Sunday, October 30, 2011

What Zombies Can Teach Us About the Affordable Care Act

In George Romero's campy movie Land of the Dead, the zombies undergo a very worrisome change. While they used to just pathetically stumble around looking for brains to eat, they organize and make menacing plans. The living survivors, holed up inside the fence at the former city of Pittsburgh, have a fight on their hands.

Maybe it's the Halloween season, but the recent slew of late night walking dead horror has inspired the Disease Management Care Blog.  It's entered sweeps for a cameo appearance in AMC's cool zombie series.  It's assessed the relative merits of the undead staggering vs. running, being loners vs. in packs and being wrathful vs. both hungry and wrathful.  The DMCB has also discovered one key commonality of this fearsome species: while maximum head trauma undoes the undead, more of them just keep coming and coming. That DMCB thinks that, despite the spouse's advice to the contrary, is an important lesson.

The political dimensions of the Affordable Care Act are becoming more zombie-like with each passing week.  According to the Kaiser Health Foundation, public support for health reform has not only remained stubbornly underwhelming, it has just taken a recent downturn.  While it's too early to tell if this is bad news or statistical variation, there's no denying President and his allies are being forced to fight one-on-one with undead employer pessimism, oppositional Republicans and the CLASS Act's failures, while more ever more issues slowly stumble closer.  And who can blame the living Dems for their post-apocalyptic anxiety? It was only yesterday that the ACA was a signature achievement and the world was a wonderful place of Congressional majorities, fawning media support and supreme self-confidence.

While supporters of health reform may take comfort in the notion that the zombies have been unorganized and are attacking the margins, the DMCB worries that the Kaiser poll slide may portend a worrisome Romero-esque development: unable to grasp the details if the Affordable Care Act, Americans' support for it was always based less on the underlying policy and more on the President himself.  A slip in support, therefore, has less to do with the law's merits and more with a shift in what people fundamentally think about Mr. Obama.

With just over a year until the elections, that's a scary thought for this Halloween. It seems the folks inside the White House fence have a fight on their hands.

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