On June 28, I returned home from a week of strategic meetings in our Denver office, in a state somewhere between that feeling kids get when they know they have presents beneath the Christmas tree but have not yet gotten the parental go-ahead to tear into them, and the nervousness that typically arises before the first day of school, or in the moments right before a big race starts. Yep, I’m talking about the Supreme Court decision on whether or not the Patient Protection and Affordable Care Act (PPACA) is constitutional.
The verdict was set to drop at 10:00 am (or 8:00 am Denver time), and my flight home was set to board at 8:07. I feverishly monitored the SCOTUS blog on my phone for the latest, knowing full well that my news team was already fired up and ready to tackle the news right away.
As the verdict pushed back to 10:15, I suddenly found myself dangerously close to re-enacting Alec Baldwin’s infamous Words with Friends moment, especially since I am firmly of the thought that electronic devices, when their connectivity is shut off, have no meaningful impact on planes at all. (This, of course, is the subject for a different editorial altogether.) Unwilling to turn off my phone until I had a verdict I could rely on, I watched and waited, secretly grateful that our plane had minor mechanical problems that kept us on the tarmac for an additional 45 minutes. By the time we really had to turn off our phones, the news was out and the drama was, for the most part, over. PPACA had been upheld 5-4, with Justice Roberts supposedly reversing himself to uphold the law rather than see it entirely dismantled. It is a moment many friends who are more conservative than I am regard as a kind of “Et tu, Brute?” moment.
On the flight home, I thought about the decision and what it meant. We have been covering this intensely for many months now, and in one way, the story is now over. (Kind of. More on that later.) The next acts are all about implementing things that a bunch of major health insurers said they would abide by even if PPACA had been overturned. And while the law itself remains a vague mess of sometimes conflicting regulations and restrictions, it is what we all are left to live with.
So what has this whole experience taught me so far about the state of our health care system, the health insurance industry, the role of the federal government, and the American people? Read on, dear reader. Read on.
#1: People don’t care.
As I waited for my plane to board, hunched over my phone like it was a tank of oxygen and I was under water, I periodically looked up to see if anybody else was as fixated on the impending news as I was. The fate of PPACA would be determined in the next few minutes! Wasn’t everybody on tenterhooks about it? They weren’t.
Even the Fox News on the terminal TV wasn’t getting a lot of attention. Folks mainly wanted to drink their coffee and focus on their Sudoku puzzle or the trashy novel they had for the flight. (More than a few moms in the crowd were reading Fifty Shades of Grey rather than anything news-related. I know it’s summer, but come on, people!)
On the plane itself, every single television screen on the seatbacks was tuned to CNBC and their Supreme Court coverage. Again, folks were largely ignoring it. When the recent college grad next to me asked what I did for a living, I told him I was a business journalist who covered health insurance, and this was the biggest story of the year, unfolding by the moment. He appreciated the import of it, and he had his opinions about health care, but really, he couldn’t be bothered too much by it. Like most folks his age, he was glad he could enjoy his parent’s insurance for a few more years while he got his career going, but otherwise, it was all a huge collection of things he really did not understand, nor could be troubled to learn. He was a nice guy, but his willful ignorance of a topic that a) so clearly affected him and b) was a litmus of our current political environment was a bit depressing.
The guy next to me on the plane wasn’t alone. I asked a number of people as I went through the day what they thought about the ruling. More often than not, they didn’t have an opinion. And not in the “avoiding-speaking-to-a-journalist” sense, but in the “hmm-let-me-think-about-that…nope-I-really-have-no-opinion” sense. A day later, when I asked some high schoolers what they thought of it all, none of them had a clue, except for one who was instantly and roundly mocked by his friends for being a nerd. Nerd or not, at least that kid will know if he’s got health care when he enters the world. The whole thing reminded me of how, at election time, we see comparisons to how readily people call in to vote on shows like American Idol versus how readily people do their civic duty and vote.
Voting in American Idol is easy; all you have to do is generate a gut reaction to music. Voting on issues is hard. You have to care, and you have to be at least a little bit informed. And frankly, with so much news media reflecting the divided political camps of our country these days, I can forgive those who eschew watching the news out of an effort to avoid political squabbling. But honestly, most of it is simply people who would rather not do the intellectual heavy lifting of keeping tabs on how their government operates. And while I totally appreciate the concerns of those who insist that a law like PPACA is the first step on a slippery slope toward too much government in our lives, a much bigger step is a populace that doesn’t care about it one way or the other.
#2: People are misinformed. (Part l)
I spent a good portion of that night online talking and debating with various friends, colleagues, acquaintances and friends of friends over what had happened and what it all really meant. One of the things I decided early on was that the world’s got enough political blather in it and folks don’t really care if I supported PPACA being upheld or overturned. What I did dedicate myself to, however, was addressing clear misconceptions people had about the law and what it meant to do. And on this front, there was (and still is) more than enough work to go around.
One of the most pernicious misconceptions I came up against was the notion that there was absolutely no precedent for this in American politics, and that we had, as a nation, entered some strange and undiscovered country where Congress can order us to eat broccoli if it really wanted to. I understand where such sentiment comes from. Pew Research recently published a poll showing that 59% of Americans were worried about the federal government’s role in health care. What that tells me is that even if you support PPACA and the individual mandate, you’re still likely to be afraid that the government will screw it all up somehow. That’s probably a good stance to take.
That aside, though, one thing I tried to tell people was that it’s not like we have not been here before. If you want to go all the way back to the beginning, George Washington signed into law two forced-buy bills. One of them required farmers to purchase rifles for their own protection. The other required maritime sailors to buy some health insurance, mainly for the same reason that Congress is requiring it now: to make people pay something into a system which they inevitably draw from. When I could, I directed them to Allison Bell’s excellent article on the history not just of PPACA, but of health care reforms since antiquity. It is a great piece of content, if only to provide everybody with some much-needed context for this debate. There is plenty in PPACA to oppose with all of one’s heart. Opposing it for reasons based on a lack of information or an adherence to information that is factually incorrect, however, usually won’t help one’s cause.
Lest this seem like a dig at those who oppose PPACA, let me say that I saw an equal degree of ignorance and misinformation on both sides of the aisle, politically. The bottom line here is simple: educate thyself. Now, reading PPACA itself is an extended exercise in self-torture (believe me, I have tried), but it’s not quite so bad to read the Justices’ decision and the fairly extensive dissent to it. If you can’t be bothered to figure out the law itself, then at least read how the Court ruled.