Monday, August 29, 2011

What "experts" fail to understand


An in-house description of a new Kaiser Family Foundation survey expresses "a real surprise" that nearly half of those currently without health insurance don't think the Affordable Care Act (ACA), known to detractors as Obamacare, will do anything for them.

We know from survey after survey that the uninsured want insurance coverage. And we know that the main reason they don’t have it is that they cannot afford it. Experts who have advocated for expanded coverage for decades probably envision the uninsured sitting around the kitchen table anxiously awaiting the implementation of coverage expansions under the ACA. But surprisingly, only three in ten of the uninsured say the ACA will help them get health care.

These "experts" just don't get it. Even if you tell people over and over that there will be insurance and subsidies to help them pay for it, folks who live close to the economic margin (or under it) won't believe you. All they've ever experienced with the dribs and drabs of insurance they may have occasionally had was that there were expensive deductibles and co-pays. Or insurers refused to pay if they tried to use the "insurance." And all they can imagine from the ACA is perhaps another bureaucratic mountain they'll be expected to surmount, complete with ugly insinuations that they are "failures" because they need help.

Plus, they listen the political noise and figure that, even if this thing someday comes into existence, the cheapskates in power will nickel and dime it to death, perpetually shifting costs from government to them. After all, if they've had any experience with state-run health programs like CHIP (federal children's health) or Medicaid, they've lived how that works.

Anyone who expects poor people to have confidence in a government program that doesn't exist yet is living in an ivory tower.

Now give them some experience of something that works for them and they'll fight tooth and nail to keep it -- just look how most of us feel about Social Security and Medicare. But that trust comes from experience. No wonder the party of NO taxes for the rich needs to kill Obamacare before it lives. If it's benefits become tangible, it will be lively indeed.


elizabeth Geraghty said...

In Vermont, it works. My 18 year old daughter has really good coverage for $60 a month....when I made less, and she was younger it cost$0-$45 depending on the whim of something I could not figure out. Yes, I keep waiting for the gotcha far so good. The only provider to be rude about it was a dentist that we have since fired.
It is also true that i had to be pushed to the wall before I would consider trying this because it couldn't possibly be true. Or maybe because I had failed horribly be even being in the situation where I would need to apply for help getting my kid insurance.

janinsanfran said...

Hi Elizabeth! Yeah -- it works here in San Francisco too. We have a city resident thing called Healthy San Francisco that insures low income residents and I know multiple people who've been able to go to doctors because of it.

It will take living it to convince folks that these things work. And it it will take an ongoing fight to make sure they keep getting funded!

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