How Washington State doctors battled it and won.

Area of Science:

• Health Policy
• Medical Economics
• Public Health

Background:

• Mandatory medical assignment legislation has been introduced in 16 states since 1985.
• Massachusetts enacted a law in 1985 linking medical licensure to assignment acceptance.
• Physician billing practices and patient cost-sharing are significant healthcare policy issues.

Purpose of the Study:

• To detail the Washington State Medical Association's strategy against a voter initiative.
• To analyze the shift in public opinion regarding physician fees and Medicare rates.
• To examine the first instance of physician fee limits being presented directly to state voters.

Main Methods:

• The Washington State Medical Association (WSMA) implemented a campaign to influence public opinion.
• Analysis of voter sentiment shifts from initial support to eventual opposition.
• Case study of a state-level political and public relations battle over healthcare costs.

Main Results:

• An initiative to cap physician charges at Medicare's "reasonable" fee was initially favored by 68% of Washington voters.
• The WSMA's counter-campaign successfully shifted public opinion.
• The initiative ultimately failed, with 63.9% of voters opposing it.

Conclusions:

• Effective advocacy and public education can significantly alter voter perceptions on complex medical economic issues.
• Physician organizations can successfully mobilize against legislative or ballot measures impacting their practice.
• The Washington State experience demonstrates a successful model for combating physician payment limitations.