By Evan Falchuk
Steven Pearlstein wants to know:
Are you with him, or are you with the terrorists?
He’s serious. And it’s part of the continuing, thoughtful debate on health care.
By Evan Falchuk
Steven Pearlstein wants to know:
Are you with him, or are you with the terrorists?
He’s serious. And it’s part of the continuing, thoughtful debate on health care.
By Evan Falchuk
Another day, another round of disastrous town hall meetings for congressional representatives.
Why is it going so badly?
As I noted yesterday, angry resistance to change in health benefits is totally predictable.
The RAND Corporation and Watson Wyatt did a survey of 42 large U.S. employers that implemented major changes to their benefits plans in recent years. They found that employees were normally “wary,” “confused,” “apprehensive” and “risk averse” about changes. Employees assume – rightly or wrongly – that when management talks about “controlling costs,” it is just a nice way of saying, “we want to spend less money on you.“ No one likes to hear that.
So what does work?
Clear, direct, honest communication. Companies that spent 6 months or more talking about their plans were far more successful than those that didn’t. What worked were real, specific examples of what change means for an employee and their family. How much will my take home pay be affected? How much more will I have to pay for care? Can I still pick my own doctors?
There was no replacement for concrete, simple, real illustrations done over and over again.
It’s very much the opposite of what’s happening in health care reform.
Sure, we have been talking about it for months, but mostly about the need to cut costs. People think – I’ve heard this story before at my job. What it means is that my health care is about to get cut. So they get anxious.
But unlike a company trying to implement a benefits change, representatives returning to their districts have no plan to explain. Instead, they have multiple bills, and no idea of what may become law. They can’t give real, practical examples of what reform may mean, and don’t seem to be trying. It’s a very bad combination given how delicate the question of health care is.
And it also makes the statements by some of our representatives all the more bizarre. There’s nothing at all helpful about trying to dismiss skeptical citizens as swastika-carrying agents of the insurance lobby.
So think about the angry people at town halls like employees at a company who are being told that their jobs are being eliminated, or their benefits are being cut. And think when you watch our representatives talking about this how they are missing real, honest reaction, and making it worse.
By Evan Falchuk
If you were hoping for a thoughtful discussion on the reform of our health care system, I have bad, bad news.
It turns out that health insurers are “villians.” Public anger over the massive, mostly unread, reform bills is “manufactured,” and anxiety created by the expectation of unknown changes to people’s most valued benefits is the result of disinformation and “fishy” stories.
It’s like an employee benefits roll-out gone horribly awry.
The protests and disastrous town halls look to me just like the kinds of angry protests that happen all the time when employers make important changes to a benefit plan and the employees either don’t understand them or don’t agree.
Blaming the people who don’t follow what you’re doing and why is a big mistake. Sure, there is politics. But health care is a serious, emotional issue, and it should be no surprise that people react badly when they think something to do with it may be taken away.
Dreaming up ideas of how health care ought to work is relatively easy. But figuring out how to implement it is hard, and there are no short cuts. The people who actually run benefits plans – employers, benefits consultants, HR professionals – can tell you: there is no replacement for communication, engagement and respect for opposing views.
The strategy of demonizing those who aren’t on board is a mistake, and is as likely to set back the cause of reform as it is to further inflame an already volatile audience.
By Evan Falchuk
A blogger at the event put it simply: As bad as it is being sick, there are many things in our system that make it worse.
All of the clinicians who spoke at the event understood this, and talked about ways to improve the doctor-patient relationship.
But the problem is worse than the clinicians may think, and it’s not something health care reformers are talking about.
Let me share some data with you so you can see what I mean.
By Evan Falchuk
Ezra Klein is back with another post showing what happens when you form strong opinions without knowing very much about your subject matter.
Today, he’s here to tell us the “truth” about the insurance industry. He succeeds – but only in making himself look very silly.
By Evan Falchuk
Ezra Klein recently wrote that doctors were at the root of our health care problems, citing Atul Gawande’s discussion of McAllen as his inspiration, as well as Steve Pearlstein’s work. I’ve already noted how both Klein and Pearlstein misunderstand Gawande’s work.
Now, Klein has scored an interview with Gawande.
By Evan Falchuk
The New York Times has been running a series on its Economix blog about health care reform.
Today, they post answers to following the questson from three health care experts: “What should our priorities for health care reform be?”
You should read them all, but you should think about two things.
By Evan Falchuk
Everything is McAllen, Texas.
It’s all part of our “uniquely American” approach to many issues: oversimplify the problem, so we can solve it. Ideally, on an artificially short time line.
In the case of health care reform, let’s say we get ‘er done by August 1.
By Evan Falchuk
Ezra Klein suggests that the Problem with Doctors is that public opinion polls show that they are “pretty much beyond reproach.”
Why is this a problem?
By Evan Falchuk
Steven Pearlstein actually wrote that in the Washington Post on Wednesday, right after (another) long rant against physicians. At the end, he offers doctors an olive branch. Or maybe its an offer he thinks doctors can’t refuse:
The choice for doctors now is quite clear: They can agree to give up a modest amount of autonomy and income, embrace more collaboration in the way they practice medicine and take their rightful place at the center of a reform effort that will allow them to focus more on patient care. Or they can continue to blame everyone else and remain — stubbornly — a part of the problem.
After reading Pearlstein’s columns, I’m still sure not why he has such a problem with doctors. I am beginning to think it’s because he just misunderstands them.