BY: JEFF TIEMAN
The story of health reform has not been told very well. Misinformation continues to confuse and overwhelm the American public. Little mainstream media coverage during the debate offered context outside the political skirmishes or framed the issue as a matter of realizing shared values.
Even after the Patient Protection and Affordable Care Act became law in March 2010, the story line didn't improve. Public opinion polls show that since President Obama signed the bill, fewer than half of Americans support it and those numbers have hardly moved.
As I've written in this column before, the top-line opinion survey numbers can be misleading. Although only 41 percent of the public supports health reform, according to the Kaiser Family Foundation, large majorities of Americans surveyed support many of its core provisions. For instance, 82 percent support tax credits for small businesses; 76 percent support gradually closing the Medicare "doughnut hole"; 74 percent believe everyone should be guaranteed access to health insurance; and 72 percent support subsidies for lower-income people to buy meaningful coverage.
Why, then, are Americans so split on whether the health law was the right thing to do? Three related theories: Health reform hasn't been explained very well by its proponents. It has been effectively maligned by its opponents. There has been no compelling and forward-looking narrative about why health reform was the right thing to do.
Part of this disconnect is grounded in a different perspective inside the Washington D.C. beltway, where it is all too easy to get mired in political and fiscal abstractions. One provision in a health care bill will help 12 million people; another will cost $10 billion over 10 years. These numbers — and the partisan games that are played to move them up, down or out — obscure the real effects of the proposed change and the people it intends to help.
During negotiations to pass the Affordable Care Act, pronouncements of individuals covered, costs incurred and consequences unconsidered flew around the beltway with more annoying effects than the cicada bugs that invaded our city in 2004. Unlike the cicadas, however, political maneuvering will not go back underground for 17 years before resurfacing. We are stuck with it.
We can, however, move beyond the mind-numbing statistics and policy details and, in doing so, tell a more powerful story. Through stories of the actual people who have benefited from this law — children, young adults, seniors, small businesses, people with pre-existing conditions — we can better convey what a given policy actually means, whom it affects and why it is both necessary and helpful.
At CHA we recently began an effort to find and tell the stories of people whose lives have already changed for the better as a result of health reform. In the coming months and years, we hope to build a collection of these stories to share with lawmakers, community leaders, friends and colleagues. We have come to understand that promoting health reform isn't as simple as touting its provisions and benefits. We need to illustrate — in a powerful and personal way —why this law is so important and must be protected.
At CHA's June assembly in Atlanta, we showed four video vignettes featuring families around the country who have found help and hope in the reform law. Here is a brief summary of two of those stories. To watch all the video stories we have told so far, visit www.youtube.com/catholichealthassoc — and please share the link.
DIXON DAIRY FARM
Our first health reform success story comes from a dairy farm in Cosby, Mo., not far from the Kansas border. Bryce Dixon is 24 years old and suffers from ankylosing spondylitis, a form of arthritis that primarily affects the spine. This condition can cause debilitating swelling of the joints and feet, as well as autoimmune deficiencies.
To manage his disease, Bryce requires twice monthly injections of a drug that costs more than $1,400 per dose. He recently reached the age that would disqualify him from his parents' health insurance plan, leaving him wondering how he could afford the injections he needs to be able to work. Then the Affordable Care Act kicked in with a provision allowing young adults to stay on their parents' plan through age 26.
Bryce told me farming is the only work he can imagine doing, and if his condition couldn't be managed, he would be immobile and miserable. He said the health reform law was a "big help" because without it, he would have to find the money for his injections or face the prospect of serious pain and the inability to work. For Bryce, stopping work is simply not an option.
I was amazed by how hard Bryce works. Along with his father Brad, Bryce milks and cares for 160 cows every day. Bryce takes a half-hour for lunch, but otherwise there is little time to spare — and no weekends or vacation — from his 15-hour days. During the six or so hours I spent on the farm, I never saw Bryce stop working except when we took 20 minutes to do an on-camera interview.
When Bryce turns 26, he will once again "age off" of his parents' insurance plan. At that point he will find help in the pre-existing condition insurance plans made available by the Affordable Care Act, and, in 2014, he will have access to a state-based insurance exchange from which he can buy affordable health coverage.
Bryce and his family are dedicated people who spend their time producing milk for our country. I would urge those who oppose health reform to spend a day on the Dixon farm as I did. It would be impossible to leave and not feel like health reform was the right thing for Bryce Dixon, his farm and his family.
VINTAGE VINYL
If you believe some of the blog and cable TV hype, small businesses are being harmed by health reform. In Lew Prince, we found strong evidence that the opposite is true. Prince is the co-owner of Vintage Vinyl, a 35-year-old music store in the Delmar Loop area of St. Louis. He employs 16 full-time and seven part-time people in his independent record store. Prince has made it a priority, even when business is slow and margins are tight, to provide health insurance to his workers.
"As the business grew, we came to the conclusion that it was really good for productivity, it was really good for our relationship with the people we worked [with], and it was the only real moral thing to do, to provide health insurance for our employees," said Prince, who expects to receive a tax credit from the Affordable Care Act that will reimburse him for 20 percent of last year's health insurance costs.
Vintage Vinyl is a cool store — a music fan's dream with more than 50,000 titles to choose from on CD and LP and several thousand square feet of every genre of music one can imagine. It was clear from spending an afternoon with Lew Prince that for him, a cool store is even cooler when it treats people fairly.
NEXT STEPS AND STORIES
Bryce Dixon and Lew Prince are just two of the people whose health care stories we told at the CHA Assembly and are sharing on the Internet. The other stories illustrate how the Affordable Care Act has provided needed coverage to children and to seniors. Now we need to show them in every venue we can — presentations on health reform, on our websites and YouTube channels and in our interactions with media.
We also need more stories, and this is where CHA members come in. Please keep an eye out for people in your hospitals who have received care or coverage because of the Affordable Care Act. When you can, send their names and stories to CHA so that we can add them to our growing story bank and make sure the voices of those we serve are heard on this important issue.
Catholic-sponsored health care providers are some of the best messengers out there when it comes to supporting the Affordable Care Act and the opportunities it offers. The best messages we have tell the stories of people in our care. Let's keep telling the story of health reform and the people whose lives are better because of it.
JEFF TIEMAN is senior director, health reform initiatives, Catholic Health Association, Washington, D.C. Write to him at [email protected].
Copyright © 2011 by the Catholic Health Association of the United States
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