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Don't Be Afraid to Talk (and Listen)

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As we all know the Patient Protection and Affordable Care Act was passed this past March, and if you do not follow the news closely you might think not much has happened since then. Some people are asking about various aspects of the reform including the timelines of when changes will occur and how it all will work, but good information is not easy to find. Never mind whether anyone thinks the reform is good or bad because there is no real answer to that question right now. Reform has already been voted into law so the case is closed... for now. What many Americans do not know is the tremendous amount of activity occurring behind the scenes. Implementing healthcare reform is a very big deal and everyone should be paying close attention. The law is extraordinarily vague and as always the devil is in the details. Yet most of these details have not yet been written or at least made available for public consumption. What has happened over the past few months and what will be happening over the next few years is going to have a profound impact on all of our lives. Given the economic and social impact of healthcare in our society today, and the scope of the reform, we all have a great deal at stake.

Healthcare reform was designed and legislated to provide broad access to all Americans starting in 2014. It also has key components which get implemented before 2014 including rules for insuring dependent children up to age 26, a high risk insurance pool, and the elimination of lifetime caps. The purpose here is not to discuss these elements but rather answer the question: Should we be happy with what has happened so far? The answer is, not really; here is why...

Healthcare is complex (like you have never heard that before). We all know it and everyone agrees tackling the various issues is not an easy task. It is also widely accepted the current system is severely broken, leaving far too many Americans vulnerable to losing health insurance coverage and facing the prospect of financial ruin if something goes terribly wrong. Healthcare reform was supposed to fix the most unjustifiable shortcomings of our current system -- denying coverage for those with pre-existing conditions and exponentially increasing premiums for those who actually use their insurance due to treatment of an illness. It is also supposed to look at how we spend our healthcare dollars and attempt to reduce those expenditures while improving the clinical outcomes. How can American citizens know the relief they were promised is near? If you were listening back in March you would have thought changes were coming very soon with many asking "where do I sign up?" The new system is not going into effect anytime soon and the process to write the rules and implement the reform has been less than transparent. The government seems to have failed to recognize the capacity for people to understand the healthcare system. Perhaps it is intentional so as to limit the impact of congressional elections this coming fall. Either way, the information about the future is less than clear. Just take a look at the new government sponsored healthcare reform website www.healthcare.gov. This site was mandated under healthcare reform to ensure Americans have access to all the information they will need on getting their healthcare including the rules of the game that everyone will ultimately have to follow. The launch of the site two weeks ago only highlights how limited good information can be to provide.

Under healthcare reform, the federal government has allocated $5 billion in support for state high risk insurance pools to insure those that have been denied healthcare insurance because of a preexisting condition. States that do not want the responsibility to run the programs could rely on the federal government to provide the coverage. Yet the information on healthcare.gov is surprisingly vague and in some cases, conflicting with other information on the site. The purpose here is not to be critical. It is to highlight how far the government is going to have to go to get this right. On Healthcare Connect -- Doctor Radio (Sirius 114/XM 119), the producers of the show have tried at least a dozen times to get anyone from the Department of Health and Human Services to (HHS) come on air and explain healthcare reform. They do not even respond to emails. The radio show's sole purpose is to answer questions on healthcare-access issues facing ordinary Americans and answer questions on the current and future healthcare system. What better venue to have the pro-reform HHS come on air and talk? Yet there is silence.

How can anyone really understand what is going to happen if all the information is kept under lock and key until it is released. Better yet, is something being hidden from the public? Most polls are showing Americans are willing to give healthcare reform a chance. But to give it a chance, one needs to understand and participate in the conversation before it is too late. As a democracy, it is the voice of the people that will effectuate change. It is every day Americans, not politicians, that will ultimately decide if they like what has been done in reforming our healthcare system. For that reason, the government needs to start talking in more detail, starting with explaining to those who want to listen how this is going to work. Our elected officials inherently underestimate our ability to comprehend what is happening, and television sound bites continue to oversimplify the problems. There are only so many times you can talk about someone being denied insurance or filing bankruptcy. Everyone already appreciates how bad it is out there for so many. Start talking. Give us the details. Give us all a chance to weigh in before those who care the most decide it is no longer worth talking about.