De-Symbolizing Healthcare Reform

With a couple of breathing days since the election that swept a near-record number of majority-party congressmembers out of their seats, we thought we'd add our own voice to the din of analysts trying to figure out WHAT THIS MEANS FOR HEALTHCARE REFORM.  

Because, as we all know, the (former) majority party voted the reform law into existence.  Now that many of them are gone, we and others are left nervously wondering what the future holds.  

Couple of points here.  First of all, it's notoriously hard to judge the public's opinion on an issue based on the party it votes into power.  It's not like a vote for a Republican is an automatic vote against extending health insurance to those with pre-existing conditions.

And even direct polling, in which members of the public are explicitly asked whether healthcare reform should be repealed, is hard to decipher.  In October, the Kaiser Family Foundation published a round-up of polls on this point and basically concluded that even though about 1/2 of the country supports repeal, responses vary widely with the way "repeal" is defined and how the polling questions are asked, and that it's impossible to judge the intensity of the public's sentiments from the polling that's been done so far.  

Second, the political math of repeal is fuzzier than a new crew cut.  It's hard to see the Democrat-controlled Senate or the President acceding to any "repeal" that goes beyond some tweaks around the edges.  In the House of Reps itself, the big news is that San Francisco's Nancy Pelosi will seek election as the minority leader, and if she retains her leadership position you can be sure she'll work overtime to stop any rollback of one of her most significant policy victories.  

Also, let's not forget that the public basically doesn't know what's good about healthcare reform.  That's in large part because most of the awesome provisions of the law have yet to kick in.  The difficulty of repealing a law that becomes more and more popular as time goes on (and as benefits kick in for seniors and others) may be insurmountable.  A good discussion on the politics of taking away benefits from key constituencies played on PBS this week and is worth a gander.  

Our own take is that healthcare reform is - in the minds of many in this country - a symbol of what is perceived to be too much government control over the private sector.  

Maybe with this week's election the voting public has blown off some steam, feels more secure about its representation in DC, and no longer needs a symbol of government over-reach to rally around.  

But just in case that's not the case, it may be time that we supporters of the law start purposefully stripping it of any symbolic importance whatsoever.  That means filling in details where now there's only broad abstract ideas.  

And it means ceasing to talk about "the healthcare law" as a single Thing altogether.  Skeptics always assume that "the reform law" is an enormous, Godzilla-like creature bent on destroying mom and apple pie.  So let's start talking about one specific part of the bill at a time.  We're excited about how comprehensive it is, but that's because we're health policy nerds.  Normal people are somewhat less stoked on thousands of pages of statutory modification.  

So, no, it's not "healthcare reform."  It's "Help Paying for Prescription Drugs" when talking to seniors.  It's "No More Exclusions for Children" when talking to parents.

The more that we as supporters of reform can shine light on specific parts of the law, the less it serves as a symbol and the more it becomes an unrelated set of common-sense, average-Joe friendly rules of the road.  

Much easier to understand.  Much easier to embrace.  

So here's to the death of a symbol, and to the long, long life of a hundred really good ideas to fix healthcare in this country.  

Comments

[Wanda Session]

You have made some very interesting points. We do need to take time out to thoughtfully think about where we are as a country and what small role we can each play to de-symbolize health reform and talk about what it means to us personally, and to those whom we come in contact with.