Healthcare reform without risk
Coming off of a terrible August for health care reform, one thing is clear: the effort needs to be re-branded. Recently, Washington's savvy Democratic House Speaker Frank Chopp shared some advice with Crosscut on the subject of branding liberal initiatives, including the importance of dumping alphabet soup and finding works that resonate with Mom and apple pie. An example: Forget SCHIP and call it Apple Health for Kids.
Breaking down the behavior of the American people can be helpful in explaining why things are getting off track on health care. Why, if so many people think our system is broken and needs fixing, are so many also balking at serious reform?
James Surowiecki writing in the Aug. 31 issue of The New Yorker has some explanations from the world of economic behavior studies. People are inclined to resist change for two reasons. One is the so-called "endowment effect," which means that people routinely undervalue what belongs to other people, and over-value what they have simply because they have it (something I've routinely observed at garage sales). Second is what economists call "status quo bias." Surowiecki explains:
Behavioral economists have established that we feel the pain of losses more than we enjoy the pleasure of gains. So when we think about change we focus more on what we might lose rather than on what we might gain.
What this suggests, Surowiecki concludes, is that the way to sell health care reform is to convince people that it is needed to protect the status quo. In other words, that reform is the only way to ensure you can keep what you have and prevent insurance companies from taking it away (if you lose your job, for example). Don't emphasize covering the uninsured, focus on protecting the insured.
Medicare is popular even among those who claim to hate socialized medicine. Partly, it's in the name: care. Social Security is also popular (and has also been reform resistant) in part because it promises security for the elderly, and therefore society at large. So maybe the Medi-Security Act of 2009 will reassure folks. In any case, I think Surowiecki is on to something important, which is the power of branding change as no change at all.
Comments:
Posted Wed, Sep 2, 2:28 p.m. inappropriate
I'd suggest another reason (contrary to Chopp's "Liberals are smarter than everyone else" theory) why "Obama-care" is facing a tough sell. Everybody agrees that what we need most is a way to get people who want health care, but cannot afford it, a way to "buy in" to the system. What we need second is a way to hold down increasing costs. Obama's plan (really a-buncha-guys-in-Congress' plan) promises only to offer the insured a chance to switch to a government insurer, at the cost of an added $1 trillion in debt. This is not an attractive prospect. If the president wants health care reform that the average American can support he should do one thing: Come up with a way to get the approximately 10-15 million people who want health insurance, but can't afford it, insured. Then step back and see what happens. Then work to establish a national consensus on what step two should be. The "Panic! Panic! Do something! Do anything!" atmosphere that's been jiggered up around health care is patently silly.
Posted Thu, Sep 10, 11:06 a.m. inappropriate
Veteran Groups Oppose HR 3200.
On July 30, several veteran groups sent letters to Congress expressing their concerns on proposed health care legislation. On behalf of 24 million veterans they wrote “We are writing to express grave concerns about HR 3200, America’s Affordable Health Choices Act of 2009. As currently drafted, we would oppose this legislation because it could limit the health care choices for veterans, increase the cost of health care for veterans, deny coverage to dependents family members of veterans, and threaten the quality of health care offered to veterans through VA health care system.” The letters, which I received 9/3/09, run several pages. The pdf documents were provided to me directly by the Disabled American Veterans (DAV) association, and include official signatures of: VFW (Veterans of Foreign Wars); AMVETS (American Veterans); DAV, Blinded Veterans Association; Jewish War Veterans of the USA; Military Order of the Purple Heart of the USA; Vietnam Veterans of America; The American Legion; Wounded Warrior Project; and Paralyzed Veterans of America. Among the issues of concern are: Penalty Tax for failure to enroll in an “acceptable” health insurance; disincentive for employers to hire members of the Reserve components; multiple health care options; independence of the DoD and VA health care systems; third party reimbursements for treatment of nonservice-connected conditions; and penalty tax on Reserve components Federalized or activated by the Governor. These are real concerns by real patriots and should not be dismissed as rantings of an ill-informed few.
Such correspondence illustrates just how unacceptable this legislation is. We need to slow down the legislative process to allow reasoned debate, and improve upon our health care system with better options, maximum freedom of choices, and implement fiscal restraint.