Health Reform: Upset WIth Democrats, Afraid of Republicans

My take, based on conversations with professionals and just plain people, is public apprehension about the impact of the 2010 health reform package. On the one hand, people complain about the threat of federalization of health care and on the other, they demand that their Medicare program not be affected by health reform.  While there is recognition of the need to clean up the the old inefficient expensive system which provided economic rationing of care, there is a sense that the political parties are at odds, and that any gains made since passage of health reform in March, 2010 will be undone by Republicans should they gain control of Congress. The uncertainty created by Democratic passage of reform is threatened by the fear that - if the Republicans can control health care - it will be the bad old days again and people will sit in movie theaters (or in front of their big home TVscreens) booing insurance companies, HMOs and any theatrical reference to institutions that control of health care.

The Democrats haven't exactly made it easy for the public to understand what is happening and what will happen under health reform. A recent posting of a letter from Kathleen Sebelius  calling on Health Insurers to Stop Misinformation and Unjustified Rate Increases, said

"Any premium increases will be moderated by out-of-pocket savings resulting from the law.  These savings include a reduction in the "hidden tax" on insured Americans that subsidizes care for the uninsured.  By making sure insurance covers people who are most at risk, there will be less uncompensated care, and, as a result, the amount of cost shifting to those who have coverage today will be reduced by up to $1 billion in 2013.  By making sure that high-risk individuals have insurance and emphasizing health care that prevents illnesses from becoming serious, long-term health problems, the law will also reduce the cost of avoidable hospitalizations.  Prioritizing prevention without cost sharing could also result in significant savings: from lowering people's out-of-pocket spending to lowering costs due to conditions like obesity, and to increasing worker productivity - today, increased sickness and lack of coverage security reduce economic output by $260 billion per year."

Walk into any hospital Emergency Department and you may observe terribly sick and injured people who, because they are not insured American citizens, may still run up substantial costs which will be shifted to the insured population making the Secretary's claim of dubious validity. We need the facts to substantiate claims of savings as an offset to the doubts proclaimed by the political and corporate opponents of health reform.

Otherwise we will have more upset which will outweigh fear.