Navigating Health Care Complexities

A survey conducted near the deadline for  the enrollment to the Affordable Care Act revealed that many consumers do not grasp health care concepts as well as they need to. 62% did not realize that an HMO restricts the choice of doctors more than a PPO (preferred provider organization). 42% could not describe what is a deductible and 39%  did not understand the relationship between premium and deductible. Given that car insurance has long been a requirement, one may be skeptical, and yet the fact remains that health care is far more complex. Besides if a survey were conducted about people’s familiarity with their car insurance, we may find a corresponding lack of understanding.

While the critics of Obamacare may point to the law’s many provisions as being responsible, we do live in a world that requires a certain sophistication and  level of knowledge about things such as computers, cars, cable subscription plans, smart phones and their providers, taxes, and of course now the health care law. The lack of understanding makes some consumers prey to scams and/or it  can lead to confusion or overwhelm. In turn these lead to errors and certainly people cannot protect themselves nor safeguard their interest if they cannot make informed choices.

Given that it’s doubtful the society will ease its level of complexity in the foreseeable future, it would seem some means to mediate how many handle that complexity does look necessary.

About “Gapping”

I became aware quite recently of “gapping”, the practice of U.S. universities to admit students without providing enough financial aid for them. The practice implies that financial aid people are aware that some of the students they admit will, down the road, end up burdened, some unduly. Private colleges are said to be 27% more likely to engage in gapping than public ones. A survey of Inside Higher ED and Gallup published recently found that 53% of public college directors and 74% of private ones said gapping was ethical. It seems that while there may be some in the higher education financial aid community who are conflicted about current practices, their concerns do not extend  to informing students of the issues they face and the consequences of their borrowing. As we’ve all heard, student debt is not a small problem for a large number of young people. And now new data reveals that people from higher income, not surprisingly, are not affected by any of this; those from lower income  have certain resources available, so the consequences of gapping end up particularly acute for middle income families and students.

It’s troubling that institutions which ought to know better, and who seem so eager to justify their higher and higher tuition, engage in practices at the expense of the future of their charges.

Today’s Issues

Surely, you’ve heard that the Congressional Budget Office study of the impact of raising the minimum wage to $10.10, would, by 2016, reduce employment by about 500,000 jobs. But it would also lift 900,000 families out of poverty and increase the wages of 16.5 million low wage workers. It’s become ammunition for the right and justification for the left. But beyond that it illustrates how many contemporary issues are not either/or, neither all good nor all bad. Most policies have positive and negative consequences, and whether or not they are constructive depends on placing both sides in context, the way costs/benefits analyses do. Issues have a down and up side. In societies as complex as ours, it is doubtful that any decision, law or policy will be one without the other, will exist without some trade-offs. That’s an old idea, several disciplines have been teaching it in any number of courses for decades. Yet given the nature of today’s political culture using facts to bolster the user’s agenda and today’s media, sounds bites and 140 characters messages, issues tend to be simplified to the point of distortion. Increasingly media sources want attention getters even when those bend, alter, exaggerate, minimize, warp and twist the facts that gave rise to them. And so it’s up to us to remember that with the minimum wage as with almost any issue in today’s economy, it is imperative to avoid seeing them in categorical terms.

Death of an Actor

The evidence points to Philip Seymour Hoffman having died of an overdose. Since his death was announced, and for days afterwards, stories and segments abounded, all related to his struggle with addiction and the loss of a great artist. No matter the subject linked to his death, what was forefront it seems was the compassion that colleagues, critics, the public or all involved expressed towards what cut short a promising life and career. People die of an overdose every day, and we label them, criticize them, condemn them, ignore them, whatever will convey our distaste and negative view of addiction. True, we may not know them, but then we really didn’t know Philip Seymour Hoffman either. Yet because we think we knew him we are willing to grant him understanding, and look upon his addiction with compassion. And in the same way his death opened the opportunity for us to know the new face of contemporary heroin addiction, let’s hope it will guide us away from our double standard of having compassion for actors who overdose but not for the nameless others. Let’s hope it takes us towards a greater understanding of addicts and addiction wherever they may be.