• The Risks of Reform Revisited

    Why Public Support for Health Care Faltered (Kaiser Health News) runs down the list of explanations why health reform is a tough sell. Here’s just one:

    For the majority of voters who get insurance through their employers, the downsides of the overhaul have became increasingly tangible while the promised benefits – among them lower costs – have seemed increasingly nebulous. …

    [M]ost of the bills’ provisions are targeted at the more than 30 million Americans lacking coverage and the 17 million people who buy insurance in the individual market. The bills would bar insurers from rejecting individuals with health problems and would guarantee that policies couldn’t be cancelled if enrollees got sick. But such promises seem hypothetical for many people who already have jobs and insurance – the very constituency the Democrats need to succeed. …

    I worried about this very thing earlier this month and last. I wrote,

    Moreover, I’ve been writing about a weakness in Democrats’ health reform approach that Republicans are likely to exploit. By design it does not disrupt the employer-based insurance system upon which most middle class, fully-employed individuals rely. As such, most of the ways it might improve the health care system will not be immediately apparent to middle class voters. In fact, were I to consider my own narrow interests I might not support health reform or those who championed it. If health insurance premiums do not stabilize for the working middle class it will be hard for most of them to appreciate its benefits. This is a weakness of the legislation and a source of political risk for Democrats.

    But I thought the political risk would be revealed in the mid-terms. Turns out I was wrong. It was already there.

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    • As one of the 17 million Americans purchasing insurance from the individual market (self-employed), I am hoping for reform to go through. I see your point about Democrats not disrupting the employer-based system, and your previous post about the Administration not going on the offensive for its agenda. But the victory in Massachusetts seems to be more of a populist coup. If all you need to do to win is drive around in a truck and talk about killing health reform, what does that say about the effectiveness of the opposition? I don’t think the seat was lost primarily as a result of failing to educate the public about the benefits of health reform. I think it was lost because the Administration didn’t correctly read and respond to the public mood.

    • Ultimately, people get what they want. If they don’t want pre-existing condition coverage, if they do want to see medicare costs increase and coverage decrease, if they want to pay for other’s uncompensated care through their own insurance coverage…let them choose that option.

      They have to be responsible for their decisions when the party is over.

      Good luck.