Jacob S. Hacker, Ph.D., is the Stanley B. Resor Professor of Political Science at Yale University and a Resident Fellow at the Institution for Social and Policy Studies. He is also a Fellow at the New America Foundation in Washington, D.C., and a former Junior Fellow of the Harvard Society of Fellows. His 2007 proposal for universal health insurance, "Healthcare for America," was instrumental in bringing the "public option" to the forefront of the national healthcare debate. He has testified before Congress and written articles for a variety of publications, including The New York Times, The Washington Post, The Nation, and American Prospect. His most recent book, "The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream," was published by Oxford University Press in 2006 (paperback, 2008).
Question: How can average citizens influence the healthcare debate?
Jacob Hacker: Yeah, I think many Americans feel that this debate is kind of passing them by. And it's really something that worries me about the way in which we talk about healthcare in the United States. So much of the discussion takes place on a terrain and with language that is, health policy **** like. But most Americans can't comprehend. My favorite example of this is that you've got the White House Policy guru talking about how important it is to bend the cost curve. I mean, bend the cost curve? I don't think most Americans even knew there was a cost curve, and isn't a curve already bent?
I mean, most Americans care about affordability. Can they afford the coverage? Do they have security? Do they have stability? And I think that that is really what has to be talked about. And at the same time, I do think Americans need to be involved in this debate, and not just through ginned-up opposition that's expressed at town hall meetings, but through broader dialogue that is taking place.
To me, that's probably going to take place on two levels. On the one hand, if people want to get involved in this discussion, there is a lot still to be done. We are a long way from the end of this battle. We may be two months away, but two months in this kind of policy debate is a very long way. So, if you have an idea that you want to express to your member of Congress, or you want to take it to Washington, you should do it now. This is the moment. And I can tell you that when there is lots of attention to these issues on the part of individuals and the groups representing them, members of Congress do listen.
And the second thing I would say is that we're going to pass this bill, and it's not going to take place overnight. If this legislation gets passed, and I really hope it does, it's not going to get fully implemented until after 2013. And a lot of the responsibilities are going to have to be handled by the states, and carried out through new institutions that are going to be created. And anybody who would like to be involved is going to have ample opportunity to be involved at that stage as well.
I mean, if people are confused, they have to step back and just try to keep in mind that there really are these three broad, relatively simple goals in healthcare reform. Trying to share risks more broadly so that if you, or someone who gets a dread disease, that you're not going to be out there on your own. You're going to be sharing those costs with a large pool of Americans and you're in this with them.
And then second, you need to make sure there is shared responsibility. That employers, individuals, and the government are all stepping up and trying to address this challenge together and contributing to the costs of addressing that challenge.
And the third is individual responsibility. And that means not just taking care of yourself, but it means also taking the responsibility to get health insurance to use the new options that are available to people. If people understand that it really is three simple principles beneath all the complex policy tie, then they can start to think about what parts of those three elements of reform do they want to get engaged in trying to influence or taking advantage of if they're in need of health coverage.
Recorded on November 9, 2009
Interviewed by Austin Allen