Confused by the debate about health care reform? You’re not the only one.
"Based on what they see on the news, I think it's impossible for people to understand what’s happening," says Alwyn Cassil, director of public affairs at the Center for Studying Health System Change in Washington, D.C. "Health care reform is a lot more complicated than all the finger-pointing suggests."
Watching the contentious town halls and the ferocious debates on political talk shows can be less informative than unsettling. You can wind up feeling uncertain of what’s right – and powerless.
But you're far from powerless. There’s a lot that you can do right now to understand health care reform better and make your opinion count. This is a historic moment in the U.S. What happens in the coming months will have a huge and lasting impact on how the health care system works -- for us and our families.
Health Care Reform: What’s the Problem?
Many policy experts -- regardless of their politics -- say that U.S. health care is in crisis. About 46 million Americans have no health insurance. People with pre-existing health conditions find it difficult, costly – and sometimes impossible – to get health insurance. We spend much more on health care than other industrialized nations, yet have poorer health when judged by the number of preventable deaths and other measures.
"If our health care is supposed to help us have longer, healthier, more productive lives, we’re just not doing as well as we should be," says Stephen C. Schoenbaum, MD, director of the Commission on a High Performance Health System at the Commonwealth Fund in New York City.
Moreover, the current system is draining us financially, he says. "It's contributing to our national indebtedness, eroding our wages, and [hampering] our ability to deal with critical issues like education and infrastructure.” Indeed, about 17.6% of all spending in the U.S. pays for some form of health care – money that might otherwise be spent on schools, roads, and pensions.
Many experts agree that some change is needed. The question is: what type of change, and how will it affect you?
As the health reform debate continues, and legislation is considered, here are five ways you can begin to understand and get involved in health care reform.
1. Get Informed
It's not easy to get balanced information about the proposals for health care reform. Our political parties are polarized and there's a staggering amount of jargon – universal coverage, medical underwriting, community rating, public option, health care co-ops, and so on.
Where do you begin? You can find some of the actual legislative proposals online, but they can be a tough slog. Cassil recommends looking at the side-by-side comparisons of the bills from the Kaiser Family Foundation.
"Remember that nothing is concrete yet," she says. That’s an important point: Any final bill that goes to a vote and to the president for signature will likely look quite different from the proposals circulating early in the legislative process.
Some good resources for understanding the basics of health reform include:
- The Kaiser Family Foundation, a nonprofit group that focuses on health care issues in the U.S.
- The Commonwealth Fund, a private foundation that promotes improvements in the health care system.
- AARP, a nonprofit organization focused on the concerns of people over age 50.
- PolitiFact, a site run by the St. Petersburg Times that evaluates the accuracy of political statements about health care (and other topics.)
- HealthReform.gov a site from the Department of Health and Human Services.
Read a variety of perspectives to get a broader view on the issue. And don’t accept information passively -- question it. Health care reform is an immensely complicated issue and there are lots of different ways to look at it.
Beware of allegations and conspiracy theories you may see in emails or on TV. Do your bit to elevate the debate about health care reform – get people talking about the facts, not rumors.
2. Talk With Your Doctor
Ask your doctor about health care reform and how it may affect your family’s medical care. Your doctor may have some advice as to what sort of reforms would benefit you and your family most, given your specific situation.
In a more general way, understanding health care reform means working more closely with your doctor and becoming a better-informed patient. Experts say that culturally, Americans tend to like their doctors to do stuff. We like tests and medical interventions and surgeries. While a vigilant, aggressive approach to medicine is good up to a point, it can get expensive. And what’s more, it can become bad for our health, Cassil tells WebMD.
“More medical care than you need can get you in a lot of trouble,” says Cassil. Unnecessary tests and procedures can have side effects, sometimes serious ones. A person with back pain might opt for a type of invasive back surgery, but research might show that the approach is less effective, and riskier, than taking a painkiller.
As part of educating yourself about health care reform, become a smarter patient. When a doctor gives you some options for treatment, ask questions like:
- Which treatment has the best evidence?
- Which treatment has the fewest side effects?
- Which treatment will cost the most – even if my insurer is paying the bill?
Becoming aware of these details will make us all savvier about our health care. It could also make us healthier.
3. Understand Your Current Coverage
If you’re like a lot of people, when you get that fat booklet from your health care insurer outlining your plan’s coverage, you stick it in a “to read” pile – where it languishes unread for months. Or you just throw it right into the trash.
But experts say that you have to understand your coverage. First of all, your health – and finances – depend on it.
“Don’t wait until you’re in a crisis to understand how your health care works, because by then it could be too late,” says Cassil. “Everyone needs to sit down with that mind-numbingly detailed, jargon-riddled document and read it. There’s no substitute.”
Second, it’s hard to form a clear opinion about health care reform if you don’t know about your current coverage. People with coverage from their employer tend to be insulated from the financial realities of their care, says Nicole Duritz, Health Care Portfolio Director at AARP in Washington D.C. They know what their co-pays are, and maybe they know how much their employer takes off their paycheck for health care. But they often don’t understand the larger picture – the total cost of their care.
Start paying attention to your medical bills -- not only what you pay, but how much a drug or doctor’s visit or procedure cost in total.
4. Ask Yourself: How Could Your Health Care Be Better?
This can be trickier than it seems. “I think it’s very hard for people to evaluate their own health care,” says Schoenbaum. For one, many of us have a tendency to accept things as they are. We forget that other ways might be possible. There’s also a natural fear of giving up the health care system that we know for something unknown, says Duritz.
- Are your co-pays and premiums getting harder to afford?
- Have you had trouble getting coverage for an appointment, test, or procedure?
- Are drug costs eating up more of your budget?
- Do you sometimes skimp on treatment – avoiding the doctor, not filling prescriptions – because you can’t afford it?
- Can you see the doctors you want to see?
- Do you get adequate preventive care, the screenings, vaccinations, and checkups that could prevent or detect a health problem early?
Don’t forget to consider other ways health insurance may affect your life. Some people stay in jobs they don’t like because they’re worried about losing health insurance, Duritz says. “We also hear about small business owners who want to expand, but don’t because they’re worried they couldn’t afford coverage for the extra employees.” These sorts of anxieties are directly relevant to health care reform.
5. Speak Out
The U.S. is on the brink of making one of the biggest changes to health policy since the introduction of Medicare in 1965. This is a historic moment. And it’s one in which you, as a citizen, have some real power.
What can you do?
- Write or call your elected officials. Let them know what you think about health care reform. Talk about your own experiences. Many politicians are looking to voters for guidance. Here are links for finding and contacting:
- Join an advocacy organization. No matter where you come down on health care reform, there are advocacy organizations you can assist, and in doing so make your point of view more widely known.
- Talk to your family, friends, and co-workers. Once you understand the issues at stake in health care reform, make your case to the people around you. A lot of people are confused by the debate and anxious about reform. They could use your help in understanding what it might mean for them.
Remember, we all have a say in how health care works in this country. This is a moment when your family, friends, neighbors, and elected officials are listening. So make your opinion about health care reform known. It matters.