Update on Obama-care: Truth & Consequences of the New Healthcare Law by Dr. Rick Bayer
The Obama Administration will likely be remembered for healthcare reform. In our Summer issue of Alternatives Magazine, we discussed how the Patient Protection and Affordable Care Act is only a good start, since politics prevented good policy.
Healthcare reform is confusing partly because lobbyists are paid to create confusion. No member of Congress had time to read the encyclopedia-length documents written by health insurance lobbyists that became our law. So, it’s no surprise there’s confusion on Capitol Hill. And, if our representatives who passed the law don’t understand it, where does that leave us?
To find out, Harris Interactive (www.theharrispoll.com) conducted a poll this summer of 2104 Americans. These volunteers were given a list of 18 possible reform items and asked whether or not the item was included in the new law. Republican lobbyists scored big because Americans have no clue what’s in our new healthcare reform law.
The good news is that 58% of us know our new law prohibits insurers from denying coverage to people with pre-existing illness, while 55% know the law permits children to stay on parents’ insurance until age 26. Interestingly, 52% know that people choosing not to get insurance will be financially penalized. Half know that employers with more than 50 employees must offer insurance.
And now for the rest. An astonishing 82% of the public thinks our law results in healthcare rationing, when it will not. Actually, it does the opposite by expanding coverage. Rationing is what we have now, when people cannot afford care so they avoid doctor visits or cut medication dosage to make it last longer. Rationing is when parents don’t get care so their children can. Those with insurance don’t have to ration: they can see doctors in an office setting early in the illness, which prevents expensive emergency visits and hospitalization, and avoids complications that cause premature disability or death. This perception of the law leading to healthcare rationing is a good example of “managed perception”, meaning that it is based upon an untruth but has been so often repeated and reported that it has become accepted as fact in the public mind. A more prosaic and accurate term for this kind of thing is propaganda.
That 66% were unaware of insurance exchanges means either they are so smart that they believe Republicans will overturn them or, more likely, they were not paying attention. Sadly, I believe that ignorance is an indicator that America is different than we like to think it is.
Marketing ads say Americans care about neighbors, but unfortunately, that is fluff. The American culture (class) wars pit rich against poor to create winners and losers, and the new healthcare law has not been exempt from this dynamic. When 63% of the public claim they were unaware that the law increases eligibility for Medicaid, I question whether Americans care about neighbors if they are poor.
More that Americans got wrong is a belief that Obama-care would increase the federal deficit or result in higher income taxes for the middle class—it won’t. More than a third believe it gives every American healthcare—it won’t. These optimistic voters are probably the same third who believe the public option passed—it didn’t.
Need more proof propaganda works? Almost a third of those polled admitted to the belief that “death panels” are included for the elderly. That part of the healthcare “debate” was a contemptible fabrication to scare and bewilder the public.
I think beltway politicians let the lobbyists make healthcare reform more complicated than necessary and that citizens are still trying to disentangle rhetoric from reality. I agree with Humphrey Taylor, chairman of the Harris Poll, who said, “The level of ignorance and misinformation is sort of astounding. It seems people are still reacting to the rhetoric, not the substance of what is in the bill, because they don’t actually know what is or is not in the actual legislation.”
The mantra for the Obama Administration should be “Medicare for everyone? Seniors like it— you will too”. Nothing needs to be torn down—just build on success. Medicare has a 45-year history of success helping elderly Americans avoid poverty and live healthier lives. And the Medicare single-payer system is far more cost-effective that our chaotic private market.
But lobbyists used smoke and mirrors to confuse Americans while Congress exhibited a gutless focus on getting re-elected. The result was that lobbyists kicked the sick to the curb while Obama waited too long for Congress to act. The sick, lacking any powerful political advocacy, lost the crown jewel in the debate—the public option.
And once again, the USA still has no healthcare system for those under 65—it only has a market. In a system, citizens regulate healthcare. The unregulated, or “free” market works fine for consumer goods we can live without. But Americans deserve well-functioning systems of essential public services like police and fire, basic education—and healthcare.
Questions Harris did not ask Americans include: are we aware we pay more for healthcare than anyone in the world? Do we get the value we pay for? And, should we explore expanding Medicare, a successful single-payer system?
We already pay the most for healthcare, but our public health data are abysmal making the USA appear to be a third-world country, which is absurd considering our total wealth. Many lives are lost when citizens cannot afford healthcare, so don’t let lobbyists win the day. By spiking healthcare, lobbyists and their Republican employers are literally getting away with murder.
Richard “Rick” Bayer, MD, FACP is board-certified in internal medicine, a Fellow in the American College of Physicians (FACP), practiced, and lives in Oregon.