Nearly 60% of physicians ages 40 and younger don’t hold out much hope for American healthcare, according to results of an online survey released by the Physicians’ Foundation.

Among the 500 respondents, nearly a third (31%) said they were ‘highly pessimistic’ about the future of the U.S. healthcare system. Another 26% characterized themselves as ‘somewhat’ pessimistic.

Only one in five see a brighter side — just 4% said they were ‘highly optimistic,’ and 18% claimed to be ‘somewhat’ optimistic.

About a third of those who were pessimistic (34%) specifically cited the ‘new healthcare law/regulations’ as the reason. But that proportion would come closer to half if those who provided responses such as ‘system is a mess,’ ‘distrust of government,’ ‘government intervention,’ and ‘Medicare is a mess and will only get worse’ are added in.

In fact, when asked specifically how the Affordable Care Act will impact their practice, 49% of all respondents — those optimistic about the future of healthcare as well as the pessimists — said the ACA will have a negative impact.

Nearly a quarter, though, said it would have a positive effect.

Even among the optimists, there was a decided sense of negativism — 10% said they were optimistic because things couldn’t get […]