PHYSICIANS AND MEDICARE: A BEFORE-AFTER STUDY OF THE EFFECTS OF LEGISLATION ON ATTITUDES.

Medicare was bitterly opposed by the medical profession before it became law in 1965. This paper examines how individual physicians reacted, in their behavior and in their thinking, to Medicare after it became law. The more general issue is the role of law as an instrument of social change. Interviews with a sample of New York State physicians before the law was passed and reinterviews at two points in time after the law was passed-once before the program went into effect and again about six months after it had gone into effect-make it possible to separate the direct effects of the law itself on attitudes from the effects of short-term experience with the program. There has been no evidence of a physicians' boycott of Medicare. With respect to their attitudes, the proportion of physicians in favor of the main part of Medicare, the hospitalization program for the elderly (Title 18, Part A), jumped from 38% before the law was passed to 70% ten months after it was passed, even before it was implemented, and again to 81% six months after it was implemented. Some laws, according to these results, may influence attitudes without first changing behavior. [ABSTRACT FROM AUTHOR]