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The Town Hall Effect

Picture 7 We’ve all been reading a lot about the congressional town hall meetings around the country, where protesters rail about President Obama’s health reform plan. News reports and video clips indicate that half or more of the protesters yelling about socialism and a government takeover are of Medicare age.

I’ve wondered about these senior citizens and other protesters. They look like ordinary working- and middle-class people who probably have the same problems with the U.S. health care system as millions of other Americans. How can they just say no to legislation that would help them personally, or that would give others the kind of guaranteed coverage they already enjoy?

Earlier this month, Mike Sola, accompanied by his adult son with cerebral palsy, bellowed at Michigan congressman John Dingell, demanding to know why his son supposedly wouldn’t be covered under reform legislation. Of course, people like the Solas would be some of the biggest beneficiaries of reform provisions that would bar insurers from denying coverage based on preexisting conditions. But Sola didn’t want to hear it.

Last week [Aug. 11], I had my first personal encounter with this paradoxical mindset. I was in the waiting room at my dentist’s office reading Time Magazine’s good cover story about Obama’s efforts to pass health reform. An attractive white woman who appeared to be in her early 60s asked me what I was reading. I told her.

Given that Yakima, where I live, is a conservative town, I cautiously added a little editorial about how much I hoped Obama succeeded because for so many of us our health coverage is precariously dependent on our jobs. She nodded in seeming sympathy.

But suddenly she frowned and said how awful she thought the proposed Obama reforms would be and that it would be just like Canada’s dreadful system, with total government control. I pointed out that the U.S. Medicare system is a government, single-payer insurance system like Canada’s, and that most people on Medicare seem to like it.

Then came the surprise. “Yes,” she said, “we like it.” (I hadn’t pegged her as being old enough for Medicare.) But, she added, the government system shouldn’t be expanded beyond that.

Just when the discussion was getting interesting, she was summoned into the dentist’s chambers. So I didn’t get to explore this bewildering contradiction.

That same day, Missouri Democratic Sen. Claire McCaskill asked the hundreds of senior citizens at her town hall meeting, including many protesting against a “government takeover” of health care, whether they want to get rid of Medicare. No hands went up.

“So we have a whole bunch of folks here that have a government health care program and they like it,” McCaskill said over jeers. “The irony seems to be lost on people that sometimes the very people who are saying, ‘Make sure the government keeps its hands off my health care but by the way don’t touch Medicare’ — that is ironic.”

Talking to Yakima Protesters

Ironic is one way of describing it. I still wanted to understand the thinking of reform foes better. So last Friday [Aug. 14] I went to an anti-health reform rally in Yakima held in front of Sen. Patty Murray’s office, organized by the anti-government “tea party” folks.

About 75 people, at least half of them 65 or older, were marching and brandishing signs like “Obama’s health care plan makes me $ick!” Quite a few passing cards and trucks honked in approval. Three lonely counterdemonstrators across the street held pro-reform and single-payer signs.

Keep in mind that the health care crisis in Yakima is dire. The Yakima/Tri-cities area has the second highest rate of uninsured residents of all the state’s regions, according to state figures. And the rest of the state is hardly in good shape. Across Washington, nearly 900,000 residents – about one in five — lack health insurance this year. That’s 21 percent more than last year. On top of that, state budget cuts recently prompted Yakima Valley Memorial Hospital to implement job layoffs and furloughs.

So why do these demonstrators oppose Obama’s proposal to extend health coverage to all Americans, improve health care quality, and control costs? And are they in a personally secure enough position to refuse government-arranged health insurance? Based on my sample of eight people, the answers are “the government sucks” and no.

It’s no surprise that these conservative folks think that the government can’t do anything right, and that anything it does will be more expensive than a comparable effort by the private sector. “Every program they start gets into debt,” complained Ralph Welch, a fit-looking 72-year old Yakima retiree.

It’s also predictable that they think Big Brother wants to control their lives, and that people should be more self-reliant. “The government is dictating what our lives should be,” said Paula, a 49-year-old who provides elder care in a state program and who didn’t want to give her last name.

Stock of Misinformation

Equally unsurprising — but perhaps more dangerous — was their deep stock of misinformation about the Democratic legislation in Congress. They wrongly think, among many other things, that the reforms would force old people to die instead of receiving treatment; provide insurance coverage for illegal immigrants; give everyone free coverage; allow the government access to everyone’s bank account and financial records; and allow the government to dictate the health care everyone gets.

They insist they get this stuff from reading the legislation. But actually, some admit, they either heard it from Fox News or conservative talk radio and cable TV hosts like Lou Dobbs, or they read it in some of the deranged bill descriptions by anti-reform zealots that currently are choking the Web and e-mail boxes [see http://nhiemstra.wordpress.com/2009/07/29/national-health-scare-by-rick-joyner/].

“There are three or four pages floating around the Internet that show the specific problems,” said Bob West, 67, a retired Yakima County worker who helped organize the rally and who leads an anti-illegal immigrant group in Yakima. “It’s pretty scary. They’d have complete access to your bank account.”

When it’s pointed out there’s nothing in the legislation about access to bank accounts, mandatory end-of-life counseling, or rationing care for seniors, they refuse to believe it. “My God and I will decide when I die,” said Kathleen Baker, a 66-year-old retiree from Ephrata who formerly ran her own business. “Our senators are lying to us. I don’t believe a word they say.”

David Domke, a professor of political communication at University of Washington, said it’s now almost impossible to introduce information within the conservative political network that contradicts the partisan health reform messages promoted by Fox News, talk radio, and right-wing blogs. “The system is suspicious of everything outside the system, so any critiques from outside are immediately doubted,” he said.

Profound Disconnect

After talking with these protesters for two hours, I saw a profound disconnect between their opposition to health reform and their own personal health care circumstances.

Cynthia Attar, 54, a self-employed “hypnotherapist” from Sunnyside, said she hasn’t had health insurance in 25 years, hasn’t seen a physician in all that time, and doesn’t need either one because she has learned to “self-heal.” And if she ever has to go to the emergency room for a serious injury — which could cost tens or hundreds of thousands of dollars — she’d simply set up a payment plan. “I’m not afraid of that,” she said.

Paula, whose caregiver job doesn’t offer health benefits, is enrolled in the state’s Basic Health Plan for low-income workers. Her children receive government health coverage because they are disabled and on Supplemental Security Income. She thinks all Americans should have a basic health plan like hers and doesn’t object to the government being involved. But she fears that reform would take away the choice of doctors, pay for abortion, and take needed care away from the elderly.

Bob Sharp, 63, who runs his own financial services business in Yakima, buys high-deductible individual insurance coverage. The coverage is restrictive and he knows he could run up thousands of dollars in out-of-pocket costs. “I get concerned if I have high costs,” he said. “I’d have to depend on others to help me. But that’s the history of this country. There’s too much government involvement in the first place.”

Then there are those who went without coverage for many years, suffered hardship due to that, and now have Medicare or private insurance but don’t see why 46 million uninsured Americans is a problem.

After Baker sold her business, she had no insurance for 20 years because she couldn’t afford it. A haystack fell on her and she had to go the ER; it took her “a couple of years” to pay off the hospital bill. “I was nervous about the lack of coverage,” she said. “But I don’t think reform will make it more affordable.”

Brian Reiswig, 56, a Yakima building contractor, said he had no coverage in the 1980s because he couldn’t afford it. He blew out his knee and couldn’t afford a doctor. His knee still hurts when he bends down to do tile work. He now has coverage through his wife’s state job. Nevertheless, he said, “to say the government owes you is wrong. No one is entitled to free.”

Three of the eight anti-reform demonstrators I interviewed now are on Medicare. They grudgingly accept the benefits, with Welch even saying Medicare has been good personally for him. But they downplay that they’re receiving government coverage by stressing that they have private supplemental insurance. “We’ve got a strong supplemental policy and that covers pretty much everything I’ve needed,” West said.

None of these folks seems to recognize that they dodged the bullet by never suffering serious medical problems during their uninsured or underinsured spell. Instead, several congratulated themselves for having taken such good care of themselves and keeping healthy. “I don’t smoke, drink, or eat meat,” Reiswig boasted.

I wonder how he’d feel about reform if he’d fallen off a ladder while he was uninsured and had run up tens of thousands of dollars in bills.

But Domke argues that people’s political positions often contradict their personal circumstances. “They are advancing a set of values they care about rather than their seeming self-interest,” he said. “That’s not a bad thing. It’s not just conservatives. Liberals vote for things they believe are part of the common good that maybe don’t benefit them economically, like higher taxes.”

I would note an important difference. Middle-class and affluent liberals who support higher taxes are seeking to extend some of the same advantages they enjoy to other people. In the current debate over health care, conservatives who have government or private health insurance want to deny the same benefits to others.

Bias Trumps Benefits

West’s personal situation sheds light on the financial anxieties that may explain at least some conservatives’ opposition to health reform. When he retired two years ago, his wife, who’s 10 years younger, also planned to retire.

But the recent stock market collapse devastated their savings and forced her to keep working. She still hopes to retire in the next few years. But if she does, she’ll have to buy costly individual health coverage until she turns 65, and he’ll lose her job-based insurance which supplements his Medicare.

West frets about health reform increasing the national deficit and driving up inflation, thus making his and his wife’s retirement security even more tenuous. He’s unwilling to consider that reform would make it possible for his wife to retire without their having to worry about health coverage.

Instead, he focuses on the negatives he thinks health reform would bring. “We’d be paying for benefits for illegal aliens,” he said. “I don’t care if they have health care. Write ‘em off and send ‘em home.”

I came away from these conversations thinking that there’s no way President Obama can win over these protesters – even if he could somehow sweep away the distortions, lies, and half-truths they’ve been fed by right-wing propagandists.

Their world view is one of distrust toward the larger society, which they maintain even at the cost of personal hardship. Supporting universal health care, however, requires Americans to accept their interdependence. That’s a leap of trust that many reform opponents will never make.

I’d say the fate of Obama’s health system overhaul depends on how many other Americans are willing to take that leap.

Harris Meyer is a journalist based in Yakima, Wash., and winner of the
Gerald Loeb Award.  He has 18 years of reporting experience for law and
health care publications, alternative newsweeklies and television news.

If you found this post interesting, trying reading another Harris Meyer post:

Op-Ed: On Health Reform, Obama Faces a New Foe: Other Democrats

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CynthiaJ. ProkopC.W.Stephen KardosJames Recent comment authors
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Cynthia
Guest

Interesting blog. I’ve been looking at elder and senior care and keep coming across issues involving denture creams and neurological problems. It seems that some popular creams are involved and lawsuits are beginning to be filed. I found a site that is sponsored, I believe, by an attorney group, but that has some good health and legal information: http://www.denturecreamlawyer.com/ I hope this is of help to your readership.

J. Prokop
Guest
J. Prokop

Mr Meyer,
Me thinks you hit the nail on the head;these people are hippocrits and loons by and large. They remind me of the old Groucho Marx (not Karl): “Whatever it is,I’m against it.”

C.W.
Guest
C.W.

Dear Mr. Meyer, Since the façade of your blog is the attempt to understand the contradictions of the people you met at the town hall meeting I thought that my following comments might shed some light on why there appears to be contradictions. You reported that Sen. Claire McCaskill asked the people at the town hall meeting if they wanted to get rid of their medicare and no one raised their hand. Contrary to what you and the Senator conveniently think, asking someone if they want to lose their current insurance is not the same as asking someone if they… Read more »

Stephen Kardos
Guest

Regrettably, Harris Meyer is asking America to make the biggest health care purchase its life without knowing what exactly what is being bought. Harris should know that associated with paranoia about what is being said are elements of truth. The difficulty for a cautious America, who has been victimized by being deceived into thinking that a system of insurance is a system of health, is that America can not risk to be deceived again because health and national security are linked. Now, the country is waking up to the fact that reform they want is not a retread if the… Read more »

Peter
Guest
Peter

“You want to fix Medicare, Medicaid, VA and Indian Health programs? Put all of those people into the Federal Employees Health Benefit Program”
John, sounds great as the government also pays 75% of the premium. Where can I sign up?

john
Guest
john

You want to fix Medicare, Medicaid, VA and Indian Health programs? Put all of those people into the Federal Employees Health Benefit Program: Federally operated risk pools with private insurance policies. Feds control the risk, private insurers negotiate the provider rates, process claims, coordinate care and monitor fraud and abuse – all things they do much better than the Feds anyway.

Nate
Guest
Nate

Actually Peter there is an entire industry in the US that helps seniors shift their assests to family members so they can qualify for medicaid and nursing homes. That is the failt of Medicare, prior to Medicair 85% of seniors had enough assets to pay for all of their own care. Instead of helping the 15% Democrats crashed the whole system.
It’s an example of Democrats making prmosies they can’t keep and screwing everything up in the process.

Peter
Guest
Peter

“She was forced to sell her £200,000 home to pay her £600-a-week nursing home fees, which would have been funded if she had been categorised correctly.” Nate, why should taxpayers pay this lady to stay in her own home when she clearly can’t look after herself (diagnosed in 2002 with severe Alzheimer’s and Parkinsons.)? It looks like her children really wanted the house for themselves at the expense of the taxpayer. How many people in the U.S. have to sell their home to pay for nursing home care, or even their healthcare bills? You’re always ranting at how people should… Read more »

Peter
Guest
Peter

“Why not fix Medicare first, as it is heading to insolvency”
James, let’s hear how you’d sell increasing FICA Medicare deductions and /or cutting benefits to fix Medicare. Medicare operates in the same grossly inflated cost healthcare system we all use. Look what happens when Medicare cuts reimbursements to save money – everyone in the chain screams bloody murder.

Nate
Guest
Nate

“When it’s pointed out there’s nothing in the legislation about … mandatory end-of-life counseling,…” http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html Last year, bureaucrats at the VA’s National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, “Your Life, Your Choices.” It was first published in 1997 and later promoted as the VA’s preferred living will throughout its vast network of hospitals and nursing homes. “Your Life, Your Choices” presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political “push poll.” For example, a worksheet on page 21 lists various scenarios and asks users to then… Read more »

James
Guest
James

“So why do these demonstrators oppose Obama’s proposal to extend health coverage to all Americans, improve health care quality, and control costs?” Perhaps it is because he offers no clear plan, with evidence to back it up, to actually accomplish any of these things? Seriously, what EXACTLY is “Obama’s proposal”? Is it the House bill, which is being furiously rewritten as we speak? One of the competing Senate bills? And, what exactly is the evidence that his nebulous plan (based upon shifting legislation) will actually cover all Americans (it won’t), improve health care quality (says who?), and control costs (by… Read more »

Peter
Guest
Peter

“First, this plan does nothing to reduce the cost of healthcare delivery in the US.” Brian, as a supporter of a public option (expansion of Medicare not a separate bureaucracy) I agree that so far I haven’t seen anything that will actually reduce healthcare costs. But your ideas (1.2.3.) will also do nothing to make a dent in healthcare costs. Read this blog about rampant and fraudulent up coding of Medicare by hospitals, read about McAllen Tx and other grossly overutilized medical districts, read about how physicians order more imaging when they own the imaging center, read about the countless… Read more »

bev M.D.
Guest
bev M.D.

Well, guys, after reading all these comments, I’d say you sound exactly like the people mentioned in the post! Gotta love America, where we are free to say what we want, whether it makes sense or not. Democracy is inherently messy.

Nate
Guest
Nate

“organized by the anti-government “tea party” folks.” Apparently you still don’t have any understanding of them. “So why do these demonstrators oppose Obama’s proposal to extend health coverage to all Americans, improve health care quality, and control costs?” Becuase in reality it will still leave millions uninsured, reduce quality and access, and finally add trillions to our national debt. Just because Obama names a bill doesn’t mean any of it will come true. “mandatory end-of-life counseling,” No but providers are mandated to offer it and paid to do it. If the current crisis is partially the result of physicians abusing… Read more »

Brian
Guest
Brian

Mr Meyer, While the fanatical fringes of the GOP have done more harm than good in debating (if one can call it that) the relative merits of the democrats’ proposal to “reform” healthcare, don’t mistake honest , intellectual dissent for poppycock. The smug cloud under which you reside might preclude you from appreciating the sound, informed reasoning many (myself included) utilize in their opposition to the plan, so allow me to elaborate just a bit. First, this plan does nothing to reduce the cost of healthcare delivery in the US. Maybe you think I’m a partisan kook for stating as… Read more »