Still more had been led to believe that reform would solve all their medical problems, only to be disappointed to learn the truth. In Columbia, a fifty-seven year-old woman on Social Security disability, waiting to qualify for Medicare, said that early on she had heard politicians say that they would reduce the amount of time that she had to wait before she could get Medicare benefits. The waiting period was and still is two years. When I met her, she didn’t know that reducing the waiting period was off the table. The fix was too expensive for Congress to seriously consider; they needed the money to pay the doctors who were lobbying (and still are) to make sure that fee cuts mandated by Congress don’t take effect.
Then there was the matter of the public plan, supported by large portions of the public and ostensibly by the president, who said it would be a “good deal for consumers and would also keep pressure on private insurers to keep their policies affordable.” The media extensively covered the plan—ad nauseum, actually—but it was not until it became clear the plan was dead that most people learned they wouldn’t have been able to use it anyway. Not many in the media delved into details like these and connected the dots.
In the last ten days I have spoken to two groups of college students—in Brooklyn and in Wisconsin. Large numbers of students turned out. They were thirsting for information, and not just about whether they could stay on their parents’ health policies. They wanted to know about many aspects of reform. A Wisconsin pre-med student asked if the law could actually be implemented in a way that would be cost effective. Another student wanted to know why the AARP did not support a single payer system. One young woman told me she had insurance with an $8,000 deductible. She and her husband were ready to start a family and were worried about paying for maternity care out-of-pocket.
All year long, we have urged the media to explain the individual mandate and the penalties for not carrying insurance. But coverage was sparse for most of the year, in our judgment because the newsmakers and the pols glossed over the mandate, fearing that voters might not like it. Since much of the coverage followed what newsmakers had to say, the mandate got short shrift until very late in the debate.
Newsmakers didn’t talk much about affordability, either, except when they passed along the Democrats’ empty slogan about “affordable, quality health care for all.” There wasn’t a lot of explanation of how the subsidies would work, or how middle-income families, with incomes around $60,000, $70,000, or $80,000, will still have to pay a good chunk of the premium out of their own pockets to cover the $13,000 cost for a reasonably good policy. Again, the dots remained unconnected.
Pollack argues that “moderately informed and inquisitive readers could get more accurate information, more quickly, and more carefully-analyzed than one ever could before,” although he concedes that “one needed to know where to find this information.” Kaiser Family Foundation may have great data for those with patience and time to sift through it, and its news service may produce some fine stories. However, the public knows their local paper, and maybe the Associated Press. Not Kaiser Health News. The humongous bill may have been posted online, but even super-good lobbyists I know have trouble reading federal legislation, with its amendments, strike-outs, and references to buried clauses in sub-sections all the way in the back. Blogger Robert Laszewski clearly explained the affordability dilemma—more than once—but it’s a good bet most Americans had never heard of Laszewski’s blog. Few bloggers have PR agents touting their words.