The idea of privatizing Medicare is not winning popularity contests with voters. A Pew Research Center poll released Tuesday found that the public is aware of the proposal by GOP vice presidential candidate Paul Ryan to transform Medicare from social insurance into a voucher plan. And among Americans who have heard of the Ryan plan, 49 percent opposed it; only 34 percent were in favor. Pew found particularly high disapproval rates among older Americans, and independent voters weren’t keen on it either: 49 percent oppose and 34 percent support it. Thursday The New York Times reported that the GOP plan “is widely disliked,” and also that it has become the third most crucial issue to likely voters in the key swing states of Florida, Ohio, and Wisconsin, ranking behind the economy and healthcare.

This is another in CJR’s ongoing series of CJR Town Halls—conversations with citizens about the issues they are following in the press, and it will be the first of several Town Halls focused on Medicare. Part of the idea is to encourage journalists to do similar pieces, talking to ordinary people about dollars and cents issues and their needs and perceptions. Last week I was in Missouri, a swing state leaning red. My unscientific sample in St. Louis—made up of white women, some of whom just turned 65—pretty much lined up with what the scientific polls are showing.

Marie Cunningham and Janie Mueller

Cunningham, 65, and Mueller, 60, were on their lunch break, sitting outside the Bank of America Tower in downtown St. Louis, where they manage accounts for a property/casualty insurance broker. Cunningham, who recently signed up for Medicare, hadn’t heard much about Paul Ryan’s plan—“Are they trying to do away with it?” she wanted to know—and then let Mueller do the talking.

And Mueller had a lot to say. She had read about Ryan’s ideas in the newspapers, and watched coverage of it on CNN and MSNBC, and has an idea of how Medicare could change: “He wants to do away with what we know Medicare to be,” she said. “I’m not in favor of it at all. I’m extremely concerned.” Her main worry: preexisting conditions. She believes that under Ryan’s plan, older people who have medical conditions may not get insurance. It is an issue worth worrying about, since no one knows what final legislation might look like, though pre-existing conditions would seem to be something such legislation would address.

“Realistically when people into their 60s, their bodies start to fail,” she said. “Where are they going to get insurance? If Obamacare falls apart, we don’t have the force to make insurance companies take them.” Mueller is a Democrat and will vote for Obama, but she made clear that she views the issues independently, and also believes that “focusing on tort reform would be beneficial” in solving the healthcare cost dilemma. Tort reform is a solution pushed by the GOP.

Frances Flecke

Flecke, 55, was on her lunch break too, smoking outside the Federal Reserve Bank of St. Louis where she is the assistant manager for the Federal Reserve credit union. She told me she knew firsthand how the Great Recession has affected working families. “I saw many families suffering. They were living off courtesy pay,” she said, referring to a form of check overdraft protection that some banks and credit unions offer, which can be costly, but which allows consumers to pay their bills. “I saw more people living off that than I care to mention,” Flecke said. “A lot of our middle class is now lower class. What they had has been taken away from them.”

I asked Flecke how she gets her news. “The media doesn’t always tell you what’s true, “ she said. “What TV stations you watch are what you believe. You have to open your eyes or you’ll never have a clue.” She said she sometimes voted as an independent, and I asked her what she knew about Paul Ryan’s plan. “I would say it’s not a good one,” she said, and proceeded to accurately described what the plan would do.

Medicare had meant a great deal to her mother, who died at age 86: “I know Medicare helped my mom pay her medical expenses when she was alive. She was very ill. Without Medicare, we probably would have lost her years before.” Flecke said she planned to vote for Obama, although her boyfriend—she is divorced and has two adult children—“prays every day I’ll vote for the better of two evils, and that is Romney. People have told me I’m choosing the wrong candidate. The Christians here believe Obama is the anti-Christ. But I believe he has had his hands tied, and his overall goal is to help all Americans, not just the rich or the poor.”

Ruth Fuller and Barb Johnson

My next stop was the St. Louis Botanical Garden, where I found two former school teachers resting after a walk through the gardens. Both were 65 and had just gone on Medicare. Fuller had been a speech pathologist in the St. Louis public schools for 36 years and was glad she retired when she did. “It got so I was bombarded with paperwork, and paper work takes away from student interaction,” she told me. Her friend Johnson had taught in elementary schools. Both said they had good pensions from their school systems. They said so far their incomes were enough to let them travel and do what they wanted.

Johnson said she did not know much about Paul Ryan or Mitt Romney, “but I’m not sure any one of the candidates is attuned to my needs.” Then she quickly volunteered, “I think we need a single payer system to take the profits out of the system.” Why, I asked? Johnson said her experience with private insurance had not been good. Every two years the school systems she worked for changed insurance companies, she explained, and she had to change doctors. “It was ridiculous. I didn’t like it when I had to change doctors. I bounced around. I don’t think privatization works for anything.”

Johnson considers herself an independent and for many years has voted Republican. But she doesn’t like the Ryan plan. She said she was fiscally conservative and would vote for Obama. “My mother would never have had insurance without Medicare.”

Fuller, who says she’s an independent, often votes Republican. She twice voted for Richard Nixon. “I don’t know that I have ever voted for a Democratic president,” she said. She also calls herself a news junkie. And she does not like Ryan’s privatization plan. I asked if the Medicare issue would swing her vote for the Democrats this time. “Probably. With that in mind, I would vote for Obama,” she told me. And: “If you start messing with Social Security, these gray-haired people will march on Washington like some march for abortion. Don’t mess with people’s pocketbooks.”


Lauren McClanahan

McClanahan was getting out her car at the botanical garden on her way to a part-time job in the gift shop. As my friend and I were getting into our car, we talked about Medicare; McClanahan overheard and wanted to join the conversation. She recently turned 65 and began collecting Social Security benefits, receiving $1,027 after her Medicare premium is deducted. She is now single and said that after she signed up for Social Security benefits, she had to get a part-time job to make ends meet; she did not have enough of a work history for a larger Social Security benefit. She had been a full-time mom and worked at a lot of part-time jobs, including managing her daughter’s beauty salon for a time.

As soon as she filed for benefits, she looked for another job and found the one at the gift shop. “They don’t pay much, but it’s a job,” she said. And she had just gone on Medicare. She said she is a registered Democrat but voted for the elder George Bush. Could Paul Ryan’s Medicare plan affect her vote for the president? “Absolutely,” she said. She has been watching the coverage of Ryan, and continues to weigh the candidates. “You have Obamacare on one side, and on the other Ryan and Romney wanting to mess with Medicare. And here in Missouri we have Akin who wants to abolish Social Security.” McClanahan seemed frustrated by the politics of it all.

This is part of a series of CJR Town Halls, conversations with voters about the issues and how people learn about them through the press. And Trudy Lieberman’s “primer” on Medicare is here.

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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.