Healthcare Reform Can’t Sell Itself If America Isn’t Buying

By Brandon Greife, Thomas Jefferson Street blog

Healthcare reform is now the law of the land, but Americans are still not convinced it was the right prescription. According to a new Gallup poll, it appears that David Axelrod's prediction that "as people become familiar with it, the bill will sell itself" is off to a rocky start.

The poll shows that people have a number of concerns regarding the effects of the healthcare bill. For instance:

• More people (46 percent) believe that healthcare reform will cause the economy to get worse rather than better (35 percent);

• By a margin of 44 percent to 34 percent, voters believe that the overall quality of healthcare in the United States will go down rather than up;

• 26 percent more people believe that the overall costs of healthcare in the United States will go up (55 percent to 29 percent);

• 50 percent believe the cost of healthcare for your family will get worse while only 21 percent believe it will get better.

Not too many positives for Democrats in those statistics. After all, it is difficult to consider your signature piece of legislation a success when people believe it will simultaneously cause the cost of healthcare to rise and the quality to fall. "Less for more" simply doesn't work as an advertising pitch.

The poll shows that Americans' deepest worries center on costs. This is not a surprise. An earlier Gallup poll shows that 24 percent of people, regardless of whether they favored or opposed healthcare reform, were concerned with costs, while only 7 percent were worried about the quality of care. This is where the Obama administration fundamentally underestimated the anxiety of the American public and the effect of current events on people's perception of reform.

The housing crisis and subsequent recession have forced people to watch their personal finances carefully. As Barack Obama said in his State of the Union, "families across the country are tightening their belts and making tough decisions." But as we, the taxpayers, warily eye every dollar that leaves our wallet, we expect the same concern from our federal government. It was simply unbelievable to many newly minted penny-pinchers that the federal government could afford to create a new entitlement program, tasked with insuring millions of new people, while simultaneously saving money. Even if reform was the right prescription, that notion seems to have been too big of a pill to swallow.

When people are struggling financially, they are naturally reticent toward big-ticket items. The problem is seen in today's economy where consumers are shying away from new cars, fancy appliances, and bigger houses in favor of saving money for a murky future. But healthcare reform was the ultimate big-ticket item. While taxpayers are focused on every dollar in their bank account, healthcare reform's trillion-dollar price tag led to an incurable case of sticker shock.

Moreover, Americans with limited budgets aren't prone to take risks with the money they do have. If they're going to gamble, it had better be a sure winner. Democrats did a poor job at crafting a risk-free investment. In the realm of healthcare, nothing has ever been tested on this grand of a scale. Worse, in the areas where the government has tried its hand, the costs have almost always exceeded initial projections. Taxpayers also fear future Congress's willingness to make the hard decisions necessary to keep the bill from dipping heavily into the red. For instance, the public doesn't appear to be buying that Congress will begin to cut doctor payments after consistently ignoring the problem for 17 years. All told, while the CBO score may have looked good, for a skittish public, it needed to look great.

In their push for reform, President Obama and congressional Democrats didn't account for America's newfound fiscal concern. They tried to pitch a product based on improving a broken system without understanding that people weren't in the market to buy anything. Now Democrats had better hope their healthcare reform package begins to "sell itself," otherwise they may be going out of business come November.

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