Health Care Reform Has Americans Dazed and Confused

Most Americans still don't have a clue about health care reform.

Months of debate in Congress, endless chest-thumping by pundits and scores of dramatic 30-second ads have done shockingly little to educate Americans about the sweeping legislation that promises to affect all of them for decades to come.%%DynaPub-Enhancement class="enhancement contentType-HTML Content fragmentId-1 payloadId-61603 alignment-right size-small"%%Quoting a Pew Research Center analysis of its Dec. 9-13 nationwide poll, McClatchy Newspapers reports that "a large majority of Americans -- 69% -- say they find the issue hard to understand." That's even higher than the response Pew got in late July of 63%. For anyone involved in the debate, that statistic has to be depressing. Then again, this issue is a nightmare to explain to anybody, regardless of their political persuasion.

The bill, with the Orwellian name of Patient Protection and Affordable Care Act, that passed the U.S. Senate today in a rare Christmas Eve session weighs in at a whopping 2,000-plus pages. It revamps one-sixth of the U.S. economy, costs a staggering $871 billion over 10 years, and raises just as many questions as it answers.

Backers of health care reform, such as Andy Stern, head of the Service Employees International Union, were jubilant. In a press release, the labor leader, whose members include many health care workers, praised Senate Majority Leader Harry Reid and the members of the Democratic party for putting "the well being of the American people before Washington gridlock and partisan politics." Democrats accused Republicans of making more than 150 false claims to kill health care reform in the Senate. President Obama praised the bill's passage as "historic."

Denounced as "Irresponsible"

Many others, of course, saw things differently.

In a statement released today, Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP), the trade group representing the health insurance industry, grumbled that "specific provisions in this legislation will increase, rather than decrease, health care costs; reduce coverage options; and disrupt existing coverage for families, seniors and small businesses – particularly between now and when the legislation is fully implemented in 2014."

The U.S. Chamber of Commerce denounced the bill as "irresponsible," saying it "does little to lower the cost of health care and hurts our ability to create jobs."

The Pharmaceutical Research and Manufacturers of America (PhRMA), which represents big drug companies, sounded a more conciliatory note, saying the bill "offers the kind of change that will benefit patients today without putting medical progress at risk in the future."

Striking while the political iron is hot, the Republican Party quickly attacked the bill and President Obama, who made health care reform a signature issue of his presidential campaign. GOP National Committee Chairman Michael Steele called the bill "a $2.5 trillion lump of coal in the stocking of every American. Scrooge would be proud. I know a majority of Americans are not." The bill passed the Senate without a single Republican vote.

Will You Be Better Off?

People may not understand the new bill, but they do know the country has health care insurance crisis. According to the White House, Americans spend more on health care than on housing and food. In 2007, those costs were $2.2 trillion, or $7,421 per person -- nearly twice the average of other developed nations. Figuring out what to do about it has befuddled administration after administration for decades, and no one knows what the right answer is.

"The number of Americans who say they personally will be better off if reform passes fell to 35% in December, down from 42% last month," according to the Kaiser Family Foundation. "And 27% say they'll be worse off, while 32% said they don't expect to see much of a difference. Similarly, 45% say the country would be better off if health care reform passes, down from 54% in November."

As my colleague Eric Wahlgren pointed out yesterday, the legislation would still leave about 23 million people without health insurance and that most of the 30 million uninsured who will be helped by the bill won't get their assistance until 2013. Drew Altman, president of the Kaiser Family Foundation, told the Associated Press that "People are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in." That's a tough pill to swallow for folks who expect immediate relief.

A Plunge in Popularity

The changes mandated in the bill will be paid for by increased fees on drug companies and medical-device manufacturers. Devotees of tanning salons will be levied with a 10%t tax. Congress backed down from an earlier plan to tax elective cosmetic procedures. The Medicare payroll tax will be increased to 2.35% on income over $200,000 a year for individuals and $250,000 for couples. Insurers will no longer be able to deny coverage because of pre-existing conditions, and nearly all Americans would be required to have coverage.

A poll done by Quinnipiac University found that most Americans disapproved of Obama's handling of how the health care issue and the bills were debated in Congress. The results underscore why the president's popularity has been plunging for the past few months. Confusion doesn't usually sit well with voters.
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