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States are looking to put freeze on health reform to appease the few
Here's the latest evidence of the boundless capacity of many American politicians to sacrifice the public interest for political gain.
As of last week, officials in 33 states—mostly Republicans—were mounting legal and legislative challenges to a key portion of the recently enacted national healthcare reform law. They are focusing on the provision that requires most Americans to buy health insurance or pay a tax penalty. They argue that such a requirement is a violation of constitutional rights and a usurpation of state power by the federal government.
Backers of the law say that without a penalty, many people might forgo buying coverage. Because insurers will be prohibited from excluding people with pre-existing conditions, the insurance pool would be skewed with large numbers of sick patients taking advantage of the law.
Striking down the requirement would unravel the program. The objecting politicians know that, but they want to curry favor with a small but vocal constituency that opposes social insurance of any kind—or at least any kind that doesn't benefit them personally. (Try taking away their Medicare, for instance.)
In Massachusetts, where a reform law mirrors the national legislation, polls show citizens overwhelmingly want to keep the system. The naysayers don't want that kind of thing catching on nationally.
It's no coincidence that we didn't see a similar flurry of activity by these officials on behalf of patients and providers when the number of uninsured was growing like an oil spill in the Gulf of Mexico. They serve those who make the most noise and who contribute the most money to their campaigns.
One of the states in the vanguard of the destroy-the-reform-law movement is Florida. You would think that state has other business to attend to, like a devastated housing market, unemployment, sagging state finances or the threat of oil spills. It also is No. 3 among the top five uninsured states when it comes to healthcare, according to the U.S. Census Bureau. It ought to welcome national help with that last plague.
Let's hope that providers in Florida and other states register some complaints against the obstructionists on behalf of their patients and themselves. And remember who did and didn't try to help.
Politicians bamboozle the public so often because many Americans are, to put it nicely, unaware. The latest evidence comes in the third annual Deloitte Center for Health Solutions Survey of Health Care Consumers. For example, only 23% of consumers surveyed said they understand how the healthcare system works.
Maybe that's an unfair question. As we have observed, this country has had more of a crazy quilt than a system.
Some 57% of people were satisfied with their health plan, but only 46% said they understood their coverage and one in four didn't know how much they are paying for health insurance. Some 88% of the consumers said they were in good or excellent health, yet more than half have been diagnosed with chronic conditions or take prescription medications.
The Deloitte survey is only one of several that show Americans, despite the deluge of health reform coverage, are wandering in a fog. For example, a Pew Research Center poll in January found that only 32% of respondents knew that the Senate passed its reform bill without a single Republican vote. A Kaiser Family Foundation poll showed that 58% of respondents didn't know that pending bills would bar insurance companies from setting lifetime coverage caps.
Many providers today worry about health literacy, but maybe the problem is even broader—basic literacy.
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