Depth Takes Holiday on ACA Stories
I talk to people, type up what we've chatted about, and then share it with a bunch of other people. That makes me a member of the media. But I am by no means a proud member of that group.
A lot of what we do manages to be both vapid and breathless, misses the forest for the trees, and is often downright stupid. Sometimes it is all of that rolled into one.
The recent coverage about the rollout of the healthcare.gov website is a stellar example of that convergence.
Yes, the website rollout was problematic, if not a fiasco. But I have read article after article pivoting on the notion that the Affordable Care Act is the sum of its website only.
Since it's not only the holiday season but my impending 20th wedding anniversary, I have recently purchased items via Amazon, Kitchenaid.com and other e-commerce sites. If those sites did not function, I would have traveled the three-quarters of a mile to my local mall to purchase them. If I couldn't get to the mall, I would have ordered them by phone. It would have been more inconvenient than the Web, but my needs would have been fulfilled.
Individuals looking for insurance have similar choices. They could consult with a navigator in person, talk to an agent over the phone and fill out applications via paper and submit them by mail. These are forms of commerce commonplace in this country for the past century. Yet since healthcare.gov was balky, it was suggested by the media that the elimination of underwriting bans for most preexisting conditions, dollar caps on coverage and the expansion of Medicaid programs could all be for naught.
Along with feeding that damaging conflation to the American public, the media noted that many of the exchanges operated by states have been successful (California's particularly, with Oregon's the sole exception). What it failed to note is that the federal government was tasked with operating the exchange business for 36 states. It wound up juggling such a large number because at least two-dozen states have anti-ACA governors and legislatures. They opted out of building their own exchanges in order to pile on the feds in the hope its efforts would fail. I'm still waiting for that particular bit of reportage to appear.
Then there is the other issue that hissed of vapid breathlessness: President Obama's broken promise you could keep your health insurance policy and your doctor if you liked them. That was the decision of insurance company executives who could have beefed up existing policies to conform with ACA standards instead of canceling them outright.
Let's be clear: People like what they pay for their coverage. When they become seriously ill and find out they bought cotton candy when they were expecting air bags, their opinion tends to change.
As for my doctor, I assume she's likable – I've spent perhaps an hour with her over 15 years. That's no doubt been the experience of pretty much everyone else in this country since managed care descended three decades ago. That may be different among those with chronic illnesses, but many of them lack insurance for that same reason.
Insinuating the ACA is just a website and that President Obama is a bald-faced liar has created a wake-like feeling about healthcare reform just as it is being birthed. A recent Gallup Poll indicated just 42% of those surveyed said the government should guarantee access to healthcare. That's compared to 69% in 2006.
My advice to my colleagues: Chat with more people and type up more stuff before you rush to share it with everybody else. The ACA is complex and requires complex reporting. The depths of a black hole are not the same as depth.
Ron Shinkman is the publisher of Payers & Providers.
