On March 21, the sweeping health-care reform bill was approved by the House and sent to the White House for President Barack Obama’s signature. Here, three of AU’s faculty experts weigh in on the historic legislation and what it means for Americans.
What is the cost of the program, both in terms of government funding and implications for individual taxpayers?
The recently enacted health-care reform has been heralded as a major achievement, but major questions remain whether it will achieve its objectives and at what cost. The reform undoubtedly does move us very close to universal coverage, but with greater coverage also comes another commitment on the part of the government at a time when the gap between what the government spends and takes in as revenue continues to widen and is forecast to do so indefinitely.
Over the years, the success or failure of the reform will depend on whether it adds or subtracts from the long-term fiscal imbalance because this is the singular, major challenge facing the nation over the next several decades. While the reform did include some cuts in government spending many will not take effect for some time. More likely, the reform will not reduce the growth in per capita health costs and may well increase their growth. Thus, there remains the concern that an effort that started as one to address the long-term fiscal imbalance, may well make it worse.
— Robert Carroll, Department of Public Administration, School of Public Affairs
What communications strategies should the government use to help the American public understand this plan?
Even before the ink dries on the reform bill, President Obama needs to make it personal for all of us. Stop talking in abstractions about cost and coverage. Stop telling hard-luck stories that are better portrayed on Oprah. Instead, speak to the real hopes and worries most Americans have about their own health care situation.
I would make three principles top of mind in every communication. One is health security: no one can lose coverage, no insurance company can deny you because of preexisting conditions, never again can an insurer put a cap on your lifetime health care expenditures. Two is health reassurance: if you have health care coverage already, whether through work or through Medicare, it will only get better—and he needs to explain how in easily understood ways. Three is the moral issue: that to be a great country, we have to be a good country, and that means insuring all adults and all children so they no longer have to worry about going to a doctor and getting treatment. In other words, make the morality less about health care and more about how we want to see ourselves as a country.
Security, reassurance, morality: that's how Franklin Roosevelt sold Social Security, that's how Lyndon Johnson sold Medicare, that's how Barack Obama should sell health care reform. Keep it simple, understandable, relatable, personal.
— Leonard Steinhorn, Department of Public Communication, School of Communication
Will this legislation improve the health of Americans?
This historic piece of health-care legislation will extend coverage to most of the 44 million Americans who are currently uninsured. However, simply having health care does not ensure that Americans will be healthy. Research indicates that without coverage and when early detection of certain illness is delayed, the successful treatment of the illness may be compromised.
Access is important for health, but it needs to be coupled with a understanding of how to use the U.S. health-care system. The U.S. system is complex and highly fragmented, making it challenging for consumers to use in a cost-effective manner. Access to the health-care system combined with education on how and when to use the system may result in healthier Americans.
Maintaining access to health care is only a part of the equation for good health. Other factors that can significantly contribute to good health include regular exercise, good nutrition, and managing stress; these behaviors cannot be legislated but through providing education and environmental changes where people live, work, and go to school, more Americans might make the best choices to promote their own health.
— Stacey Snelling, School of Education, Teaching and Health, College of Arts and Sciences