The August of our discontent

Looking at the calendar, it’s hard to believe a whole year has gone by since last August. You remember: all the town hall meetings about health care reform and a whole lot of angst, apprehension and anger.

So it was interesting to come across the Kaiser Family Foundation’s latest tracking poll, issued last week, which found that support for the health care reform law remains steady, while opposition has slightly receded. The poll’s sample size, about 1,500 adults over the age of 18, isn’t particularly large. Nevertheless, the findings offer a window on the public’s opinion about an issue that continues to be both confusing and contentious.

At the risk of cherry-picking the data, I’m going to summarize some of the highlights. (To read the full report, follow the link above.)

- Respondents were split on the impact of the new law. About one-third, 32 percent, said they felt the law would leave their family better off, 29 percent said they would be worse off and 33 percent said they didn’t think it would make a difference. They were more likely to see positive changes than negative for the country as a whole (43 percent vs. 35 percent).

- Respondents used a variety of words to describe their feelings about the health care reform law. Many of them were still confused, and it was pretty clear from the poll that the anger hasn’t entirely gone away. The breakdown: “confused” – 43 percent; “disappointed,” 42 percent; “pleased,” 42 percent; “anxious,” 39 percent; “relieved,” 38 percent; “angry,” 28 percent.

- People 65 and older who participated in the poll were more likely to have an unfavorable view of the law – 46 percent, compared to 38 percent who saw it favorably and 17 percent who said they didn’t know. Twenty percent thought they would be better off under the new law but 35 percent feared they would be worse off. Seniors were most worried about cutting Medicare benefits, the potential for rising costs and increased taxes, and fears of health care rationing.

It’s interesting to note that many of the older respondents to the poll weren’t quite clear on what’s actually in the health care reform law. More than one-third, for instance, believed it will allow a government panel to make end-of-life decisions for people on Medicare, even though this provision was cut from the reform bill months before it came up for a final vote in Congress.

What conclusions can be drawn from this poll, which was conducted at the beginning of July? For one thing, the anger and discontent that boiled over in August 2009 is still simmering away. For another, there’s still a fair amount of confusion over what’s in the health care reform bill. Maybe this is a reflection of the complexity of the bill and the many versions through which it evolved. At some point last summer, it became increasingly difficult, even for veteran observers, to keep track of what was actually on the table. Although federal leaders and politicians have talked about the need to educate the public about the contents of the new law, to date I haven’t seen much of a concerted effort to make this happen.

Finally, I think the poll reflects the fact that there’s still a lot of uncertainty about what the impact of health care reform will be. The law is huge and ambitious and, as this news roundup suggests, largely uncharted territory. While there have been some concrete results, such as the first rebate checks that went out in June to Medicare recipients who entered the prescription drug doughnut hole, many of the provisions won’t go into effect for months. How is the public supposed to form an opinion, favorable or not, when there are so many unknowns?

We’ll likely see some of the answers unfold in the next few years as the law solidifies. It’s not much comfort, though, to people who are uneasy right now about the impact, or perhaps impatient to start seeing results. All I can say is: It took many years for the health care system to devolve into its current situation and it cannot be fixed or changed overnight. Patience, patience, patience.

Photo: Associated Press

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