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 way out in full force, trying to influence the hearts and minds of people who have turned out at town hall meetings. All this leaves reporters in a pickle, though: How do they know what people really think? 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 for them.
On Labor Day weekend, I journeyed to Scranton, Pa., hoping to catch a town hall meeting called by the progressive group Health Care for America Now (HCAN). HCAN had advertised a gathering on the steps of Scranton’s city hall. What better way to find out what Pennsylvanians were thinking, I figured. But at the appointed hour, not a soul from HCAN nor a single supporter showed up. Instead, there was Jack O’Rourke sitting alone on the steps, cane in hand and solar-shield glasses covering his eyes. O’Rourke was heading toward the Italian festival down the street. “I was originally for the plan,” he told me. But the more he learned about it, the more he disliked it. I asked why.
O’Rourke, age sixty-eight, has little income and depends on Medicare for his health needs. He was scared that Medicare would disappear. “I think it (Obama’s plan) is going to undermine the Medicare system,” he said. “There’s no way I can pay $9300 for another cataract operation.” He said he was watching a program about health care on cable and heard that they had tried reform in other states. He knew about the failure in Tennessee. “It’s a good predictor of what might happen with Medicare,” he explained.
O’Rourke said that if “they open health care to forty million more,” he might not get his other cataract removed. “Suppose they cut the payment in half,” he said. “I couldn’t afford it.” What else doesn’t he like? Abortion funding. “And I am against a panel of doctors telling you when you can live and die.”
After visiting with O’Rourke, I checked out La Festa, where opinions were as varied as the food—everything from bruschetta to Belgian waffles. Robert Marrara was dishing out porchetta at the Unico booth. He owns a small home improvement company and told me he was for reform, but “not this plan.”
“I like reform,” he said. “I don’t like government control of anything one hundred percent. I don’t like the way it’s being portrayed.” Marrara then admitted he really didn’t know what’s going on. He said he was getting only the information that was given out. “The only people explaining it are people on the right. The people on the left are followers. They don’t have the details,” he explained.
What exactly was bothering him about the Obama plan? He liked making everyone buy insurance, but it was the penalty for not buying that concerned him; he said “it would drive everyone into this public plan.” How would reform affect him personally? “I am very worried about the end-of-life committee,” Marrara said. “I have heard all the arguments, and nobody has convinced me it doesn’t exist. I’m one of those guys who quit the AARP—a month ago.”
His co-worker at the porchetta booth, David Bieri, saw things differently. Bieri, an elementary school principal, sees what happens when children don’t get medical care—like those who don’t get SCHIP because their parents are too embarrassed to apply, or the kid with an abscessed tooth. “I see more kids without insurance than ever before,” he told me. “Their parents have lost their jobs, and they don’t know who to turn to.”
Bieri, age forty-five, says “it burns me when I hear this is socialism. So when I hear people talk about socialism, I throw it back at them.” He says he points out that Medicare and Social Security are social insurance programs.
Bieri said he knew quite a bit about the reform proposals and watched a lot of media coverage, both liberal and conservative. “I am one hundred percent for a public option,” he explained. “Without it, people have no incentive to change. Putting insurance companies on notice will bring down the cost of health care. They will have to do a better job.” I probed more on the cost question. How is Obama going to bring down the cost of medical care? “That’s one thing I can’t answer,” Bieri said. “I am not a cynic, so if they tell me they are going to do it, they are going to do it.”
I met fifty-two-year old Gail Groff selling ice cream and waffles at Yogi’s Ethnic Foods. Between scooping up butter pecan and making root beer floats, she told me she had no health insurance and wasn’t about to buy any. Her income was $40 or $50 over the limit for state help, and she has no extra cash to buy it on her own. “I don’t go to the doctor,” she said. “I can’t afford to go, but there’s not a whole lot I can do about it.”
Groff was worried about the disabled and the elderly, and what would happen to them when the death panels decided if they could live or die. She had heard about a woman in Oregon who was denied cancer care, and “the story really scares me,” she explained. “Are they going to say we’re not going to pay for your care?”
Where did Groff get her news? She had heard about the lady in Oregon on MSNBC, Fox, and CNN. And then she turns to a Web site called Snopes to verify whether something is true or not.
Juliana Piccini, age fifty-seven, had recently retired after thirty-five years as an elementary school teacher in the Valley View school district. “I’m really not up on health care, she said. “I don’t want him (Obama) to mess with the system I have. I’m perfectly happy with what I have.” Piccini has a Blue Cross PPO—why shouldn’t she be happy? “My district pays for everything,” she told me. Are you following the debate, I wanted to know. “Not really,” she replied.
Diane Bolton and her husband Bill were munching on bruschetta topped with diced tomatoes when I asked what they knew about health reform. “My understanding is that it’s insurance from the government, and there’s one set price everyone will pay for health care.”
“It’s sort of like Canada,” Bill chimed in. “There’s one set price, and everyone can get coverage there.” Bill, who is forty-one, added: “If you make it across the board for everybody, then everybody can pull their own weight.” I asked the Boltons where they had heard all this. On ABC News, they said.
How will Obama’s plan affect them? “I don’t know the good points,” Diane admitted, and then added: “I honestly don’t know how it will affect me. I think it’s a good plan. Obama is trying to do the best by helping everybody.”
I wanted to hear some younger voices, so I stopped by the booth manned by young men wearing Army fatigues. They were ROTC students recruiting for the military, and the sign-ups were slow. Mark Edwards, who goes to the University of Scranton, also works as an emergency room technician at a local hospital. He has seen the health system close up. For a health care worker, he seemed strangely disengaged from health reform.
When I asked what reform was all about, he replied that it “is going to benefit as many people as possible.” And then he said with conviction: “It’s going to pass. I know that for a fact.” But when I asked more questions, Edwards, age twenty-three, said he hadn’t paid attention to health reform because he doesn’t watch much TV. “I know there’s a lot of debate,” he said. “There’s not a lot I can do except sit back and watch it happen.”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.