CJR’s Town Hall Meetings, Part VI

The view from Union Station, Washington D.C.

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 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 entire series is archived here.

We have come to believe that the entire debate, its complexity and its nuances, has been taking place 30,000,000 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 were not engaged, had heard lots of wrong information, and had no idea what reform means for them. This is the last installment in this series, which has examined the public’s thoughts, before a final bill comes up for debate on the floor of the Senate and House of Representatives.

To conclude this series, we thought the ideal place to take the peoples’ pulse was inside Washington, D.C.’s Union Station. Two blocks away on Capitol Hill, the offices of members of the House and Senate have been abuzz for months about reform. But what did ordinary people waiting for trains, serving food, or selling jewelry think about the political business nearby? Some weren’t shy about talking.

Lois Void of Eutawville, South Carolina, had come north for a funeral and was waiting for a train to take her to Charleston, about fifty miles from home. At age sixty-one, she lives alone surviving on her deceased husband’s VA pension. She hasn’t had health insurance since thirteen years ago, when she worked in a sewing room making placemats and tablecloths. She had to quit work to care for her sick husband. For her medical care she goes to the Family Health Center near Orangeburg which treats the medically underserved. There, she pays according to a sliding fee schedule.

At first Void said that she didn’t know too much about health reform, but then said: “I think it would affect me because I don’t have health insurance.” She thought that it would help her pay for hospital visits and medicine. Void told me she depended on the local news and CNN for information. “I would like to know more,” she said. “I would like to know a little more—as much as I can find out.” Void put her finger on a missing aspect of the debate—how reform would specifically affect her. “I would like him (Obama) to give a little more about the guidelines for different people, and age groups like seniors, and people who have different health issues,” she said. “What would happen to them?”

Shirley Goldston, age sixty-four, was also waiting for a train to go home to Rocky Mount, North Carolina, not far from Raleigh. She thought reform was “long overdue” and couldn’t understand why people were fighting against it. I asked her why she thought that. “That’s a good question,” she said. “I think it’s sabotage against the president. It’s the Republicans and the self interest groups that are part of it.”

Goldston is a retired employee of New York City, and she also worked at CBS for fifteen years, so she has had retiree coverage. Now she is on Medicare because her kidney failure requires dialysis, and Medicare covers end-stage renal disease. But, she says, her drugs aren’t always covered, and the costs are off the charts. Each month she spends about $75 out-of-pocket for medicines. She also has diabetes and high blood pressure and says if she had had preventive care and followed instructions, she wouldn’t be in this position today.

What about Obama’s plan, I asked. She summarized it this way: “I know he said it would be mandatory—everybody would be covered. “If you can give me coverage without pre-existing conditions at minimal rates, then we can have preventive care instead of care at the other end.”

Thomas Mason had been on the job one month selling ice cream and drinks at Ben and Jerry’s, where, he said, smoothies were the most popular items. He earns $8 an hour for twenty to thirty hours of work each week. Buying insurance is out of the question. But he told me he has coverage through a state program in Maryland, where he lives, and he showed me his Priority Partners card. He got it when he wasn’t working and doesn’t know how the new job will affect his coverage. Nor did he have much of an idea how reform would affect him. “I really don’t know,” he replied when I asked.

Mason, age thirty-three, said he saw people arguing on the news—mostly he watches Fox—“but I don’t understand what they are saying…. Is he (Obama) making mandatory health care for everybody? Why are they arguing about that?” Of Fox, he said, “they keep you somewhat informed about what you need to know.”

Manau Rosales, age twenty-one, works at Fire & Ice, a jewelry store selling to visitors who come to the nation’s capital. She has been there about a year and a half and has no insurance from her employer. At first she tells me she has Medicare but then corrects herself and says Medicaid. Both she and her toddler receive health care through Medicaid. Rosales told me she was not following the debate but was concerned that if she no longer had Medicaid, she would be in trouble. “I’m glad they give me insurance, or I’d struggle like crazy. If it wasn’t for that, I wouldn’t get care. So if something changes because of his (Obama’s) decision, it would be a big problem.”

Rosales gets her information from MSNBC, the Internet, and Express, the free newspaper distributed on the train she takes every day from Prince George’s County. The day after we chatted, Express, a publication of The Washington Post, ran a story on page three announcing Sen. Max Baucus had revealed his reform bill. Said Rosales: “When it comes to the point where anything changes, they will put it in there. They will give us important information.”

I stopped by Sbarro’s Pizzeria and found a fiftyish woman sipping a coke. She said she was waiting for a train to New York City and wouldn’t let me use her name. She agreed to talk and did not hesitate to tell me how she felt about reform. She did not like it. The woman had government health care through her husband, who was an administrative law judge at one of the federal agencies. “I have the really good federal government policy,” she told me. The woman was Hungarian and had left Hungary more than thirty years ago. “I am skeptical of socialized medicine. Period! We had socialized medicine—long lines to wait for the doctor.”

She was certain that the quality of medical care would be affected badly under Obama’s plan. “Definitely,” she said. Here’s how she explained it: “If he’s not going to increase the costs and bring in more people, either he’s dishonest, as they say in Congress, or it will affect the quality of care. If something is too good to be true, it probably is.” The woman said she was afraid government bureaucrats may tell doctors what to do. “I don’t understand why we need to overhaul the whole system,” she said, and told me that she supported reforming Medicaid and community clinics to “enrich that part of the system.”
As the woman got up to catch her train, she said she was a Republican and liked Politico, Fox, and CNN. “I’m praying to God I won’t be affected by it. You can put that down.”

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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.