The Dose

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Health Care & Life Sciences / Life Science & Biotech

For the holidays: A hopeful, health care reading list

December 19, 2013

It's two days till Christmas, the day when Christians celebrate the birth of Jesus. And you don't have to be a Christian to see that the Christmas story, as it is told, is supposed to spread hope in the midst of gloom.

The message of the Bible leading up to Christmas is a bit dark: God made humans to live with Him, but all people sinned, separating themselves from God and leading to their death.

But the birth of Jesus means that God becomes human. As both God and man, He can live a sinless life, He can die to pay the penalty for human sin, yet He can also rise from the dead and, in turn, raise up all people after death to live with God.

So, in that Christmas spirit of hope—and at the risk of being a bit trite—I’m offering a reading list of several optimistic reports about health care reform—even though many of my recent posts, and the mood of the country in general, have been decidedly gloomy.

Consider: A recent poll by the New York Times and CBS News found that two-thirds of Americans think Obamacare will either leave the country’s health care system no better or make it worse. Even more startlingly, only one-third of uninsured Americans—the people the entire law is designed to help—think Obamacare will help them personally or will improve the health care system generally. (For more of the same, see this poll.)

With that kind of sentiment going around, there’s a need for some Christmas cheer. And, in fact, there’s been a lot of it recently. Here are a few things I recommend:

1. There will be no death spiral in the Obamacare exchanges. The Kaiser Family Foundation analyzed what would happen if young adults shun the Obamacare exchanges, as many have feared will occur because of the technical problems suffered by the HealthCare.gov web site. Kaiser’s answer? Not much. The health research foundation expects that, even if only half as many Americans aged 18-34 as expected enroll in the Obamacare exchanges, it will cause a corresponding rise in premiums of just 2.4 percent (before factoring in other issues that also typically drive up insurance premiums).

2. December is turning out to be a breakout month for the Obamacare exchanges. California’s pace of enrollments has doubled this month to about 15,000 per day. Other states are seeing a rush to enroll as well.

3. Hoosiers may not suffer as much as feared. Indiana Gov. Mike Pence is considered a Grinch by some readers, because he refused Obamacare’s expansion of traditional Medicaid. Instead, Pence is negotiating for permission to use the Healthy Indiana Plan to expand coverage to low-income, uninsured Hoosiers. That will leave an estimated 182,000 Hoosiers who live below the poverty line out in the cold next year. But here’s the sunny side of the situation, according to another analysis by the Kaiser Family Foundation: Half of those uncovered folks are under age 35, meaning their health needs on the whole will be limited. Another 37 percent are under age 55. Most of them (73 percent) are adults with no children. Also, 63 percent of them either have a job or are in a family with someone who does. Having health coverage would, of course, be a better situation. But the majority of Hoosiers affected are not the most vulnerable of society.

4. Long-term, health reform is expected to work. A canvassing of hospital executives published on the Health Affairs blog shows that they are optimistic in the long term. They expect costs to go down and quality to go up. And isn’t that the overall goal of the Affordable Care Act?

So hopefully that cheers you up. Have a happy, hopeful holiday.

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