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

21 replies »

  1. 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.

  2. 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.”

  3. 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 like it.
    On the same note, you glossed over the fact that one of the gentlemen you interviewed said that he needed to obtain supplemental insurance to cover his needs that medicare was not covering. In fact, you state that they are downplaying their government coverage “by stressing” that they have supplemental coverage. It seems as though you are the one who is downplaying the fact that they are trying in earnest to convey to you that they need the supplemental insurance because the government one is not working for them.
    On top of that, you give a quote by a political communications professor about how people aligned with the conservative party are closed to hearing arguments from the advocates for more governmental coverage. This irony resonates with the old saying of the pot calling the kettle black.
    In broader terms, the answer to your question is in the book Atlas Shrugged.

  4. 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 past, but something really new. America has not yet realized the solution to expanding health expense can only come from actions the people and their care givers take to follow accpeted guidelines for health prevention and treatment.
    Our president should be commended for making health a top national issue. He should be chastised for falling prey to special interests whose interest is served by preserving the past. He needs to articulate the specific responsibilities of everyone that are required to gain control of runaway health costs. He needs to document the challenge with medical facts and opportunities.
    We can not make a faith based decision on the greatest health expenditure of our country, one we all will pay for.
    Please see my Blog healthgadfly.com for more explanation of how to proceed to make real change in health in America.

  5. “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?

  6. 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.

  7. 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.

  8. “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 look after themselves and not rely on the govmnt – are you now advocating that Medicare pay people to stay in their own homes at 100% taxpayer funding so that they can keep their assets to pass on to their children?

  9. “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.

  10. “When it’s pointed out there’s nothing in the legislation about … mandatory end-of-life counseling,…”
    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 decide whether their own life would be “not worth living.”
    Silly seniors no one is considering death panels. If more of them would just suffer from social problems like this in the excellent NHS they wouldn’t lose so much sleep.
    NHS Worcestershire ruled that Judith Roe, 74, did not qualify for NHS funding because her condition was a “social” rather than “health” problem, even though she was so ill she could not make a cup of tea and regularly left the stove on.
    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.
    Mrs Roe, a retired church warden and school teacher, was diagnosed in 2002 with severe Alzheimer’s and Parkinsons.
    Under English law, elderly people must pay for their own residential care unless their needs are deemed health-related.
    She was assessed but her needs were regarded to be social rather than health, meaning she did not qualify for funding.
    Nothing to worry about Seniors reform will make everything all better!

  11. “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 what mechanism, pray tell?).
    We are being asked to support the concept of “health care reform”, but laws are actual words on paper with real-world consequences, not feel-good slogans and misty promises.
    Not all reform is improvement. Show me a bill that looks like it offers improvement and I can evaluate it. But, what I see looks like it won’t work and it costs a bundle in the process.
    Why not fix Medicare first, as it is heading to insolvency and it is seemingly insane to expand coverage when you are going broke with the programs you have.

  12. “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 seniors that spend millions of tax payer money on non-effective end-of-life care, read about the demise of PCPs and how specialists are costing this system millions in over priced care. Real cost reform will mean universal budgets, not just universal access. Can conservatives live with that or ar you just fanning the flames of opposition for opposition’s sake?

  13. 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.

  14. “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 their power over patients to perform unneeded care it is not by any means a stretch of the imagination to assume they will persuade people to have the consult and then who knows what. There has already been claims of providers in Oregon which offers assisted suicide “pushing” end of life as an option to control cost. Just because it is not written and labeled in a bill doesn’t mean it can’t be an unintended or even intended consequence. The way bills are poorly written today this is an even greater threat. There is no law that says you have to take Medicare to collect your Social Security benefits yet you must, this was accomplished by interrupting other statutes and provisions. No where in the bill does it specifically out law the practice, why when confronted about the perceived risk did the Democrats not just add a provision making it illegal, instead they dropped the entire section…curious response if you didn’t intend for a death panel.
    “rationing care for seniors”
    The bill might not spell out rationing of care but it does set the table and Obama has called for it, the prudent action would be to act skeptically.
    20 years of premium savings would easily pay her ER bill, she came out ahead what is the problem with that? As did Cynthia Attar.
    “Middle-class and affluent liberals who support higher taxes are seeking to extend some of the same advantages they enjoy to other people.”
    BS if that was the case they wouldn’t dodge them and commit so much tax fraud. They feel good about spending other people’s money. Public housing was an advantage? Medicaid is an advantage?
    “conservatives who have government or private health insurance want to deny the same benefits to others.”
    LIES, they don’t want to make promises that can’t be kept. Medicare and Medicaid promised benefits they can’t afford to deliver. Liberals want to up that ante and do the same with the remaining systems.

  15. 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 much. Fine. Maybe you’ll consider , then , the opinion of Denis Cortese? I know he wouldn’t be as well-informed as you might be, inasmuch as the Mayo Clinic is only tangentially involved in healthcare, right?
    Furthermore, how can adding a medicare-like “public option” be fiscally sound and reasonable when Medicare , itself, is on the verge of insolvency?
    Second, while many of us on the opposite side of the political spectrum from you believe strongly that government’s influence is already degrading a once-robust economy , as well as our societal fabric, you’ll find common ground with many of us on what I consider to be common-sense actions the government can and should take. Chief among them would be:
    1) Some measure of real tort reform
    2) The eradication of state-level mandates for insurance coverage minimums, etc.
    3) The enforcement of a REAL standard, uniform claim submission form to which ALL insurers AND providers must comply.
    I know it’s hard to see any merit in the oppositions’ argument from that ivory tower in which you live, but if you’re willing to come down for a few minutes and chat, I think you’ll find plenty of good, intelligent folks who will agree wholeheartedly in the need for reform, but might disagree on the methods thereof. If you’re willing to consider a few of their ideas, my sense is they might be willing to consider yours, as well.

  16. I see these attitudes every day in my county – a largly conservative and low wage district. At commissioners’ meetings the voice of, “no tax, low tax” is loud but at the same time they salivate over federal or state grants to help pay for their local services and are always looking for “outsiders” to pay for what they should be paying for. I had a discussion with an elderly lady who is chair of a senior political action group. Her group was pushing for a road to be built using tolls instead of state funds. I asked her why she was doing that and she said because it was a road that was far enough away from her that she would never need to use it. I also asked her if she would be willing to pay a toll on her road to pay for maintenance – she said absolutely not.
    This country has little to no community committment or social solidarity, but the attitude is propagated by our political representatives who feed on district self-centeredness for their own political advancement. People can be generous, but lack the necessary understanding that a few cents in the donation jar is not a substitute for the amount of money, effort, and time needed to solve a problem that affects millions of people. Only a government program can muster enough resources over enough time to actually make a difference to a large number of people. Healthcare is one of those issues where leaving it up to blinded individualism, or selfishly protecting your own tax subsidy, will not solve the problem.

  17. Your state of Washington has already implemented some of the key elements of the Obamacare plan on individual and small group plans: guaranteed issue and community rating, along with strong regulations on premiums and coverage mandates. These reforms have devastated said plans and driven competition from the market, driving up prices and thus causing people to drop coverage.
    Can you explain to me how you think this has made things better in Washington State, let alone how it would improve the situation nation-wide? Massachusetts tried to solve this with mandated coverage, and we all know what that did to costs.
    Now congress wants to eliminate high deductible HSAs and force everybody to buy expensive and elaborate plans with low out of pocket expenses. Then add a public option that pays below market value rates and must, by law, pay less than private insurers. I’m still trying to figure out how that adds healthy and fair competition (this idea seems to be coming from those who would rather have single payer anyway).
    Yes, Medicare is very popular among those in the program, but that’s only because it shifts part of the cost onto private insurers. Anybody with private insurance directly subsidizes Medicare. Without this, Medicare benefits, as they exist today, would be devastated. Medicare may have a low cost as a percentage of expenditures, but that’s only because it’s expenditures are so astronomically high. It actually costs more per member in administrative costs (largely fixed costs), and that’s including all of the profits of insurance companies.
    Don’t think for one minute that, just because the loudest portion of the opposition are screaming about death panels and rationing for seniors, there are not legitimate concerns over the pure crap that is ACTUALLY IN HR 3200.
    When people like John Mackey propose solutions that actually make sense and have been shown to work, they are either ignored or ridiculed. So don’t think that protesters on the right are the only ones to blame for where we are in this debate.

  18. Mr. Rattray: recall the majority of white eagerly voted for him to even show the world that we had moved on. His behavior, color preferences on selections, affirmative action, Acorn, who he associates with, who he panders with slang with and other misbehaviors, breeds this bias in those who have lingering thoughts. Most of us feel he is immature, untrained, ill suited, unpresidential and is white ans much as he is black. The country in polls (I know) still regard him highly as a BLACK PRESIDENT–but do not like his behavior nor policies. You have had one bad experience, and that is it. Use the mirror and your rapid judgment of Americans.

  19. My family recently trekked the 5 hour journey from Seattle to a remote family farm off the Columbia River in central Washington for a family reunion.
    I went to talk to my favorite uncle at the elder’s campfire. The group of about twelve recognized me as an in-law and as the only physician in the crowd.
    The topic of health reform soon came up and turned vicious quickly.
    Obama was a socialist. He wasn’t to be trusted at all. What audacity that a colored person has sway in my life!
    It took me about 15 seconds to process it sufficiently to get up, tell my uncle (who seemed embarrassed – yeah for him) I would catch up with him later and left trying to catch my breath.

  20. Really interesting article, thanks.
    It’s easy to see, from data, that anti-reform sentiment runs high in areas that are in dire circumstances. It was always clear that there was a strong overlap between those who need help and those opposing it, where folks are not working in their own best interests.
    It is interesting is to read the stories and opinions of these folks.
    And, this line basically says it all: “Their world view is one of distrust toward the larger society, which they maintain even at the cost of personal hardship.”
    It seems a very sad existence, though.

  21. Mr. Meyer:
    Your ideology is transparent and facts are incorrect or partial truths. Good to see some transparency during this administration.
    Medicare is going broke-a governmental system run by both parties–the cruel joke is major rationing will/must occur to remain viable. Either cut benefits across the board or cut benefits by social value–the method expoused by Obama’s advisors and consistent with his “social justice” beliefs. Yes, Qaly methods are not guarnteed, but you must look at the philosophy of the administration and the risk to humanity. I more than begin to worry when a cat has more value to society than a 80 y/0.
    Get informed re: pre-existing conditions. It is a requirement of just individual health plans who MUST have this to be actuarially viable–health care coverage when you are sick on demand just does not pencil out financially anywhere in this world. If we have universal care and in the individual market, then removal of Pre-ex is doable and fiscally sound.
    No health plan is allowed to stop coverage because a person is sick–it is against the law unless that patient lied on the application–again, insurance on demand that is not fiscally viable. Make Cobra more affordable if there is issue if they stop working. Much cheaper than current country ruining plans.
    Remember socialist, 50% of those uninsured earn >$100K annually and choose to self insure, 25% are young immortals, 10% are ilegal aliens, and the rest really need assistance. I believe in compassion and taxing myself to help the disabled, and truly needly, but not the clueless and those who choose to be non productive. That is their choice.
    I want reform-real reform. haven’t seen it yet but delusions and demonization of stakeholders (people). both parties are culpable.