Reactions

Yesterday, I was picking up my children from their afterschool program, and two of the teachers who run the program pulled me aside and said:  “Uh, do you have a few minutes?  We were wondering if you could tell us about health reform—like what, exactly, was in that bill that just passed, and how it will affect us.”

I was astonished.  These teachers know where I work (you have to include that info on the enrollment forms for the program) but I had no idea they knew anything about the Robert Wood Johnson Foundation or, for that matter, what my job is here.  (Which recently changed.)   But getting past my astonishment about the questions, I was also struck by how straightforward and simple their desire was:  they wanted to know more about the health reform legislation.  And, they wanted to know if their lives would change.  In today's 24/7 media spin cycle, you’d have to be deaf, dumb, and blind to not be aware that something was going on related to America’s health care, in the last 14 months, but clearly, so much of what happened with respect to the health reform debate was challenging for the ordinary citizen to understand, especially in terms of what was at stake, for different people.   

I don’t think I have an opinion on whether it’s a good or a bad thing that the bill became law without greater understanding from people like these teachers about what was actually in the bill, even though there are many who would argue one side or another of that question.  First of all, I’ve seen enough policy sausage-making to know that no matter how much you try to get people to understand what’s at stake, and no matter how much you invite comment and input from different perspectives, you’re still gonna get accused of leaving people out.  And it seems reasonable to assume that there was no intentional, diabolical plan to leave people like these teachers out of the debate; it’s more that that health care reform is, by its very nature,  a highly complex topic, and as far as I can tell, many efforts were made to engage different groups, but America’s collective attention span for understanding this issue was a limited commodity, crowded by earthquakes and Tiger Woods. 

I do, however, have another opinion, which is this: the job of educating people about what did just happen in the health reform debate, and what will happen, is not over, not by a long shot.  Especially if they, the people, want to learn more.  And can I tell you that no matter how cynical or dispirited I feel about a particular issue, I never feel cynical about our collective reponsibility to learn, and share what we need to know about our health and health care.  Even when our learning and knowing is made tougher by the politics and ideologies coloring a particular debate like this one.

In a recent post on his Health Policy and Communications blog, Michael Miller succinctly highlights how the political debate from both sides will try to color our feelings and understanding of the health reform issue in the days to come:

The majority needs to present their actions in a way that fosters catharsis in people, (particularly in voters), by actually improving some problem. Their goal is to turn that catharsis into positive feelings about the majority party, leading to votes in future elections. Conversely, the minority party needs to create anger about what the majority party is doing or proposing, with the goal of turning that anger into….. (no surprise here)…… votes in future elections.  Thus the key for the party leadership, individual elected officials, and their communications and campaign staffs, is how to best create catharsis or anger - depending upon which side of the fence they are on.

So, in other words: gird your loins for the emotional and political whiplash of health reform to continue, but that doesn't let us off the hook for our own learning and understanding of the relevant issues. Really, I thought it was lovely and surprising that the teachers asked me to explain to them what was in the bill.  I''ve gotten similar phone calls and e-mails from friends and family members in recent weeks, even from those who I would have described as "civically engaged." And even though I am by no means the sort of person a true policy wonk would turn to for an analysis of the full bill, I’ve spent enough time in health policy communications so that I felt comfortable sitting down on a worn-out mat in a classroom with these teachers and giving them the 10-minute overview of what the heck just happened in our country over the past year and a half, and in particular, over the past few days.

On a final note, even though the health care and health policy wonk blogs I peruse are chock-full of reactions to the health reform legislation, I’m going to point you in an unlikely direction:  the queen of all mommy bloggers, at dooce.com (a.k.a. Heather Armstrong) named one of the most powerful women in media by Forbes magazine, recently posted on this subject, and it’s worth a look to see how she tried to explain one aspect, related to insurance reform, of the health reform debate to her (literally) millions of readers.  Score one for good ol' plain English.

 

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[Minna Jung]

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