Jimmy Kimmel isn’t considered a preeminent source on health policy and public opinion. But his television show’s trip to Hollywood Boulevard two months ago revealed more about the relationship the average American has with healthcare reform than our elected officials or the news media have ever managed to. Mr. Kimmel’s video crew took to the iconic Los Angeles street to ask random passersby about their opinions on what will most likely be remembered as the most significant piece of legislation passed during the Obama Administration: The Affordable Care Act (ACA).
A member of Kimmel’s crew asked one passerby, “We’re talking about health care today. Which plan do you support, the Affordable Care Act or Obamacare?” After the passerby answered “The Affordable Care Act,” Kimmel’s crew asked what is was about “Obamacare” the person did not like. The passerby answered, “I just think there’s a lot of holes in it and it needs to be revamped. It hasn’t been thought out.” Kimmel’s crew prodded again: “And you think the Affordable Care Act is a better plan than Obamacare?” “Better, but I’m not happy about that either.” They kept asking, but the answers aired were mostly the same: “So the Affordable Care Act is more affordable than Obamacare?” the cameraman asked one passerby. “Just the name says it all.”
The majority of Americans may at least understand that the ACA and Obamacare are the same piece of legislation, but do they truly understand what the measures in the ACA actually entail? Is it filed away in their minds as just another point of contention between Democrat and Republican partisan fight? The ACA has been dissected and examined from both a bird’s eye view and the most microscopic angle, but for a bill whose overall objective is to cover all uninsured US residents, the fact that people don’t even recognize how to become covered should be a concern to both legislators and American people alike.
Pollsters account for poorly informed respondents by providing “I don’t know” or “Cannot answer” as a potential answers on questions relating to healthcare. But they have additionally chosen to explore the confusion surrounding the ACA by conducting polls that purposely refer to the law by each of its nicknames. CNBC released a survey in September that revealed 46 percent of respondents had negative feelings towards “Obamacare” while a significantly lower 37 percent of respondents had negative feelings towards the “Affordable Care Act.” Twelve percent said they didn’t know enough to say anything about “Obamacare” and 30 percent said the same about the ACA. Since the debate about healthcare began, polls have captured a confusion about healthcare reform.
Why The Confusion?
Compare the Affordable Care Act to the Elementary and Secondary Education Act, otherwise known as “No Child Left Behind,” passed in 2001 with bipartisan congressional support and signed into law by President George W. Bush. No Child Left Behind was far more popular than the ACA is, and while it would seem that fact would make it less recognizable, people are still very familiar with the bill. Robert J. Blendon, Professor of Health Policy and Political Analysis at the School of Public Health, a faculty member of Harvard Kennedy School, and Director of the Harvard Opinion Research Program, speculated in an interview with the HPR that whenever a President’s name is attached to a piece of legislation—such as the ACA’s colloquial name, “Obamacare”—people may love the bill or automatically dislike or ignore it simply based on their opinions of that President. .
Professor Blendon went on to explain that the health care reform conversation has transformed into a “deeply philosophical” debate. Opponents of the ACA oppose the ACA as government overstepping its boundaries. Supporters consider universal health care to be a human right, referencing all the other developed nations that have had systems similar to that defined by the ACA in place for years. But each side argues about the ACA without any non-hypothetical information about the law itself. Instead, they clash over fundamental differences in ideology, using the plan as a proxy: too big government versus government’s social responsibility. Professor Blendon went so far as to suggest that neither side has the true details of what will result from ACA and will not have them until the ACA takes full effect.
To blame the media for public misinformation would be easy, but unfair. Though the United States news media is more politically polarized that it was even fifteen years ago, most platforms allow both supporters and opponents of the Affordable Care Act to maintain a notable presence on their webpages and television networks. Interestingly, the Associated Press’ Deputy Managing Editor and Standards Editor Tom Kent recently wrote in a blog post that “In AP news reports, our preference is to use wording like ‘the nation’s new health insurance system,’ ‘the health care overhaul’ or ‘the new health care law’” because “terms like ‘Obamacare’ and the Affordable Care Act’ have their downsides.”
The conversation that envelops the ACA has moved out of Washington and into the public domain. Opponents of the ACA, who call it “Obamacare,” regularly only emphasize what they perceive as negative aspects of the bill: that doctors will become overwhelmed by an influx of patients, that people will lose control over who their health care providers are and health insurance carrier is. The ACA’s supporters, who remember to call it the Affordable Care Act, tout what they see as highlights: that people will no longer be denied coverage based on preexisting conditions and that children can remain on their parents health insurance until age 26.
Former Massachusetts interim Senator William “Mo” Cowan, a Fellow at the Harvard University Institute of Politics, told the HPR he believes that the Obama administration did not do enough to sell the plan they proposed, and that the ACA’s opposition has defined the conversation and forced the ACA’s creators and supporters to defend, rather than promote, the law. To the busy American who picks up tidbits of the conversation on the commute to work or while watching a waiting room television: Obamacare and the Affordable Care Act may actually sound like two completely separate plans.
Politics and the People
Without removing responsibility from the representatives we elect to be our liaisons and advocates within the government, another truth must be considered: we, as a populace, may have ourselves to blame. No one can accurately say if Americans have become more apathetic in comparison to prior generations. But when only fifty-four percent of the American voting age-population shows up to vote in the 2012 presidential election, one questions whether some of the other forty-six percent who stayed home are those who do not understand the ACA.
Whether you are in favor of big government or self-government, someone is accountable for our civic knowledge. The job of educating and informing is clearly not being accomplished on the most essential of current issues. And the further we remove ourselves from the hotbed of Washington, the further we stray from caring and participating in our legislative process, the less likely our leaders are to recognize single digit approval ratings and the more likely they are to continue to ignore the power of the constituent.
The modus operandi of our political system needs to undergo significant changes and the most essential of these may be a move back to discourse between elected officials and the people. Imagine a “fireside chat” style broadcast conducted by a congresswoman or a senator or the President about the Affordable Care Act. POLITICO can release flow charts and explanatory paragraphs about the ACA again and again, singularly informing those who choose to read and those who the readers talk to. But leaders should be expected to do the other job of a representative—effectively representing the government to the American people.
Photo Credits: obamacarefacts.com, allianceforajustsociety.org