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
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A reporter talks to protesters at a Yakima rally and discovers profound disconnects between beliefs and behavior

Those Congressional town hall meetings around the country, where protesters, many of them on Medicare, rail about President Obama'ꀙs 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'ꀙs office in Yakima reading Time magazine'ꀙs cover story about Obama'ꀙs 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'ꀙs, and that most people on Medicare seem to like it.

Then came the surprise. 'ꀜYes,'ꀝ she said, 'ꀜwe like it.'ꀝ 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'ꀙs office, organized by the anti-government 'ꀜtea party'ꀝ folks. About 75 people, at least half of them 65 or older, were marching and brandishing signs like 'ꀜObama'ꀙs health care plan makes me $ick!'ꀝ 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'ꀙs 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'ꀙs 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'ꀙs 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 'ꀜthe government sucks'ꀝ and no.

It'ꀙs no surprise that these conservative folks think that the government can'ꀙt do anything right, and that anything it does will be more expensive than a comparable effort by the private sector. 'ꀜEvery program they start gets into debt,'ꀝ complained Ralph Welch, a fit-looking 72-year-old Yakima retiree. It'ꀙs also predictable that they think Big Brother wants to control their lives, and that people should be more self-reliant. 'ꀜThe government is dictating what our lives should be,'ꀝ said Paula, a 49-year-old who provides elder care in a state program and who didn'ꀙt 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'ꀙs 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. 'ꀜThere are three or four pages floating around the Internet that show the specific problems,'ꀝ said Bob West, 67, a retired Yakima County worker who helped organize the rally and who leads an anti-illegal immigrant group in Yakima. 'ꀜIt'ꀙs pretty scary. They'ꀙd have complete access to your bank account.'ꀝ

Point out there'ꀙs nothing in the legislation about access to bank accounts, mandatory end-of-life counseling, or rationing care for seniors, they refuse to believe it. 'ꀜMy God and I will decide when I die,'ꀝ said Kathleen Baker, a 66-year-old retiree from Ephrata who formerly ran her own business. 'ꀜOur senators are lying to us. I don'ꀙt believe a word they say.'ꀝ

David Domke, a professor of political communication at University of Washington, says it'ꀙs now almost impossible to introduce information within the conservative political network that contradicts the partisan messages promoted by Fox News, talk radio, and right-wing blogs. 'ꀜThe system is suspicious of everything outside the system, so any critiques from outside are immediately doubted,'ꀝ he says.

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

Cynthia Attar, 54, a self-employed 'ꀜhypnotherapist'ꀝ from Sunnyside, said she hasn'ꀙt had health insurance in 25 years, hasn'ꀙt seen a physician in all that time, and doesn'ꀙt need one because she has learned to 'ꀜself-heal.'ꀝ 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'ꀙd simply set up a payment plan. 'ꀜI'ꀙm not afraid of that,'ꀝ she said.

Paula, whose caregiver job doesn'ꀙt offer health benefits, is enrolled in the state'ꀙs 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'ꀙt object to the government being involved. But she fears that reform would take away the choice of doctors, pay for abortions, 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. 'ꀜI get concerned if I have high costs,'ꀝ he said. 'ꀜI'ꀙd have to depend on others to help me. But that'ꀙs the history of this country. There'ꀙs too much government involvement in the first place.'ꀝ

After Kathleen Baker, the Ephrata retiree, sold her business, she had no insurance for 20 years because she couldn'ꀙt afford it. A haystack fell on her and she had to go the ER; it took her 'ꀜa couple of years'ꀝ to pay off the hospital bill. 'ꀜI was nervous about the lack of coverage,'ꀝ she said. 'ꀜBut I don'ꀙt think reform will make it more affordable.'ꀝ

Brian Reiswig, 56, a Yakima building contractor, said he had no coverage in the 1980s because he couldn'ꀙt afford it. He blew out his knee and couldn'ꀙt afford a doctor. His knee still hurts when he bends down to do tile work. He now has coverage through his wife'ꀙs state job. Nevertheless, he said, 'ꀜto say the government owes you is wrong. No one is entitled to free.'ꀝ

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'ꀙre receiving government coverage by stressing that they have private supplemental insurance. 'ꀜWe'ꀙve got a strong supplemental policy and that covers pretty much everything I'ꀙve needed,'ꀝ West said. Several congratulated themselves for having taken such good care of themselves and keeping healthy. 'ꀜI don'ꀙt smoke, drink, or eat meat,'ꀝ Reiswig boasted.

Such a disconnect may seem odd, but Professor Domke observes that people'ꀙs political positions often contradict their personal circumstances. 'ꀜThey are advancing a set of values they care about rather than their seeming self-interest,'ꀝ he said. 'ꀜThat'ꀙs not a bad thing. It'ꀙs not just conservatives. Liberals vote for things they believe are part of the common good that maybe don'ꀙt benefit them economically, like higher taxes.'ꀝ

I also came to see that the current financial slump could explain at least some conservatives'ꀙ opposition to health reform. When Bob West, the former Yakima County worker, retired two years ago, his wife, who'ꀙs 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'ꀙll have to buy costly individual health coverage until she turns 65, and he'ꀙll lose her job-based insurance which supplements his Medicare.

West worries about health reform's costs increasing the national deficit and driving up inflation, thus making his and his wife'ꀙs retirement security even more tenuous. He'ꀙs unwilling to believe 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. 'ꀜWe'ꀙd be paying for benefits for illegal aliens,'ꀝ he said. 'ꀜI don'ꀙt care if they have health care. Write 'ꀘem off and send 'ꀘem home.'ꀝ

I came away from these conversations thinking that there'ꀙs no way President Obama can win over these protesters — even if he could somehow sweep away the distortions, lies, and half-truths they'ꀙve been fed by right-wing propagandists. Their world view is hardened by 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'ꀙs a leap of trust that many reform opponents will never make. So it looks like the fate of Obama'ꀙs health system overhaul depends on how many other Americans are willing to take that leap.


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