Do the People Really Understand Health Care Reform?

09/19/2009 05:12 am ET | Updated May 25, 2011

It is often difficult when one is close to a problem to step back and envision how that problem looks to those who do not perceive to be ensnared in the problem. It is similarly difficult to realize the complexity of large issues when there are competing issues that seem far more pressing and immediate and affect one directly. No one will argue that we as individuals both consciously and subconsciously perform triage on issues and prioritize them, dealing with the most serious first and the least serious last.

What makes the current cacophony of voices that substitutes for dialogue on health care reform so frustrating is that in each of the instances identified above there is a disconnect among a large proportion of the population as to the seriousness of the issue as it affects them. A large number of the electorate fail to realize that the problem affects them in a very direct way regardless of how close they perceive themselves to be involved with it and has a huge ripple effect on aspects of their lives that they feel are unconnected.

Make no mistake about it, this is a complicated and complex issue, but no more so than climate change and to his everlasting credit Al Gore has educated millions and millions of people worldwide about the importance of this largely scientific phenomenon to their personal lives. Sometimes we need to simplify in ways that seem elementary. Let me attempt to do so in a way that may help the public to become further engaged in an issue that is of tremendous long-term importance not only to them personally but to the society as a whole. I would like to ask a series of questions that need to be answered in the clearest way possible so as to craft a message that may strike the appropriate chord. And remember, as important as it is to ask the right questions, it is every bit as important to shape the answers in a clear, concise, and understandable form.

First, is there a need for health care reform? Why? And specifically, what is it in the current system that needs to be reformed? Incredibly, there appears to be confusion as to whether or not the current system is indeed in need of reform. I know to many of us it appears we have crossed that bridge long ago, but evidently not. Hence, officials and others can begin their arguments with the premise that this is the finest health care system in the world, so why fix what ain't broken?

Second, what are the best ways to fix our health care system? How exactly would that affect me directly? What would change for me if we put this fix into place?

Third, can we control health care costs that are spiraling out of control by fixing the system? How will this occur? What does it mean for me, both as an individual and as a contributing (read tax-paying) member of society?

Fourth, what exactly are the goals of the current health care system? Should we institute a better set of goals? What are the actual outcomes of the current system? Can we effect a better set of outcomes? How will these outcomes affect me as an individual?

Fifth, please outline everything, I mean everything, in terms of what it means to me. I need to know exactly how my life will change and why it will be better. If it is better for me, it must be better for everyone.

Now if all this sounds like it is a little me-centered, it is. And unfortunately, that is the only language we Americans seem to be able to relate to, at least those who are currently spewing the ill-informed spittle that is being voiced and covered at these town hall meetings or that is being propagated by the conservative opposition forces.

I fear that sometimes we give the populace far too much credit for being well-versed on the issues. For instance, single-payer system, public option, co-ops, even though they may seem to be evident on their respective faces, far too many seem confused, and who among us would feel comfortable explaining the differences in ways that would not force average people's eyes to glaze over?

Keep it simple stupid (KISS) would be well employed here. We must first show unequivocally that the patient, in this case our health care system, is very ill. Strange thing, when people are seriously ill they care little about how they get better, only that that is the ultimate outcome. It seems to me that far too few people are either aware or accepting that the patient is ill, seriously ill. Thus, this must be our first and most prominent task.

Given the time table for action it does not appear to be too late to employ such a simplification strategy. Given our failure to succeed in reforming the health care system it seems imperative that we take the time to lay the proper foundation for this debate and in many instances we need to fill in the cracks of the current foundation, one that is permeated with misinformation and deception.

The opposition forces are strong, but the forces for change are stronger. We must arm these forces for change with arguments and rationales that are understandable and persuasive. My guess is that if understood and conveyed correctly, they will be persuasive.