Designing Health Communications about the Affordable Care Act
Improving Healthcare Sign Design
The Affordable Care Act (ACA) has lead to the health coverage of over 2o million adults, and the lowest uninsured rate in the history of the US. Despite these achievements, congressional Republicans are in the process of trying to repeal the ACA.
It is therefore absolutely critical that the public understand the possible consequences of the proposed repeal.
Unfortunately, healthcare is complicated, and there has been a lot of public misunderstanding of the ACA. For example, in this Vox.com article, reporter Sarah Kliff describes the dilemma:
Kentuckians just did not understand that what they signed up for was part of Obamacare. If they had, certainly they would have voted to save the law.
Kentucky had been deliberate in trying to hide Obamacare’s role in its coverage expansion. The state built a marketplace called Kynect where consumers could shop for the law’s private plans, in part to obscure the fact that it had anything to do with the unpopular federal law.
“We wanted to get as far away from the word Obamacare as we could,” Steve Beshear, the former Kentucky governor who oversaw the effort, says. “Polls at the time in Kentucky showed that Obamacare was disapproved of by maybe 60 percent of the people.”
I heard from Obamacare enrollment counselors who had seen this confusion play out firsthand, too. “When we’re approaching people about getting signed up on health care, one of the first questions they have is, ‘Is this Obamacare?’” says Michael Wynn, one of Oller’s co-workers. “So we would tell them, ‘No, this is not Obamacare. This is a state-run plan.’
Another article in the New York Times described a series of post-election focus groups conducted by the Kaiser Foundation with Trump voters in Rust Belt areas enrolled in the ACA marketplaces and/or on Medicaid.
…asked about policies found in several Republican plans to replace the Affordable Care Act — including a tax credit to help defray the cost of premiums, a tax-preferred savings account and a large deductible typical of catastrophic coverage — several of these Trump voters recoiled, calling such proposals “not insurance at all.”
When told Mr. Trump might embrace a plan that included these elements, and particularly very high deductibles, they expressed disbelief. They were also worried about what they called “chaos” if there was a gap between repealing and replacing Obamacare. But most did not think that, as one participant put it, “a smart businessman like Trump would let that happen.”
The Democrats are now mobilizing to fight the ACA repeal plan. In their effort to inform the public of the consequences, they have developed a campaign that riffs off of Trump’s slogan: “make American great again”, with the phrase “Make America Sick Again”, which refers to what they predict will happen with the dismantling of the ACA. Here is the sign that they created and posted on social media:
This campaign is long overdue. We need simple and clear messaging to communicate with the public about the possible consequences of an ACA repeal.
However, I think the signs and the hashtag need to be modified!
The preface of the text referring to the cause of what would make America sick again is in very tiny letters:
The slogan, “Make America Sick Again” is in big bold letters.
The design is problematic when you see the sign displayed from a distance at a press conference (see photograph below). You can’t even read the words in small letters. All you can see is the slogan, and it makes it look like the Democrats are endorsing the slogan “Make America Sick Again!” The hashtag they are using #MakeAmericaSickAgain also reinforces this!
I found some other additional images which follow the same format, which could also cause confusion.
The sign needs a redesign to avoid the perception that Democrats are endorsing the sickening of America.
I am not a signage expert, but maybe the words “repeal” or “ACA repeal” need to be added to the slogan (i.e. “REPEAL WILL MAKE AMERICA SICK AGAIN”).
This may seem like a minor issue, but given previous misconceptions about the ACA, we need good communication design to achieve good health. Otherwise millions of Americans may lose their healthcare coverage.
Designers, given your desire to take action post-election:
What ideas do you have for improving the design of the sign?
What other ideas do you have for effectively communicating with the public about the consequences of the ACA repeal?
Tweet them to me at @joyclee or share them in this Google Document which has more links and information that I have been curating about the ACA and repeal if you are interested.
I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter.
