CJR’s Town Hall Meetings, Part III

The view from Wal-Mart, Honesdale, Pa.

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.

Wal-Mart, the shopping mecca for middle America, was high on our list of places to gauge the thinking of ordinary folks. People with their grocery carts brimming had certainly heard of the health reform debate. Two things stood out from my Wal-Mart interviews. The “death panels” provoked a strong reaction, leading me to believe it may be the issue that has penetrated the psyche the deepest so far in this debate. People were firm in their principles. But sometimes they seemed to mix them in odd sorts of ways.

I hardly had the words “health care” out of my mouth when eighty-one-year old Russell Fullem, a long-time resident of Honesdale in northeastern Pennsylvania, boomed: “I believe we should have the same insurance as Sen. Kennedy had, and I will broadcast that everywhere.” Fullem seemed to be saying he was in favor of health care equity, amplifying his point this way: “I want the same insurance to go to the biggest and best hospital in the world to take care of my cancer [if he gets it].”

But he didn’t want socialism—definitely not. Fullem told me that Vladimir Putin had told President Obama that his country had had enough socialism, so why should the U.S be getting it now? He believed that Obama himself had the best health care in the world, but “he’s trying to shove something down us that’s unrecognizable. It’s socialism,” he said.

What exactly is Obama’s plan? I asked. His answer: it was going to cost too much. I pressed for a few specifics, and Fullem, who considers himself a political independent leaning toward a constitutionalist, brought up the death panels. “If people are going to die, he [Obama] is going to put them to sleep. It’s like Soylent Green. That’s his health plan.” He asked if I had seen the movie. I nodded, and my mind raced back decades. He continued: “Why should we have to change for some dream plan that’s not going to work?”

Next, we discussed Medicare, which covers his medical expenses. I explained that it was social insurance, run by the government. “I have no dislikes about Medicare,” he said. “It’s a proven, government plan that works. If they want to build on it, that’s fine, but don’t change the whole goddamn thing.”

Chris and Danielle Oettinger were shopping with their two-month old daughter Laela—baby seat attached to their cart full of Huggies and food. They are a young family—he’s twenty-two and she’s twenty. Health insurance is a big problem. Danielle and the baby have Medicaid, but Chris is uninsured. Contrary to the conventional wisdom that young people don’t get sick and need insurance, Chris has needed a doctor a few times recently. He had stomach pains a few months ago and went to the hospital—a visit that cost the family $800, which they’re paying on an installment plan. Twice he had bronchitis, but saw the doctor only once—that bill came to $70.

Chris is a roofer and doesn’t get coverage from his employer. It’s a dangerous job, but he’s in no financial position to buy health insurance. Danielle supplements their income with part-time work at Turkey Hill, a convenience store.

What did they know about health reform? Danielle told me: “I know it’s government health care like everyone would get.”

“Like Canada,” Chris chimed in. “Didn’t they say if you have a company plan, you could get a government plan?” Danielle admitted the debate has been hard to follow. “You hear ten different things. It’s hard to put in words what it means. It’s so confusing,” she said.

How would health reform benefit them? Chris said it would make it easier for him to get insurance, and that health care wouldn’t be so expensive. “It would definitely benefit me,” he said. “I think I make too much money for insurance from the state.”

Sixty-seven-year-old Barbara had strong opinions. She wouldn’t give her last name, but said she was a Republican who lived in the Boston suburbs and had a home in Pennsylvania. As with Fullem, I didn’t have to say much before she blurted out: “I’m very much against national health care. There are too many people who can afford insurance, but don’t have it. I had to pay for insurance for a long time. It used to cost $800 a month.” That was before she went on Medicare.

Why was she so against national health insurance? “I want to choose my own doctor. I want to choose what I want. I don’t want anyone telling me what I can have. My surgery wouldn’t have been allowed under his [Obama’s] plan,” she said. Barbara made it clear she didn’t like the president. “I think President Obama is the devil,” she told me.

Barbara was also upset with Obama’s advisers, Rahm Emanuel and his brother Ezekiel. She cited an article Ezekiel had written some time ago that was floating around the Internet. In it, she said, was information that the administration was planning to spend health care money on people ages fifteen to forty, not on elders like her. So what’s going to happen to old people, I wanted to know. “They will give them the pill,” she said.

I wanted to probe her thoughts on national health care a bit more and asked why that was different in her mind than Social Security, a social insurance program. Isn’t it like Social Security? I asked. “But I paid into it; it’s mine,” she told me as she moved down the aisle. I thought of the genius of FDR and his payroll taxes that gave everyone who paid them a right to a benefit in old age. With those taxes in there, no damn politicians have ever scrapped Roosevelt’s plan. Ardent Republicans like Barbara believe in it, even if they don’t quite believe in health reform.

Robert and Theresa Moore, from Glen Rock, N.J., have been following the debate and said they knew about Obama’s plan “in broad strokes.” “We don’t think he wants to kill grandma,” they said. The Moores thought the president was well-intentioned and reform was needed, but he was taking on too much. “Not everything is wrong,” Therese said. “Certain things are okay. The things that need to be reformed glare out at you.”

“Like the involuntarily uninsured,” Robert interjected. “The voluntarily uninsured—they ought not to be forced to have health insurance.”

“We have to look at more preventive care,” Theresa believed. “There are certain things people have to do for themselves.”

Robert, seventy-four, is on Medicare and has a supplemental policy from his former employer. Theresa, sixty-three, is still entitled to benefits under his old company coverage. Robert told me that a high percentage of people are satisfied with their insurance. “I would be in that category,” he said, adding that he wouldn’t mind sacrificing a little so others could have insurance. “Didn’t Marx say something about the greatest good for the greatest number?” he asked. Robert said he was a broadminded Republican, but that didn’t mean he disagreed with everything Marx said.

Has the president been clear about health reform? “No,” the Moores replied. “He wants to leave it up to Congress for the specifics. He has more confidence in Congress.”

“I have great hopes for Wednesday night [when the president gives a major health address],” Robert wanted me to know. “But Obama should be talking to the people like Reagan did, not the Congress.”

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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.