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Megaphones on the Midway

In the small Ohio town where I grew up, summer revolved around the Cuyahoga County Fair.

You could actually see the differences among Holstein, Black Angus, Guernsey and Santa Gertrudis cows, discover Rhode Island Red chickens and Peking ducks that were raised in Ohio, and enjoy parades of ponies and horses, stalls of pigs and displays of flowers and farm produce, some raised by schoolmates.

But the fair came to life on the midway. There was a new ride every year, you could see the world’s smallest man or the strongest woman or the sword-eater, and try your luck at winning a giant stuffed animal bigger than the prize you won last year. That’s also where you could meet and hear campaigning politicians, who knew where to find the crowds. But when the fair ended, so did summer fun. And it was time again for the serious work and daily routine of school.

It’s fair season again, and an election year. Walk down any midway, and amid all the blinking lights, clanging bells and shouting kids, you’ll hear plenty of political promises. And this being 2010, much of the rhetoric addresses the nation’s new health care law. A lot of people don’t like it. Many do. Most don’t know enough about it to have decided. But it’s the opponents who have the loudest megaphones at the moment.

Here’s what the critics, mostly Republicans, say: It costs too much. It’s too complicated. And it puts medical decisions in the hands of someone else.

If you think that sounds familiar, you’re right. Except that the last time you heard it, at county fairs in 2004, it was Democrats, not Republicans, howling. Just months earlier, the Republican-controlled Congress had created Medicare’s Part D prescription drug program, and Democrats warned that the cost of the program would bust the budget, that seniors would reject it because it was too complicated, and that it put insurance companies in the middle of decisions that you and your doctor should make.

Much of this year’s county fair rhetoric focuses on costs. The truth is that the cost of health care in America really is going to go up. When the new law is implemented, an additional 32 million citizens who don’t have health insurance will get it. That’s not free. As any sixth-grader can tell you, 32 million people paying insurance premiums means more money is being spent on health care.

That leads to an important principle essential for the insurance industry: Because the majority of the new enrollees will be younger—and healthier—their premiums will more than pay for the health services they need, and help spread the costs of caring for older enrollees. This economic reality is the essential building block of the health care reform effort. More people buying insurance should mean premiums across the board will fall.

Here’s the point: This is a complicated new law we’re implementing. Rather than get swept up in county fair rhetoric, let’s concentrate on explaining it and understanding it.

Enjoy the fairs. I hope everyone wins a giant teddy bear. Then let’s get to the serious work of explaining this new, complex law and finding ways to implement it efficiently and promptly. ­

Jim Toedtman is editor and vice president of AARP Bulletin.

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