Friday, February 27, 2015

Health Reform is Still Shrouded in Myths

Derivatives, credit default swaps, and health reform. Few people seem to really understand any of them.
Congress passed the health reform law over a year and a half ago, yet it is still shrouded in myths. A new poll by the Kaiser Family Foundation found that 53% of American think it includes a government-run insurance option, and 13% aren't sure. That provision was dropped during Senate negotiations.

Health Reform is Still Shrouded in Myths

Derivatives, credit default swaps, and health reform. Few people seem to really understand any of them.

Congress passed the health reform law over a year and a half ago, yet it is still shrouded in myths. A new poll by the Kaiser Family Foundation found that 53% of American think it includes a government-run insurance option, and 13% aren’t sure. That provision was dropped during Senate negotiations. (Click here to read the full report.)

Even more surprising, 35% think it allows a government panel to make end-of-life decisions for Medicare beneficiaries, with 12% unsure. Such a provision never existed. The myth of death panels apparently lives on.

Many respondents in the poll were also unaware of important elements that the law does contain. It requires health plans to produce straightforward summaries of benefits, but 42% didn’t know that. And 64% were unaware that it eliminates all co-payments and deductibles for preventive care.

These elements are extremely popular when people find out about them. The provision requiring clear benefit summaries is supported by 84%, with 60% giving it strong support. The preventive care provision has 64% behind it, with 33% backing it strongly.

In fact, of 15 major provisions that the survey asked about, only one was supported by less than a majority. That is the mandate requiring all individuals to have health insurance.

Even most Republicans support many elements of the health reform law, in some cases by wide margins. 76% of them favor the clear benefit summaries provision, and 53% support free preventive care. Overall, majorities of Republicans reacted positively to eight of the 15 health reform provisions that the survey asked about.

But here’s where the responses get confusing. More people now disapprove of the overall law than support it by a margin of 44% to 37%. But 50% want Congress to keep or even expand it.

So, what’s going on? Are people really so fickle?

Maybe not. Another recent study published in the journal Health Affairs showed that polling results on health reform depend greatly on how the questions are asked. For example, support for the individual mandate varied from a low of 34.7% to a high of 62.5% depending on the question’s context.

Perhaps people are easily swayed because the law is so widely misunderstood.

One conclusion from these results is that the Obama administration continues to do a horrendous job of explaining health reform to the public. Why it is unable to effectively communicate key elements of its signature domestic initiative remains the most mysterious part of the entire health reform debate.

Apparently, the media hasn’t done much better. Its focus on reporting political battles, baseless charges and myths seems to have kept much of the actual content of health reform from public view.

It is disconcerting that one of today’s most bitterly disputed political issues - and one that may play a role in deciding the next presidential election - is the subject of widely believed myths and misunderstandings. If voters are to be influenced by health reform, they should at least know what it is.

At least, we can be thankful for one thing. Most of us won’t be voting based on our understanding of credit default swaps.

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About this blog

Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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