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Their Diagnosis: It Stinks

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If the managed-care industry wants consumers to make peace with the current healthcare setup, it may need to win over an influential constituency of its own. Physicians are even more hostile to managed care than their patients are. The chart below, summarizing data from a Kaiser Family Foundation survey of doctors, indicates the breadth of negative sentiment. And while polling tends to find consumers relatively content with their own health plans, even as they deplore the general setup, doctors' antipathy toward the current system is based very much on their own bad experience with it. Eighty-seven percent of the doctors surveyed believe the overall morale of physicians has declined during the past five years. Complaints about added paperwork are nearly universal among the respondents, while more than four out of five think managed care has raised the overhead costs for their profession. Nor do they see the system accomplishing the practical goal of holding down overall costs: 41 percent said the current regime has tended to raise total healthcare costs during the past five years, vs. 23 percent seeing a reduction in costs. If negative opinions are contagious, consumers are likely to catch even more managed-care phobia than they already have on their own.