Test (Or Prove) Your Ignorance About Obamacare

Here's a short Kaiser Health Reform quiz with ten "yes" or "no" questions to test if you really know the key points about the Affordable Care Act (Obamacare).  You can take it and see how you compare with the rest of the country before reading further.

While the quiz responses are being continuously updated the picture has hardly changed since a Kaiser analysis of the responses in February 2011, a year after the passing of the law.  It shows less than 1% of Americans getting all 10 answers right.  Worse, (given the bell shape of a normal distribution) even monkeys pulling levers with these yes or no choices would have done better than Americans actually did.  That's because the Americans' average score was under 5 while blind guessing or coin toss would get you 5 out of 10 correct on average.  (Assuming you ignore the "don't know" option as that is throwing away the question without even trying to score.)

This may largely explain why half the Americans are opposed to Obamacare - they don't even know what's in it.  True, Obamacare has way too many flaws and limitations but at least it makes the overall US health care situation better than before. 

I have another hypothesis which may be fun to test if the quiz respondents are also asked to state their political affiliations - whether they are / lean Democrat, Republican (or are truly independent).  I expect Republicans on average to fare worse on this quiz, i.e., they are more ignorant about this law.  Here's why:
 (a) True to human nature their political leanings and prejudices make them subconsciously block out facts about a law that they associate with Democrats.
(b) They get their news mainly from sources like "Fair and Balanced" Fox News where facts take a back seat to furthering Republican causes.
(c) People living in red states (by definition Republican dominated) that are largely in the US hinterland tend to be less well read or informed about the issues and simply go by what their favorite politicians tell them. Remember the "Keep Government out of My Medicare" slogans of Tea Party protesters?

In his July 16 column "Five Obamacare Myths" in NYTimes, Bill Keller does a good job killing some of the biggest pieces of misinformation. He followed it up today with "More Myths of Obamacare" by refuting some of the blow back, mostly from special interests and political opponents, and addressing three more myths.  I wonder though about the "taking the horse to the water" factor, as to how much of such fine work actually reaches the people who are the least informed, or the most misinformed. 

Back to the quiz, if you did score well on it, congratulations!  You're also then an outlier, or not a typical American.  Or un-American, in Tea Party parlance.

Are You A Good Candidate For Medical Tourism?

Here's a quiz I wrote at the request of my colleague and fellow BCG alum, David Williams who runs medtripinfo.com. This is a site dedicated to international medical travel (also called medical tourism) for Americans.

Many factors go into deciding whether you are a good candidate for going abroad for a particular procedure and a destination you may have in mind. Reducing these into a single quiz runs the risk of over-simplification. The scores and conclusions from it are not a substitute for common sense and are certainly not medical advice. But they can give some idea about your suitability. There's a reason why some choices are not labeled in continuous alphabetical order.

10 Question Quiz:

1. How much traveling have you done?

a. A lot, including to the region where my intended foreign hospital is located
b. Quite a bit by air, though not to my intended medical travel destination
c. Rarely by air, though some by ground (driving, train, etc.) in the US
d. Never / hardly ever

2. How fit are you to travel?

a. My doctor and I foresee no / hardly any problems
c. I am at very low risk, and can further minimize this with precautions
e. My risk is quite low, but much higher than for an average traveler
f. My doctor has advised against air/extended travel under any circumstances

3. What is the treatment and recovery time for the procedure (before you can fly back)?

a. Less than a week for minor procedures, 2 weeks for major ones
b. 7 - 10 days for minor procedures, or 2 - 4 weeks for major ones
c. 10 - 20 days for minor procedures, or 4 - 8 weeks for major ones
d. Over 20 days for minor procedures, or over 8 weeks for major ones

4. What is you financial situation?

a. Very tight. The savings from foreign treatment will save me from bankruptcy
b. So-so. I can just about afford US care but take a large hit to my savings
c. Comfortable. I can easily afford the US care but will welcome savings
d. Very good. Paying for US care is not a problem at all


5. Approximately how much will your intended treatment cost you in the US?

a. More than $50,000
b. $30,000 - $50,000
c. $10,000 - $30,000
d. $4,000 - $10,000 ($2,000 - $10,000 if you're driving distance away)
f. Below $4,000 (below $2,000 if you're driving distance away)

6. Is the added privacy and anonymity of treatment abroad (e.g., cosmetic surgery) important to you?

a. Very important
b. Somewhat important
d. Not a factor
e. Quite the opposite - I strongly prefer lots of friends and family close at hand

7. How much do you expect to save through treatment abroad?
(Consider your out of pocket costs, factoring in your insurance coverage, if any.)

a. Over 75% of the cost AND this works out to over $10,000
b. 50% - 75% of the cost AND/OR this works out to $5,000 - $10,000
c. 30% - 50% of the cost AND/OR this works out to $5,000 - $10,000
d. 15% - 30% of the cost (0% - 30% if your answer to "6" above is "a")
f. Below 15% of the cost (but choose "d" if your answer to "6" above is "a")

8. How much do you value sight-seeing and the experience of going to a new place?

a. Very important - it's one of the reasons I want to go abroad
b. A good side-benefit but my treatment quality is by far my key priority
c. Hardly matters - but if it helps pass the time while recuperating, that's nice
d. I dislike unfamiliar surroundings, and dread going to a new place

9. Are you familiar with the culture and the language spoken in the country you plan to travel to?

a. Very/quite familiar, and most or all of the people there speak my language
b. Not too familiar, but most or all of the people I'll be with speak my language
c. Not familiar, but many people at the hospital and hotel speak my language
d. The doctor and some of my hospital and hotel staff speak my language

10. How internet savvy are you?

a. Excellent at researching through Google (or equivalent), regular email user
b. Use email; occasionally surf the internet
c. Rarely use email or internet
d. I don't use the internet (someone else is helping with this quiz!)

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Scoring:

Give yourself 3 points for an "a"; 2 points for a "b"; 1 point for a "c"; zero points for a "d"; minus 3 points for an "e"; and minus 15 points for an "f".

Add your points and rate yourself for the condition and destination that you have in mind:

25 - 30 points: You are an excellent candidate
20 - 24 points: You are likely still a very good candidate
15 - 19 points: You may gain significantly from this option, but weigh it carefully
6 - 14 points: The pros of your medical travel are probably outweighed by the cons
5 points or below: There's no place like home, including for medical care