For those of you nervous about the success the health-care
exchanges, take a look at this letter:
It's a boring HR letter. That's actually the point.(Photo by Patrick O'Mahen) |
It comes from the benefits office of my most recent
employer, the University of Michigan, with which I am still nominally
affiliated. The letter describes coming options under the Affordable Care Act.
It indicates that UM offers many employees health care benefits that meet
standards for the ACA, and indicates that other employees can go get health
insurance on the exchanges.
Polls suggest that Americans don’t particularly love
the ACA. Most polls also suggest that they don’t
understand it. With uncertain roll-out and the loud and well-funded campaign
encouraging people not to sign up on the exchanges, many of the law’s backers
(including me) are a bit nervous. But it’s reassuring that a letter like this
that will be many Americans’ first contact with the health care law.
Follow me below the fold for my reasoning.
One thing that’s easy for many of us in the activist and
political science community to forget is that most Americans pay very little
attention to politics, and know even less.
Political Scientist Phillip Converse was one of the first
who widely popularized this notion with survey research in the 1950s and 1960s,
which found that few Americans had a very well-developed political ideology, in part because they didn't have basic knowledge of politics.
Many respondents could not even identify the stances of major parties or
identify which party was in control of Congress. Other studies have generally confirmed
relatively low levels of knowledge, though they disagree about precisely
whether it matters or not for how well Americans can intelligently make
political decisions. See here and here for scholars suggesting knowledge isn’t
too important, while see here and here for studies suggesting that it
makes a big difference. And yes, the quality of media makes a large
difference in knowledge: see this excellent article and this review designed
for a layperson.
Here I’ll step outside the bounds of strict scholarship and
offer up some (hopefully) reasoned speculation about how middle- and
low-information Americans might view health reform.
I strongly suspect that one effect of low knowledge is that many citizens believe that there is a disconnection between many things in their everyday lives and the “politics” of far-off Washington. (Read Chapter 1 of Public Opinion by Walter Lippmann for a succinct example of how this theory might work) That was often frustrating for me when teaching – one of the things that I emphasized to my students over and over and over again was that government policy making connected quite clearly with their personal lives. And it’s frustrating for us, especially as progressives because we see people who generally might be (or ought to be) on our side tuning out.
But for the ACA, that might be a good thing, because
people’s first experience with “Obamacare” won’t be a political one, but rather
an administrative one. Remember that letter I posted at the beginning? That’s
the first contact with this law for millions of apolitical or occasionally political
people. They don’t pay much attention to the background noise of politics, but
they’ll pay attention to a letter from their employer talking about their
health insurance. And they will interpret that letter in an immediate way
disconnected from the politics of health reform. For most people the letter
will say that they have insurance through the company and they won’t have to
change a thing. But people who don’t have insurance will have the ability to
call a number, or visit a Web site, or talk to an administrative professional
(not a politician) about how they can get health insurance. When they realize
they can get it, they’ll be happy. Then they might tell their friends and
family, who might be able to get their own insurance.
Millions of letters like this are going out from thousands of
companies. Remember that the vast majority of mid-level human resources
department employees are pretty professional, especially for mundane administrative issues that don’t
expose the company to liability or cost.
And thus Obama-care spreads successfully beyond the reach of
any multimillion dollar ad campaign from the Club for Growth. Sometimes even
some political people might get affordable insurance in spite of themselves,
because they don’t connect the insurance exchanges with the hated “Obamacare” –
like this poor sap, God bless him.
There are still some serious challenges – states blocking navigators from
helping poor or unemployed people from registering will do damage, for example, but overall I have considerable confidence.
I suspect that 75 percent of Americans have never heard of
Grover Norquist. And the beauty of it is in this case that what they don’t know
not only isn’t going to hurt them, but might very well help them and all of us.
No comments:
Post a Comment