One of the questions I'm most interested in is whether misperceptions about health care reform, which plagued the debate (PDF) over President Obama's proposal, will decline as the law is implemented. I'm not optimistic. Given the continued flow of criticism from the right and the extent to which people rely on their prior beliefs in interpreting new information, it seems likely that false claims about the law will be a continuing problem for years to come.
However, things may be even worse than I thought. One factor I hadn't anticipated is the potential incentive for insurers and other stakeholders to appeal to anti-reform sentiments using potentially misleading language. For instance, Kaiser Permanente recently distributed a flyer to members in California (PDF) which ominously warns that "health care choices may be limited" starting in 2014 and that anyone who changes plans "may need to choose a government-mandated plan":
While Kaiser does not make any false claims about the changes that will result from the law in 2014, members who have negative preconceptions about the law may read that language as suggesting that the government will restrict their choice of health care. In fact, many of the most important benefits provided by the law take effect in 2014. As a result, a number of people will have more choice over health care and better benefits starting that year (though of course others may find that their plans and benefits change in less advantageous ways).
Brendan, I think Kaiser is probably correct. The health bill will reduce private options substantially by burdening private insurance plans to the point where they're dropped or where the cost becomes unaffordable.
E.g., children with pre-existing conditions:
Health plans in at least four states have announced they're dropping children's coverage just days ahead of new rules created by the healthcare reform law, according to the liberal grassroots group Health Care for America Now (HCAN).
The new healthcare law forbids insurers from turning down children with pre-existing conditions starting Thursday, one of several reforms Democrats are eager to highlight this week as they try to build support for the law ahead of the mid-term elections. But news of insurers dropping their plans as a result of the new law has thrown a damper on that strategy and prompted fierce push-back from the administration's allies at HCAN.
Here's another example:
ObamaCare causes union to drop 6,000 children's health insurance coverage
When all the regulations are written, it's likely that there will be lots more interference with existing insurance plans.
Posted by: David in Cal | December 15, 2010 at 01:02 PM
Kaiser tells the truth and Brendan is alarmed because some may infer that "the government will restrict their choice of health care." I don't know about restricting their choice of health care, but the government will restrict their choice of health care insurance plans. (I love Brendan's euphemism: "others may find that their plans and benefits change in less advantageous ways.") Apparently we don't want to let people know about that; it might upset the poor dears.
Brendan's concerned about "false claims about the law" from the right. Meanwhile, false claims about the law from the left--especially the Administration--don't seem to concern Brendan at all. Remember President Obama repeatedly assuring us, "If you like your health care plan, you can keep your health care plan." Except when you can't.
Posted by: Rob | December 15, 2010 at 01:37 PM
Brendan predicts that people will have better benefits provided by law and more choice. However, economic principles tells us that in most spheres more benefits provided by the law lead to less choice. That's because the mandated benefits may not be feasible for some providers, so they'll exit the market.
A striking example is the inadvertent harm done by minimum wage laws. By law, workers have the benefit of a decent minimum wage. However, many employers can't afford to pay that much for certain jobs, particularly entry level jobs. As a result, fewer than 14 in 100 young black men actually have jobs. http://www.npr.org/templates/story/story.php?storyId=122367407
Will health reform destroy insurance coverage options as much as minimum wage laws destroyed low-paying job options? It might. The law heaps so many "benefits" onto insurance customers that companies may be driven out of most markets.
Posted by: David in Cal | December 16, 2010 at 11:08 AM