TABLE 2.
Attitudinal Measures Predicting the Political Legitimacy of Physicians
| Hypotheses about Declining Legitimacy | Specific Measures from Interviews | Specific Measures from Surveys |
|---|---|---|
| Core Hypothesis 1: Doubts about Professional Efficacy | ||
| Medical care is ineffec tive. | None | Disagree that “adequate health care is essential for there to be equal opportunity.” |
| Need is not an appropriate standard. | Disagree that “people should get health care based on needs.” | None |
| Faith in science has been lost. | None | Disagree with allocating services to meet “basic needs” using “scientifically correct answers”. |
| Core Hypothesis 2: Doubts about Professional Agency | ||
| Physicians are commercially oriented. | Agree that providers are “self-interested and out to make money from medical problems.” | None |
| Physicians are too sensitive about medical costs. | Agree that “doctors no longer place your well-being above concerns about health care costs.” | None |
| Needs are not held foremost. | Agree that providers “are no longer committed to meeting the needs of communities.” | None |
| Physicians do not care about the poor. | None | Agree that a physician-run health care system would be worse for the poor than would a system run by the federal government. |
| Core Hypothesis 3: The Rise of Countervailing Authority | ||
| The federal government's role in health care should be supported. | Agree that “you need national solutions” to address the problems of the current American health care system. | Agree that “it is the responsibility of the government in Washington to help people pay for doctor and hospital bills.” |
| Employers’ involvement in health care should be supported. | Agree that the American health care system would work better if “workers and managers bargain with one another to decide on health benefits.” | Favors greater influence by business interests over “government health policies and programs.” |
| Medical consumerism should be supported. | Agree that “each person ought to make the choices” about health care. | Agree that medical care is “not the responsibility of the federal government” and that “people should take care of these things themselves.” |
| Core Hypothesis 4: Violation of Professional Boundaries | ||
| Community involvement should be supported. | Agree that solutions to health problems are best found by “local government or community-based groups.” | Agree that allocating medical care through community-based groups would be “good for the country as a whole.” |
| Physicians’ political influence is worrisome. | Disagree with the claim that most people are “comfortable having physicians guide policymakers” about health policy. | None |
| Physicians’ political influence should be reduced. | None | Agree that physicians have too much influence over “government health policies and programs.” |