The New Health Dialogue

You probably all saw the National Council on Aging poll this week showing that seniors were quite confused about health reform (here, Pulse). Not even a third of them knew half the facts deemed “senior pertinent.” I went up to the Washington, D.C. senior center where the results were released in front of a group of seniors, and I couldn’t help thinking, are they really more misinformed than any other segment of the population? Is it really so strange that they can’t quite grasp the legislative niceties about ACA and SGR. (The Accountable Care Act, aka health reform, doesn’t cut doctors pay in traditional Medicare. The SGR formula -- which Congress has been struggling with for years -- does). Do people my age have a better understanding of health care reform and what it means for our future, of what is "millenial pertinent?"

Of course, seniors traditionally vote in mid-term congressional elections, and if they are scared and confused, it may make a difference. Mike Lillis over at The Hill's "Healthwatch" blog notes:

"The poll [...] highlights the dilemma facing Democrats as they seek to use the healthcare reform law to their advantage in November: convincing voters -- particularly seniors -- that the law’s benefits outweigh its new costs and mandates."

Seniors constantly hear that health reform will “cut” Medicare, so it’s logical they would assume it would also “cut” payment to doctors. It seems like simple math: less money for Medicare, less money for Medicare doctors. That argument is easy to understand, and repeat, and shout. The truth about cutting waste, and bending the curve, and improving care coordination, and reforming delivery systems to get more value-based care, all get drowned out in the din.

I could hear the confusion in the questions at the senior center. One gentleman in the crowd asked, “Covering all these people, it seems very expensive. How can it cut the deficit?” Again, simple, yet incorrect, logic can lead you astray:

Millions more covered
Coverage costs money
Therefore, more coverage costs more money.

This message is easy to propagate and hard to contradict. Coverage does cost money. But it’s paid for -- and then some. I'm not so sure many in the crowd, even a fairly sophisticated crowd of Washingtonian seniors, really get what the CBO and health economists have been saying about cost-savers and revenue raisers.

The NCOA is planning to do some educating, and it has its work cut out. I'm not entirely convinced that their plan to Tweet health reform is going well with this particular demographic. And as one gentleman said, the text in the pamphlet the NCOA handed out at the meeting was too small for many in the audience to read. Still, their broad network of affiliated senior centers gives me hope that the message will get through: seniors have nothing to fear, and much to hope for, in health care reform.  In fact, my grandma just got on Facebook this week. I think I'll go post that on her wall right now.