Advocates, usually at the ready with families for the press to interview, don’t seem to be trotting them out to talk about affordability or the obscure indexing provisions that the Center on Budget and Policy Priorities brought to the attention of Kaiser News Service and Campaign Desk. Those provisions would cause families with modest incomes to spend a larger and larger share of it for health insurance as time goes on. It might be easier for the Joneses in Peoria to take the penalty and run.
A perspective piece published two weeks ago in the New England Journal of Medicine pointed out that the polls now show the same things that they showed during the various stages of the Clinton reform effort. The authors say that “Americans’ impressions of the legislation’s likely impact on their own situation will be the most important factor in determining the level of public support.” The polls may be similar, but one thing is different. In 1993-94, the media, which did not do a great job then explaining the Clinton plan to the public, at least ran winners and losers pieces from time to time. This year they aren’t even doing that.
It’s past time for the story to shift from Capitol Hill to Peoria. Here’s what we suggest: Go out and find the people who will experience the good and bad of reform and tell their stories. Report on what they spend now for the usual things—car and mortgage payments, food, gasoline, life and auto insurance premiums, clothing, entertainment, taxes, presents for Christmas, credit card debt, savings for college or retirement. Tell what spending five percent, ten percent, or twelve percent for health coverage will mean for other spending priorities. How will that change through the years, given what Congress currently has in mind for indexing the premiums? Find out what kinds of “affordable” insurance they can actually buy. Investigate what employers are offering this year? Will people with good health plans—the so-called Cadillacs—see their insurance turn into Edsels?
This is the Consumer Reports 101 the public needs. It’s the stuff that Ron Wyden worries about.