available only to paid subscribers. Fortunately a friendly internist was able to send it to me. I opened up the file on my computer and was surprised to learn that it wasn’t a “study” at all. It was a one-page letter to the editor. Now a letter has the distinct advantage of avoiding the peer review process that applies to published articles. It is also able to avoid including any embarrassing information about methodology.
The letter was written by Aaron Carroll, MD and Ronald Ackerman, MD, both of the Indiana University School of Medicine. I don’t know about Dr. Ackerman, but Dr. Carroll is a member of the board of directors of Physicians for a National Health Program (PNHP), so is hardly an unbiased researcher. Interestingly, the Annals requires the disclosure of financial conflicts of interest, but not political conflicts or biases.
The survey itself, though only summarized in the letter, apparently asks only two questions -- 1. In principle, do you support or oppose government legislation to establish national health insurance? And 2. Do you support achieving universal coverage through more incremental reforms? They sent this out to 5,000 physicians and got back 2,193 responses. So the sample was entirely self-selected. And who knows what their cover letter might have said? Coming from a leader of PNHP, it might have been calculated to infuriate physicians who believe in freedom, resulting in these doctors discarding the survey.
So, there was absolutely nothing scientific about this. It was pure propaganda. But the idiotic reporters take it at face value, much as they did a few years ago when the Commonwealth Fund published a startling survey finding that the vast majority of employers supported an employer mandate. Few reporters questioned the unlikely finding, so I dug deep into the survey and discovered that Commonwealth gave these employers only two choices – an employer mandate or a single-payer. Pick your poison. And you wonder why we enact such horrible policies in this country.
Thursday, April 3, 2008
More on the Bogus Survey
Greg Scandlen points out the following about the survey purportedly showing that physicians suppport government-mandated universal care: