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Why do people like Medicare and fear health care reform?

A reporter talks to protesters at a Yakima rally and discovers profound disconnects between beliefs and behavior
Despite reform, budget pressures could hurt health care.

Despite reform, budget pressures could hurt health care. Sen. Bernie Sanders

Those Congressional town hall meetings around the country, where protesters, many of them on Medicare, rail about President Obama’s health reform plan, have made me wonder about my fellow citizens. 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?

Last week I was in the waiting room at my dentist’s office in Yakima reading Time magazine’s cover story about Obama’s efforts to pass health reform. An attractive white woman who appeared to be in her early 60s 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.” But, she added, the government system shouldn't be expanded beyond that.

Struck by this irony, I decided to ask more of the folks in Yakima about all this. 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 cars and trucks honked in approval. Three lonely counter demonstrators 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 caused 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? Are they personally secure enough 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.

Equally unsurprising — but perhaps more dangerous — was their deep stock of misinformation about the Democratic legislation in Congress. They wrongly think 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. “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.”


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Comments:

Posted Tue, Aug 18, 2:14 p.m. Inappropriate

Not to excuse the misinformation, but HR 3200 is over a thousand pages long. (Here's the PDF: http://bit.ly/h8p8w)

I doubt anyone has read the entire legislation, and I mean anyone.

This is no way to run a government that does not create attitudes like Kathleen Baker's.

Posted Tue, Aug 18, 2:15 p.m. Inappropriate

The people you quote don't seem deluded to me. I am a medicare recipient. It has been good for me. But I do not believe it is good for our country. The cost of the program has exploded; what was conceived as a generous gift to the elderly (quite belatedly, even in the sixties the elderly enjoyed a reasonably bountiful life; the picture of deprived elders was probably an image from the thirties) has now become an entitlement and it is not, I believe, thankfully accepted as a gift from the working generations as it should be. The generosity of Medicare is seen as a right, properly belonging to those over 65 (or 59 or 62). It is not a right. You and I have no claim on the wages of those who work for a living and that is probably why Mr. Obama spoke seriously about some hard end-of-life decisions in a NYT article earlier this year. Anyone who thinks about it realizes Medicare as it is presently managed is unsustainable. During a perhaps unguarded moment Mr. O talked about that issue. He was just being thoughtful. Big mistake.

I am slightly embarrassed to see my family doctor because I know how little Medicare pays him. He is also an (I presume, unwilling) contributor to this largess to the deprived elderly.

I think those people you spoke to are admirable.

kieth

Posted Tue, Aug 18, 3:48 p.m. Inappropriate

To Kieth: Medicare is good for you but not good for the rest of the country? Exactly my point. Why not listen to the views of tens of millions of Americans who don't have health coverage or who have insecure or inadequate coverage express their views on that?

Medicare was hardly conceived of as a "generous gift to the elderly." Old people were dying from lack of health care. "Kieth" needs to read up on the dire health care situation of the elderly in America prior to the passage of Medicare. There are plenty of sources. Here are two:
http://www.cms.hhs.gov/HealthCareFinancingReview/Downloads/00fallpg75.pdf
http://books.google.com/books?id=AEn6EvuUorUC&pg;=PA29&lpg;=PA29&dq;=medicare+and+lyndon+and+johnson+and+elderly&source;=bl&ots;=x8pQaGNYWN&sig;=5yTvzZ0l3NuijwshTLckDeWB-T8&hl;=en&ei;=GyyLSp2sD4eosgPWovXRDQ&sa;=X&oi;=book_result&ct;=result&resnum;=3#v=onepage&q;=&f;=false
(see page 23)

Second, the "working generations" (like me) are in no privileged position to begrudge the elderly their guaranteed, secure Medicare coverage. If you talk to Americans, particularly those aged 45-64, about their health care situations, you'll find a great need for more secure and affordable health insurance than they have now.

One of the things I found in my interviews with the anti-reform protesters is that they also are in no personal position to begrudge anyone else guaranteed coverage. If it weren't for Medicare or the state Basic Health Plan or a spouse's private or state coverage, most of them would be up a creek. The rest have job-based coverage that depends on the whim of their employer, or individual coverage with high deductibles that depends on the whim of the private insurer.

We can have a legitimate debate about the best way to control costs. But if misinformed opponents immediately start talking about "death panels" and "rationing" and "loss of free choice" as soon as anyone talks about cost control, then you know those people aren't serious or informed about finding ways to keep health care affordable.

BTW, many doctors have done quite nicely over the years off Medicare, thank you. Seniors are obviously the biggest users of health care, and even if Medicare pays somewhat less than private insurance, it's a guaranteed payer that involves far fewer hassles for doctors and hospitals than private insurers do.

Posted Tue, Aug 18, 8:40 p.m. Inappropriate

Mr Meyer so if you think your tax burden should last until mid April and the cost of government is mid august your anti government? SIGN ME UP!!!
What government agency works ssi broke,medicare broke,cps kills kids,i wont even go into how screwed medicaid is my physically disabled son with a prosthetic leg limited sight and hearing and a survivor of 27 life saving surgeries took six years to be accepted to medicaid that's what happens when the government runs health care
p.s yes i had health insurance but went past oer cap at 2 million dollars in two years.

bigdaddy

Posted Wed, Aug 19, 8:30 a.m. Inappropriate

Yes Mr. Harris, responding to your question, just like Cash for Clunkers is good for auto dealers but not good for the country. If that's exactly your point then I don't understand your argument.

kieth

Posted Wed, Aug 19, 9:18 a.m. Inappropriate

For those of you who don't want to read the 1,000-page House health reform bill, here's a clear summary from the nonpartisan Politifact that separates truth from falsehood. This addresses many of the pieces of misinformation that have circulated among the anti-reform protesters. Then you can compare it to the actual House bill. I've included the Web site for that as well. Let's try to have a debate about the actual facts:

http://www.politifact.com/truth-o-meter/article/2009/jul/30/e-mail-analysis-health-bill-needs-check-/

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

Posted Fri, Aug 21, 11:28 a.m. Inappropriate

Mr. Meyer,

It may not have been explicitly expressed by the people you talked to, but there is a legitimate concern about "rationing" care to Medicare beneficiaries. Obama proposes to fund a significant portion of the cost of reform from "savings" and "efficiencies" in Medicare. If there's a way he can do that without reducing the quantity and quality of care, he hasn't told us.

tifoso

Posted Wed, Aug 26, 10:35 a.m. Inappropriate

For many years, the Republicans, now supposedly the great defenders of seniors, have proposed cutting the growth of Medicare by even larger sums than the Democrats now propose. The GOP savings would go not to health coverage expansion for other Americans but rather to tax cuts tilted toward wealthy people. On top of that, the Republicans long have wanted to give seniors a voucher for a fixed amount of money to buy a private plan. There would be no guarantee that the vouchers would keep pace with inflation, thus saddling seniors with higher and higher out of pocket costs. Beyond that, the entitlement cutters in both parties seek to chop huge sums out of Medicare, Medicaid, and Social Security, with no quid pro quo for seniors in terms of better benefits. Tell me how all that would be done without chopping out needed care for seniors.
Contrast that with the Democrats' proposals to enhance Medicare drug and primary care benefits, and to get savings in areas which make good sense, such as eliminating unjustified subsidies for Medicare Advantage private plans and not paying hospitals extra for re-admissions due to poor quality care. And the Democrats want more research to encourage care that's beneficial and discourage care which doesn't work.
So actually Obama and the Democrats have told us what they want to do and why, and it makes sense. But much of that discussions has been drowned out by the nonsense over death panels and rationing.

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