1. Consumer Health: Health Care Reform

2. So where have we been/what’s changed?
many states’ assistance rolls include working folks; employers will need to contribute/share cost with state
health care was previously a commodity to be bought and sold, change in thinking to “right” to health care*
*HC always a right in the ER; federal law meant we all, ultimately, paid for others’ care if they couldn’t
all health care decisions were made by the market; government will now play a greater role
insurers could make huge profits; they still can

3. So where have we been/what’s changed?
younger/healthy people NOT buying insurance means higher premiums for others
16% of the GDP covered about ½ of us adequately; other nations spending less to cover everyone
(combined costs of inequality and premature death were $1.24 billion)
Medicare Advantage plans are private plans receiving govt subsidies; large bulk of cuts will go to these plans

4. What hasn’t changed?
someone has to cover costs of care for uninsured people in an emergency
who does that?
what’s the law? when was it passed?
Guidance/Legislation/EMTALA/

5. What was the fight?
The constitutionality arguments and states’ rights perspectives
Is it constitutional to force people to purchase health insurance? Some people said absolutely not, some said absolutely. Is it a violation of states’ rights to expand Medicaid eligibility? Some said yes, some said no. The Supreme Court upheld the law. Here’s a brief summary of their decision: 01/8332.pdf
NOTE: States that filed amicus briefs in support of the Medicaid expansion in the federal district court include Colorado, Iowa, Kentucky, Maryland, Michigan, Pennsylvania, Oregon, Vermont, and Washington. In some states, the governor and the attorney general filed briefs on opposite sides.

6. Finally, we can explore perspectives & discourse (talk)
public health perspective/discourse – where do we find it?
our professional orgs, grassroots/advocacy orgs
our peer-reviewed journals
certain news outlets
free market perspective/discourse – where do we find it?
industry/trade associations

7. What we “get” about an issue often depends on how we talk about it
“government takeover” vs. “public-private system”
“stifling regulation” vs. “important consumer protection”

8. Industry thinking – one way?
Nope, doesn’t seem to be:
Q31/32. You said healthcare costs are most important. Which of the following issues do you care about the most? [Combined]
38%  Keeping healthcare costs low for American families
30%  Replacing the Affordable Care Act
29%  Giving employees more choices and control over their healthcare options
25%  Making healthcare costs more affordable for small businesses
20%  Finding state-based solutions to healthcare coverage issues
19%  Promoting innovation in the healthcare sector to reduce costs and save lives
18%  Expanding access and coverage to more people
10%  Reducing government regulation and red tape
10%  Freedom to decide whether to provide benefits like birth control

9. Who’s right? Whose language is more powerful?

10. What we see depends in part on where we look
Stewart
CNN
FOX
O’Reilly
WSJ
NPR
NY Times
Limbaugh
Time
The Nation
Krugman
National Review
Reid
Krauthammer
Maddow
Brooks
PBS
US News

11. Int’l & Indie News? What and how do others report on events in the US?
BBC, the Guardian, Al Jazeera, and other English- language foreign sources
What does news “look like” when smaller companies that don’t carry ads (or carry different ads) are the ones doing the reporting?
Pacifica Radio, Mother Jones

12. The Federal Health Care Website
What can you learn here that might change your mind or someone else’s? Say you had a concern or dislike of the law, and that question or dislike was grounded in a question you had or piece of information you needed? Does this site help change that?

13. There are different perspectives EVEN within groups
Public health professionals are more, or less, individual and behaviorally focused; more, or less, focused on environmental/system-level change
Bottom line: Health care reform that allows more people to have access to primary and preventive care will improve population outcomes, and that’s where our groups tend to focus

14. SOPHE perspective