“Obamacare is making an impact on insurance policies,” she explained. “He’s driving the price up and insurance companies are panicking to be able to keep out of the government’s hands. I worry it might turn into socialist medicine that takes away from patient care.” Westervelt believed that another type of healthcare system would “lose the specialization we have in the states.” She had once broken her back, when she fell off a horse while fox hunting, and said she knew the value of specialists. We talked some about the overtreatment that occurs in the US. “Right now we have the right to say no to overtreatment, like physical therapy,” she said. What should Obama do with healthcare? “I don’t have an answer, but it should remain in private hands,” she said.

We got around to the election. Westervelt said she is a Republican these days, having changed her affiliation a few years ago, but she did not know whom she would vote for. She hoped that a third-party candidate might appear. Westervelt said she wouldn’t vote for Obama unless he came up with some different ideas for healthcare and the wars. She was troubled by “all the money he’s throwing away. As far as the wars, she said, “it’s time to pull out.”

Carl

Carl Burrows had come across the Missouri River from nearby Iowa to have a drink at his favorite bar in the Old Market.* There is only one bar in his town, Carter Lake, he told me, and “It’s a dive.” Burrows, who is 67, worked as a technician for the phone company and took early retirement, but works part time on a contract with his old employer. He said for now he was OK financially.

Are the candidates speaking to him? “Not really,” he replied. “The Republicans are the worst. There is no cooperation in their party. The way things are, Republicans are just awful. I just don’t want Romney.”

Still, though Burrows said he was a Democrat, he is still not sure he will vote for Obama. He doesn’t really know why. Burrows does have some sympathy for the president, though. “Everything he has tried to do gets shot down. I personally don’t doubt him. I do think he’d do fine, if they gave him a chance.”

Steve

I wandered into Aromas Coffeehouse and saw a man with gray hair working at his laptop. I told him I was doing man-on-the-street interviews with ordinary people. He told me he was not an ordinary person but was a defeated politician who had just lost the Democratic primary race for the Senate to former Nebraska Sen. Bob Kerrey. Steve Lustgarten, 60, said he had jumped into the race three months ago with no expectation he would win. He had returned to Omaha from Los Angeles, where he had been in the film distribution business, and decided to try politics. The experience? In a word, he said, “sordid.” “Nothing about Bob Kerrey sits well with me,” he said. But Kerrey had name recognition, Lustgarten said, and voter turnout in the primary was low.

Lustgarten had a lot to say about politics and the election and I was eager to hear a candidate’s point of view. He told me the major newspaper in the state, the Omaha World-Herald, “would not admit I was running. They wouldn’t acknowledge anyone was running against Kerrey. Some of the TV stations were more helpful,” but he had a dim view of some reporters. He told me about one young TV reporter who interviewed him did not understand why there was a primary election. He said to Lustgarten, “’I thought the election was in November, why are we having it now?’”

“People are completely disconnected. I ran into aggressive apathy. It was sort of like ‘I don’t care,’” he said. One woman he met didn’t know what the Democratic Party was. “Their lives are constrained and they don’t have a serious news source any more,” Lustgarten said. “A lot of them watch Fox and get their news from Facebook. Their basic attitude about Social Security and Medicare is that if it ain’t broke, don’t mess with it. The younger people will have to deal with it.”

I asked the former candidate the same question I had been asking others. Were the presidential candidates speaking to their concerns? “That would be stupid” strategy, Lustgarten shot back. “They are trying to persuade only eight percent of the swing state voters and skew their messages to bring them in.” As a result, he said said, the candidates shout platitudes rather than alienate one group of voters or another. “There’s no reason to discuss other issues,” he said. “The special interests control the dialogue.”

Trudy Lieberman is a fellow at the Center for Advancing Health and 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. Follow her on Twitter @Trudy_Lieberman.