Sunday, April 27, 2014

Wedge Issues and Helping the People

Having health insurance is good for you. There is great deal of debate about whether it makes people much healthier, or adds many years to your life, but some studies have found big effects. Nobody disputes, though, that having health insurance reduces the amount of stress poor people face. And cumulative stress, as I have written here many times, is pretty much the defining misery of poverty in America -- the recent Oregon study of people who did or did not get Medicaid in a state lottery found a significant reduction in depression among those who were able to join. Health insurance also reduces the rate of personal bankruptcy. Even more, government subsidized health insurance makes it possible for hospitals and doctors to function in the poor parts of the country; there are places where more than 80% of hospital revenue comes from Medicare and Medicaid. So, anyway, I count the expansion of health insurance as a generally good thing. The Affordable Care Act is expanding health insurance coverage in America, but not as much as it might be. One reason it is not working as well as it could is vitriolic attacks from Republicans and their allies:
“The controversy about Obamacare does seem to have interfered with people’s ability to sort out the value of the marketplace for getting health insurance for themselves,” said Dr. James B. Becker, associate professor of the Marshall University School of Medicine and medical director of the state’s Medicaid program.

Other problems stymied the introduction of the law, notably the initially dysfunctional federal website. But the political polarization “complicates our efforts to enroll people and to educate people about the Affordable Care Act, there’s no question,” said Perry Bryant, head of the advocacy group West Virginians for Affordable Health Care, based in Charleston, the capital.

“Literally, people thought there would be chips embedded in their bodies if they signed up for Obamacare,” Mr. Bryant said. . . . at a branch of the Shenandoah Valley Medical System in Martinsburg, Sara R. Koontz, a social worker, said she had heard people express fears about chip implants as well as “death panels” as she sought to enroll uninsured residents. Some told her that they would rather pay a penalty than sign up for insurance, she said, and even people who did enroll paused in their excitement to ask, “Wait — this isn’t that Obamacare, is it?”
The people spreading these lies have a lot to answer for.

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