In yesterday’s plenary session, “Will the Civil War over Health Reform Ever End?,” Whit Ayers of North Star Opinion Research and Anna Greenberg of Greenberg Quinlan Rosner, with moderator Robert Blendon of Harvard University, discussed the partisan debate over health care reform and the vital role that health services researchers have in conducting effective research on the impact and implementation of the Affordable Care Act (ACA). The panelists agreed that implementation of the ACA will ultimately shape its acceptance in the future. Ayres presented poll results indicating that while voters do not believe that health care reform will improve the quality of care for those insured, they do believe that the bill will be successful in covering the uninsured. Part of the challenge, Ayres stated, is a difference in fundamental beliefs about health care: Democrats view health care as a right guaranteed by the government, and Republicans and independents believe that it is a citizen’s responsibility. Ayres suggested that the burden of truth falls on the proponents and implementers to prove that the ACA can work and that the skeptics are wrong. Greenberg noted that voters generally know what is in the bill and how it will affect people, however, a conundrum exists within Democrats – individual items within the bill are incredibly popular, but the Obama administration is not doing a good job in marketing the benefits of the ACA. Greenberg also emphasized the importance of analyzing data from social media in gauging popular opinion on the ACA and its implementation. The negative sentiments on the ACA expressed via Twitter, where activists communicate, compared to the positive sentiment across other forms of social media suggests, Greenberg argued, that health care reform is more polarizing among the elites and activists than voters. She concluded that public opinion on the ACA among voters will evolve once implementation begins in earnest. As Greenberg noted, hypothetical poll questions about ACA implementation and its potential impact produce “guess” answers and are therefore unreliable. Perhaps health services researchers can help answer the question of whether the debate over health reform will ever end in the best way they know how – with data. This is a time of great opportunity and great challenge as high-quality, relevant health services research on the impact of ACA implementation is vital to help inform health care policy and delivery.

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