In 1964, in Jacobellis versus Ohio, Supreme court Justice Potter Stewart created the test for determining whether certain material was pornographic as, “I know it when I see it.” The premise in establishing the standard is that you’ve seen it, how else can you draw a conclusion? Here, when it comes to health insurance, the greatest part of our analysis is always the “when I see it,” because without facts, the observable, we cannot determine what we do or don’t know in establishing our opinions that will dictate our actions.
Simple shorthand about the Affordable Care Act leaves us not knowing. Examining provisions without the support of how they actually work in the real world leaves us not knowing. When we haven’t seen it we can’t generate meaningful conclusions from what we don’t know. It’s my biggest objection to healthcare provisions that are “sold” rather than explained to us.
It’s been an infuriating year in many ways regarding health insurance changes provided by Affordable Care and beyond. Whether it was Republicans telling us what Affordable Insurance would or would not mean, or Democrats praising its provisions by latching onto popular concepts such as no lifetime limits without explanation of how those changes would be financed, the double-talk leaves us drawing conclusions without “seeing it.”
In 2013, this blog will continue to discuss the “seeing it” as part of an effort to “know it” so that each of us can draw our own conclusions and work for what we believe based on the facts in order to work within the system to reduce unpleasant health-related surprises, whether it’s increased costs or less access to particular types of care.
(For instance, will lifetime limits on all medical treatments be a thing of the past? Depends on how you define “medical” because lifetime limits restrictions are only removed from “essential” health benefits. Plans are coming out with lists of non-essential benefits which can still impose lifetime limits, as well as a new category of “reviewable” benefits that might or might not be subject to limits.)
If there is a single message that should have gotten through to us it’s that we need to work as our own advocates in health care and health insurance. We should NOT rely on a politician or talk-show host’s discussion of what’s “true”. (If you doubt this, double check the fact-check sites that itemize and discuss some of the election “lies”.)
2013 should be a year of education, of digging deeper, of “seeing it,” in order to best protect our healthcare options and our ability to pay for them. Be well.
