By Evan Falchuk

A new poll by NPR, the Kaiser Family Foundation and the Harvard School of Public Health asks how health care reform is playing in the public.

The answer:  really badly.  How badly?

Almost no one thinks Congress is listening to them.  You could have predicted that self-described “conservatives” would feel that way, 79% of them said that.  But what about self-described “liberals,” they should feel pretty good, right?  Not exactly.  Seventy-three percent of them said the same.  So “moderates” must be the happy ones getting all the attention?  Nope – 64% of them felt that way, too.

What’s going on is something other than politics.

As I’ve pointed out many times before (like here, here and here) reformers are ignoring the lessons learned by U.S. companies about how people react to changes to their health benefits.  Benefits executives who have been through it will tell you that doing anything that affects people’s health care is delicate business.  They know that you had better be awfully sure you know what you are doing, and that you explain your plans in simple, clear, understandable ways.  They’ll tell you that if you don’t do that, even the most well-intentioned, thoughtful plan will go awry.

So far this is exactly what has happened.  There are multiple proposals, thousands of pages of legislation and a never-ending variety of mixed and changeable messages as to what reform is all about.  It’s precisely what you should not do if you are trying to implement even the smallest change in your benefits program.  It’s a recipe for alienating everyone involved, even those who would otherwise be supportive of what you are trying to do.

To be fair, all of this work has accomplished something.  In spite of all of the complaints we hear about how politicians focus too much on polls, Congress has gotten the public to change its mind.

Fifty-six percent surveyed said Congress needs to pay more attention to public opinion polls.

UPDATE: This video of Senator Thomas Carper of Delaware explaining why no one should want to read legislative language illustrates the kind of disconnect I’m talking about.  According to Carper:

When you get into the legislative language, Senator Conrad actually read some of it, several pages of it, the other day and I don’t think anybody had a clue–including people who have served on this committee for decades–what he was talking about. . . . So, legislative language is so arcane, so confusing . . . and it’s just, it really doesn’t make much sense.

So, he’s against the Baucus plan?  No, he’s actually arguing in favor of it, even though he hasn’t read it, won’t, and doesn’t think whatever it will say will be understandable.  Now, in the corridors of the Senate this may be a perfectly reasonable point.  But to the average American, hearing that your health care is going to change in ways no one understands is not comforting.  It might even make you believe stories about nasty provisions being snuck in there that no one knows about.