CJR’s Town Hall Meetings, Part I

The view from Starbucks at Fifteenth and Third

Everyone, it seems, is trying to take the pulse of the electorate—Americans who, as the saying goes, vote with their feet and may well decide the fate of this effort to change the American way of health care. The pollsters, the wordsmiths, the PR firms, and the stealth groups have been out in full force, trying to influence the hearts and minds of people turning out at town hall meetings. All this leaves reporters in a pickle, though: How do they know what people really think? So we at Campaign Desk decided to use that age-old reporting tool—the man-on-the-street interview—and set out to look at what men and women we met have to say about health reform. The series is archived here.

We have come to believe that the entire debate, its complexity and its nuances, has been taking place 30,000 feet above the heads of people in whose name the reform battle is being waged. Our interviews confirmed that observation. Of course, our results are not scientific, but we think they offer some pretty good clues to the way ordinary Americans are thinking. Too many people we met are not engaged, have heard lots of wrong information, and have no idea what reform means to them.

The first place I stopped was a Starbucks in my neighborhood, where the baristas one morning asked me what I did, since I came every day at the same time to buy iced tea. When I told them, they asked me to come back when they weren’t busy to explain what health reform was all about. Marisol Gonzalez, the assistant store manager, told me she got interested in the debate when she heard on the hip-hop station Hot 97 that Obama planned to take health insurance away from people. But she really got alarmed when a customer came in for his latte and told her Obama is going to ruin this country with his health care. Ruin the country? Not likely, I said, and explained what was on the table.

“I know Obama is trying to implement a plan a lot of people are disagreeing with,” she said, and then asked what the disagreement was about. Gonzalez is an Army reservist and completely believes in the Afghan war. She said she learned in the military that “if you want to reshape something, you have to tear everything down and start over.” She wanted to know if that applied to health care, too.

Her co-worker, Jose Santiago, admitted he didn’t know much about reform. “I thought Obama was trying to change the health plans,” he said. “By next year he will probably eliminate health coverage completely. He is following up on what Bush already planned.” Are you worried? I asked. “Not much,” said Santiago. Starbucks provides its workers with insurance. But Santiago didn’t know a lot about his coverage, or how much he had to pay for it. He did want to know what “death care” was. Death care? A plasma TV screen at 57th and 6th piqued his interest. It flashed the words “Health Care or Death Care” as he happened to pass by.

Roger Melendez and Brent Carrington, computer technicians on a call, were just finishing their drinks and closing their laptops when I approached them. Melendez, who served in Vietnam, said he was ashamed to be a Republican. What he called “the death list” he said was “a Republican tactic to discredit this administration.” He had been following the news “quite a bit.” As he understood it, if you have insurance, nothing changes and your rates may drop. “There’s a lot of good that can come out of this,” he said. Carrington had just been rehired after a three-month layoff. He confessed he didn’t follow politics, watch the news much, or know anything about the debate.

Carrington, thirty-three, is uninsured. He had insurance once and paid $200 or $300 a month. He has no plans to buy it now. Why? I asked. “I look at insurance as a discount. You get a tab from the doctor anyway. After you pay so much money for insurance, you still get this nasty tab, so why get it? I shouldn’t be getting an extra bill.” When I told him he may be required to buy coverage, he was not pleased.

Alicia Ng, thirty-four, was listening to music and sipping coffee when I asked her what she knew about the debate. “To be honest, I don’t really know what’s going on,” she admitted. “You talk to medical students, business owners, and friends in public health. There are so many opinions back and forth. You pick up the Daily News and the New York Post, they are totally against it; the Times is for it.” Ng, a freelance journalist, has no insurance and is applying for Medicaid. She worked in France for awhile and said health care was “so easy there.” Here, insurance companies “don’t cover so many things like mental health,” she said, “so I just said ‘forget it.’” Ng had a vague idea that she might get some insurance under the proposed health plans, but to really understand how the plans affect you, she explained, you “have to know the past.” In other words, people have to know the history, the context, and how things worked before to get the gist of how reform will affect them now.

Jamie Scott, a recently unemployed copy writer, said she had worked for Big PhRMA for the last twelve years writing drug sales pitches for doctors. “I try to follow the debate, but it’s like herding cats.” Scott, who is two and a half years away from Medicare eligibility, doesn’t know how the plans might affect her. “I do know there’s so much money being spent in Washington to make sure it doesn’t affect profit margins. I don’t see how they could come up with a meaningful bill,” she said.

“I absolutely believe in Medicare for all,” said Scott. “We’re the wealthiest country on the planet. There’s no reason health care should not be available and affordable for everybody.” In the meantime, she may face unaffordable premiums when money from the stimulus package that is paying 35 percent of her COBRA premiums runs out.

Some Starbucks customers refused to chat, and frankly seemed put out when I asked. Too touchy a subject, perhaps? Ah, the perils of taking a poll, even if it’s an informal one.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.