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Health Care Reform Primer: How Might the Changes Affect You

Protesters hold signs while Rep. Jared Polis, D-Colo., meets with constituents to discuss health care reform at a Labor Day festival on Sept. 7, 2009 in Louisville, Colo. (John Moore/Getty Images)Much of the coverage of the health care reform process has left consumers -- and many of us here at ProPublica -- struggling to understand just how the various proposals in play would affect them.

To begin to tackle that, we partnered with American Public Media's Public Insight Network team, asking readers and listeners to complete a health care questionnaire. Hundreds of you responded, leaving us with a much clearer picture of what people across the country are actually coping with, and what people want to know. (Take a look at the Public Insight Network's interactive map of survey responses.)

Over the next few weeks, we will be profiling survey respondents, looking at how the proposed reforms will affect their situations.

Based on the responses to our questionnaire, here are the health care concerns we have decided to focus on:

  • The uninsured and underinsured, or those who worry they may be: What will the reforms being considered do to help people like Steve Eisenberg in Bigfork, Mont., who pays $4,000 per year for family coverage, but still struggles to pay for health care because his policy has a $10,000 deductible?
  • The burden on business and the economy: Many who answered our questions expressed concern about the effect that high health care costs are having on businesses and the economy. We'll talk to small-business owners who responded to our survey, and find out how the reforms being discussed will attempt to reduce the pressure of health care costs.
  • Covered but squeezed: Many people who wrote us just can't believe how much their health insurance premium goes up every year. Can reforms tame the rise in their health care costs?
  • Health care and the government: Many people we heard from said they are worried that the cost of health care is bankrupting government. Others were relying on government programs to get necessary care. Can the proposals in Congress find a way to reconcile helping those who need it and keeping spending in check?
  • Happy with what they have: Or maybe you're like Ralph Amadio, of Downey, Calif., who says, "I have had serious back surgery, neck surgery, and prostate cancer, all paid by either my employer or insurer. The system has worked well for me." Will health care reform make people worse off?

In addition to personal stories, we also received many questions. Why not a single-payer system, or Medicare for all? Will reforms fix underlying causes of high costs like a lack of preventive care, and patchy quality of care? How much influence do pharmaceutical companies and insurers really have over the legislative process, and how do they wield it? In shorter pieces, we'll be answering those questions, as well as taking others as we go along. (Ask away.)

Also, we will be posting up-to-date versions of the House and Senate bills in our handy document viewer, which will let users easily search the legislation and bookmark specific pages.

One final note, our survey was obviously self-selecting. Here's a snapshot of who we heard from: The average age, 57, was relatively high, and the median income was about $50,000 per year. Two-thirds of the people who wrote us had private insurance, and of those people, about half received that insurance through their employer. Another 20 percent were on Medicare. A fact that surprised us: Only 11 percent of respondents were uninsured, a lower rate than the national average.

If you want to participate in other projects like this, please join our ProPublica Reporting Network.

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