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Healthcare reform’s big question: What will it cost me?

Dante Chinni

Posted: 09.28.2009 / 8:20 AM PDT

When you get past the $900 billion price tag and how things like the “health insurance exchange” work, the math behind the 2009 healthcare reform debate is actually pretty simple.

There are about 46 million Americans without insurance, and, for most of them, the idea of reform is tantalizing. For the 250 million with coverage any talk of change brings questions.

With the healthcare town hall hubbub and President Obama’s primetime speech past, the debate for many simply seems to break down to either you like what you have for insurance, or you don’t.

People in our 12 Patchwork Nation communities are not antireform per se, but opponents – and particularly those in areas aligned against Mr. Obama – are wary of what it may cost to them as individuals in the long-run.

Reform? What’s the cost?

There are, in essence, two big parts to the healthcare debate.

That first part asks the general question about how much money Americans should spend on healthcare. The US spends more than 16 percent of its GDP on health care – $5,700 per capita annually, that’s much higher than most wealthy countries.

People seem to understand that, and they are open to changes in the big picture – so long as there aren’t any changes in their personal circumstances.

President Obama has promised that. The problem is: Many people don’t believe him.

In Clermont, Fla., an aging “Emptying Nest” community, times are still tough. The unemployment rate hovers near 12 percent, and people who worked in construction are having a hard time finding work.

But that hasn’t created a groundswell of support for reforming healthcare, says Ray San Fratello, president of the South Lake County Chamber of Commerce.

“It seems the most prevalent thing I hear is that people are thankful they are working and have access to insurance and help with premiums through their employers. Those unemployed are making difficult decisions about paying mortgages, car payments, etc., feeding families, and having the concern about the need to maintain comprehensive health insurance,” Mr. San Fratello writes in an e-mail.

“As far as the debate itself, there seems to be a sense of proceeding more slowly in addressing healthcare reform to perhaps narrow the focus from overall systemic reform to health insurance reform, something that is more tangible to folks, and goes to the heart of the questions: Who pays, how much, and what’s the benefit?”

That’s an interesting point of view considering the locale. The number of uninsured in surrounding Lake County has spiked to more than 24 percent according to 2006 data. That’s even higher than Emptying Nest counties as a group, which average about 16 percent.

Still, even in a place experiencing hard times and seeing lots of uninsured, the debate is focused on: “How much will it cost me?”

A common thought

The same is true in Nixa, Mo.

“People would love to have better coverage and lower premiums,” e-mails Gary Swearengin of Nixa’s Church of the Nazarene. “The government guaranteeing that all will be covered has a nice ring to it, but at what cost? No one seems to be answering that question. If the government spends it, it came out of my pocket.”

Nixa, a culturally conservative “Evangelical Epicenter,” is opposed to government control in most areas and would almost certainly never be supportive of large-scale reform. But Mr. Swearengin and others there were focused on the cost issue.

We heard echoes of similar statements in other communities, like Baton Rouge, La., a “Minority Central” community with many African-Americans and Burley, Id., a “Mormon Outpost.” In those counties, the percentage of uninsured is 20 percent or higher.

“No one here that I have talked to likes the healthcare reform.  They especially don’t like being mandated or taxed or penalized to make sure they have health insurance,” Burley City Administrator Mark Mitton wrote in an e-mail.