Walking the Tightrope
By Isaac Squyres
3-minute read
People with the curse of knowledge know that fewer people having health insurance coverage drives up the cost of care and makes healthcare worse for everyone. People losing coverage doesn’t take cost out of the system, because those people still require care. It just reduces the number of people/entities paying, which drives up costs for those who are.
But here’s the thing. All of us generally lead self-interested lives and aren’t naturally inclined to connect points outside our circle of care or experience. For those of us not deeply embedded in healthcare, the connection between other people not having access to insurance and the cost of my care increasing is very real but not a commonly understood cause-and-effect.
In fact, most people in our country don’t think their own healthcare is impacted when others lose coverage. Specifically, less than half of Americans think other people losing health insurance coverage would negatively affect their healthcare, according to Jarrard’s research in September.
Moreover, one in five said other people losing their health insurance would have a positive effect on their own healthcare and nearly a third (29%) said it would have no effect.
When other people lose health insurance coverage, does that have a positive or negative effect on your healthcare?
Expecting people to understand the reality of healthcare’s gordian knot and make the connection to what’s coming (and we think it’s coming regardless of how the shutdown is ultimately resolved) for their own healthcare is a high bar.
The surest bet in Vegas today is that the Democrats, with off-year election victories in hand, will make healthcare a central issue in their 2026 campaigns. Cue the deluge of TV ads and algo-driven digitally delivered messaging.
In the coming year, how hospitals, health systems and payers walk the tightrope when talking about the future of healthcare in their communities will require a deft touch, lest they get dragged into a political hurricane.
What’s in it for me?
Here, a bit of human nature may help: People want to know “What’s in it for me?”
It’s not an unfair or callous question. Lives are full, time is short, tensions are high, money is tight and what do you want now?
But by answering that question well, hospitals can carefully leverage this challenging moment.
Understanding the abstract consequences of widespread loss of insurance in U.S. healthcare is slightly more than an academic exercise for people.
But understanding the personal consequences – or, worse, experiencing them – drives the point home that this whole convoluted health system is deeply interconnected. Removing blocks from the Jenga tower will eventually topple the whole thing for all of us.
How to make the conversation personal? Well…
- Articulate a clear picture of where your organization is going and keep patients and communities – not the business of care – front and center. Healthcare organizations should lead conversations about healthcare in their communities rather than sitting back and taking the blame for the industry’s problems.
- Emphasize community impact. Make it personal. Again, the narrative of community impact should be about people, not numbers. To move the needle on perception, highlight the local, human stories that demonstrate a commitment to mission, not money.
- Communicate clearly about the good and the bad. With a forward-looking story about key decisions – especially the hard ones – an organization can convey how it’s making the future the best it can be.
- Make the connection. Our survey also found that, when presented with specific potential outcomes from Medicaid cuts, far more people were concerned than when they were asked simply whether changes to Medicaid would be good or bad. In fact, two-thirds said they’re concerned that people with private insurance would have to pay more to cover the cost of care for people who lost Medicaid coverage. And, about seven in 10 are concerned that hospitals will close.
What’s in it for you?
This reminder comes during a confluence of events where people might just be able to (eventually) appreciate that healthcare is better for everyone when more people have health insurance.
We’ve often opined in this space about how difficult it is for Joe and Jane Public to understand our country’s labyrinthian healthcare system. You know this.
The survey finding that the public sometimes doesn’t connect or even misconnects events with outcomes is a good reminder for healthcare leaders: There’s a long way to go in educating Jane and Joe.
But it offers a good clue about how to connect those dots.
Contributors: David Shifrin, David Jarrard, Tim Stewart and Emme Nelson Baxter
Image credit: Shannon Threadgill
