Sunday, June 12, 2011

Why Does The Public Distrust Health Reform Law?

June 12, 2011 - In America, distrust of the health reform law is palpable - and measurable.

The latest poll averages, as compiled by Real Clear Politics, indicate the following.

Health Reform Approval

For/Favor, 40.8%, Oppose/Against. 50.5%, Difference, 9.7%

• Health Reform Repeal

Favor Repeal, 50.4% Oppose Repeal, 40.4%, Difference, 9.6%

Why these differences ?

The law may have good intentions. It was sold politically as a national instrument for lowering costs, guaranteeing access, and improving quality.

The problem? The public smells a rat – a rat reeking of “IF’s”and”WHY’s”.

IF the reform law is so good, WHY did the Republicans unanimously oppose it?

IF the law has no flaws, WHY was it rammed through without anybody really understanding, or even reading, its 2801 pages?

IF the health insurers are so bad, WHY did the government reward the plans with 34 million more members, 16 million of whom would go Medicaid rolls?

IF Medicare “as we know it” is such a wonderful thing, WHY did the government find it necessary to gut $575 billion out of Medicare?

IF the plan saves so much money, WHY has the government rewarded 1372 waivers to companies and even states allowing them to opt out of the law?

. IF the ACA is so friendly to businesses, WHY are 30% to 50% of employers saying they will drop coverage to employees when the the reform law takes full effect in 2014?

. IF the ACA is so good for America, WHY are so many well reasoned books like The Truth about Obamacare (Regnery, 2010) and Why Obamacare Is Wrong for America (Broadside, 2011) cropping up?

Adding to Doubts

Adding to all these doubts are costs of the law, estimated to be $2.3 trillion over 10 years from 2014-2024, national debt skyrocketing to $14.5 trillion, growing suspicion of big government, and mounting, perhaps unfounded, fears that we were rocketing down a slippery slope toward “socialized medicine.”

Republicans may have overstated and distorted these doubts, but the doubts are there, and they are part of the “lack of confidence” factor.

A Gallup poll on June 17, 2009, revealed the following in terms of public confidence.

• Physicians 73%

• Health care professors, 62%

• Hospitals 61%

• President Obama, 58%

• Democratic leaders in Congress, 42%

• Drug companies, 40%

• Health plans, 35%

• Republican leaders in Congress, 34%

Hardly a Solid Foundation for Trust

These percentages are hardly a solid foundation for trust in the health reform bill once it passed in March 2010. By June 2011, confidence in Congress is down to 16% and the Obama approval bounce after the Bin Laden killing is gone.

Public confidence has waned more when it has become evident doctors and hospitals are not enthusiastic, even hostile, about health reform regulations, such as those embodied and hidden in Accountable Care Organizations.

Moreover,provisions of the bill keep clashing with harsh realities of increased premium costs, employers dropping millions from coverage, health plans withdrawing from markets, and states being unable to afford new Medicaid burdens and challenging the law’s constitutionality.

Dashed Expectations

The public’s expectations may have been too high and too unrealistic. The public expected health reform would provide affordable access to almost everything. More care would mean better care. High tech care would accompany high touch care.

People did not expect less access. longer waiting lines, and more crowded ERs. That is the situation in Massachusetts, whose 5 year old universal plan was considered a poster child for Obamacare.

Instead, the future of health reform with lower costs and more access seems more uncertain and remote than ever.

Talk of repeal is in the air, and it is becoming clear the future of health reform will hinge on a Supreme Court decision on the constitutionality of the Accountable Care Act, recovery from a dismal recession, and on the November 2012 elections.

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