Finding myself in Philadelphia recently, I decided to stroll along Market Street and see which of the day’s big political issues ordinary people had on their minds. Medicare topped the list, followed by Social Security and job security. The day of my interviews, the Democratic polling firm of Greenberg Quinlan Rosner released results showing that two thirds of respondents had serious doubts about cutting Medicare; forty percent had very serious doubts. A New York Times/CBS News poll released a week later showed that “more than 6 in 10 of those surveyed said they believed Medicare was worth the costs.” Respondents said they would rather see higher taxes than a reduction in services available for Medicare, if they had to choose between the two. A Washington Post/ABC News poll indicated that sixty-five percent opposed the proposal of Wisconsin Rep. Paul Ryan, which changes Medicare from a social insurance program into a voucher system with beneficiaries buying their coverage from private insurance companies.
I approached sixty-one-year old Sue Paton from Acworth, New Hampshire, who was visiting Philly with her husband, Bill. “You probably won’t like what I have to say,” she said when I asked about Paul Ryan’s plan. “I have read all of Paul Ryan’s “Path to Prosperity, and the CBO appraisal of it. I believe he’s trying to eliminate the safety nets of Medicare and Medicaid. It appears he is not going to have a balanced budget until 2040, and by that time seniors will be paying sixty-eight percent of medical costs themselves.” Politically, Paton said she was an independent, “not far left and pretty middle of the road.” She did not support Ryan’s proposal.
Paton continued, with her husband chiming in. She believed “vouchers are a way to get rid of Medicare,” but she did acknowledge that we have a problem with doctors who charged fees for their services and too many people going to doctors. “The biggest question I have about the vouchers,” Paton said, “is what insurance company wants to take on insuring people age sixty-five and older?” She raised a crucial point, and one that the media has failed to ask in reporting on the Ryan proposal. Bill, also an independent, wanted to chat about Social Security. Now sixty-four, he retired two years ago and told me he did not favor raising the retirement age for Social Security benefits. “There are an awful lot of jobs people can’t keep and there’s a need to move people out of the workforce to create jobs for young people,” he said. His wife said she hadn’t decided whether to take her benefits early, at sixty-two.
Clearly, the Patons were up on the issues, but both said that the news media was not particularly helpful in furthering their understanding. “There are too many generalities,” Paton said. “Like saying ‘Obamacare.’ Nobody has the time to explain things to people. People hear only sound bites and what we want to hear.”
Barbara Wilson-Whitaker was also in the mood to talk. At fifty-nine, she is one of those people who had good, stable employment but was displaced from the work force in 2008 when the recession hit. She had worked thirty-one years for Verizon in its various incarnations, starting as an installer-repair technician when the company was AT&T and working herself up to a manager in customer support. “The company thought it was a good time to get rid of even more people,” she said.
Wilson-Whitaker described what had happened to her company benefits. “We had a good pension plan, a 401(k), the whole nine yards. Then they did away with the lifetime pension and that affected younger workers. You get a 401(k) and that’s it,” she said. She has retiree health insurance, but that has changed, too. They used to pay 100 percent of the premiums, but now she says they only cover 76 percent. “I pay close to $200 a month and I’m thankful it’s not more.” Our talk turned to Social Security and Medicare, and she had a good understanding of the possible changes to each program. “I hear they want to extend the retirement age up to seventy,” she told me, “and that won’t make me happy at all. People after me, like my grandkids, are going to be zapped. It’s almost as if the government is saying that we want you to die before you collect.”
As for Medicare, Wilson-Whitaker had heard there may be cuts in the offing. “What I haven’t heard is what those cuts are. I want to know specifically how those cuts will affect me, and I haven’t been able to find out. “What cuts are they talking about? What benefits are we not going to have anymore?”
She said she listens to the Nightly Business Report, CNBC, MSNBC, sometimes CNN, and always to Suze Orman. “I am very interested in what is happening. I try to listen and even listening, I don’t get enough. They give you the high-level overview but you need the guts.” We talked about Medicare, and she had heard of Paul Ryan, knew he was from Wisconsin, but couldn’t say exactly what his plan would do. I gave her a brief description. “This is the first time I have heard how it’s going to work. I don’t want that,” she said.
I told her that the voucher to buy private insurance could rise with inflation. At that point, she said she really didn’t like the proposal: “They are never going to give you enough money to pay for decent insurance. There’s no way the government is going to give me a voucher that will cover everything.” She equated the voucher with the cost-of-living raises for Social Security, which seniors have not received lately because inflation is officially low. “Those seniors’ costs have gone up. I don’t know how they figured the numbers, but I figure they were doing it to balance the budget,” she said. “It’s going to do one thing. Those who can’t afford to pay for good insurance won’t get medical care.”
Wilson-Whitaker had one more question—the same one Sue Paton asked. “How does the voucher affect pre-existing conditions? No insurer wants to deal with us.”
A postal worker named Charles (he wouldn’t give his last name) was delivering mail. He was in a hurry and didn’t have much to say. “They want to take benefits away from people,” he said. “I really don’t pay attention to Medicare. It comes out of my paycheck, but I don’t pay attention to it.” He knew the sound bites about Social Security. “Eventually you’ll have to work longer to collect,” he said. “If it’s going to be around, they say it’s going to run out of money.” Charles is fifty-three, and could be affected by some of the changes the pols have in mind. He had never heard of Paul Ryan.
I stopped at a hoagie restaurant where a small white-haired woman with sparkling blue eyes sat down and started to talk. Elizabeth Rose, she said, was her name. At ninety, she helps out wiping up tables and doing jobs in the kitchen. It gives her a break from staying at home watching the soaps. Her niece works at the restaurant. What do you hear about Medicare, I asked? “Not too much,” she replied. “Because I am not around too much.” Besides, her niece who lives with her takes care of the paperwork.
Social Security was a different story. “That’s what I have to live on. It has to pay most of my bills,” she said. She gets about $1000 a month, and she thinks the benefit is based on her husband’s income. They were married for fifty-six years. He was a factory worker and died four years at age ninety-three. The daughter of a coal miner, Rose said she worked doing housework for others, but said she “never made big money. It wasn’t easy.”
“If I didn’t have Social Security, they would have to keep me,” she said referring to her niece and her niece’s father. Rose got up and wiped a few tables. She came back and looked me squarely in the eye. “I hope they don’t take Social Security away. That’s all I have to live on. It’s hard. Everything costs so much.” Dry cleaning bills in particular, she said.
Janet Spencer, age seventy-five, was munching a Philly cheesesteak on a street corner when I asked her to talk. She was from Lexington, Kentucky, and visiting the city with her daughter, who was attending a conference. She had worked twenty-seven years as an administrator in a school system and had a pension from the school district. She did not pay into Social Security, which some public employees did not do, so the program was irrelevant to her, financially speaking.
At first Spencer claimed not to worry about Medicare. “I don’t know if these changes will affect me or not,” she said. But the more we talked, the more I learned that she did have some concerns. She told me she “had heard all kinds of things that they are going to privatize medicine. That’s the most scary one,” she said. “If you have a heart attack but are too old, you won’t get a procedure. They will have a priority, and if you’re too old, you won’t get it.”
Spencer continued: “I don’t think privatized medicine will work.” When I asked how she thought it might work, Spencer replied. “Like I said, they will pick and choose who will get care and who won’t, and I don’t know who the “they” are. I don’t think privatization will ever happen.” Then I realized she was confusing privatization with rationing and the death panel arguments. Perhaps that’s what she heard from her news sources—mostly Fox News and her friends who heard about this on the radio.
Our conversation dipped into politics. Spencer said she was an independent although most of the time her candidates did not win. She did not vote for Rand Paul. “I like Rand Paul, but he is not a Kentucky person. He’s not going to be nearly as scary as people thought he was.” By then, Spencer had finished her sandwich and hurried off to the bus stop.
The wind was coming up, and I tucked into the lobby of Wells Fargo bank to get warm. A woman with longish red hair was selling March of Dimes raffle tickets to bank employees on their lunch break. Forty-one-year-old Kelly Murray, a bank clerk, stopped to buy a ticket. She said she works nine and a half hours a day, six days a week, and doesn’t have a lot of time to read or listen to the news. She knew about Social Security and Medicare, in broad strokes. “The Republicans want to cut and the Democrats want to keep them,” was her summary. She did have a couple of other thoughts. “From what I hear Social Security is running out of money, and it won’t be there when I am ready for it.” As for Medicare, she said: “From what I hear about privatization, it would be a huge mistake.”
The redhead selling tickets had a lot to say. She preferred not to give her name but told me her salary was about $54,000 as an administrative assistant. She knew that she would need both Social Security and Medicare. She is fifty-five and suffers from chronic migraines that sometimes interfere with her work. She said her doctor had recommended that she retire and go on Social Security disability, but the amount she would get—about $1700 a month—wouldn’t be enough to whittle down her credit card debt, pay her mortgage, repay loans against her 401(k) plan, and help with her daughter’s college tuition. She is a single mom with no child support. Her eyes filled with tears as she talked about her financial plight and the pain from her headaches. She brightened though, when I asked about the Phillies. “I am a big Phillies fan. Huge. Phillies and Eagles big time,” she said.
She had mixed emotions about raising the age for collecting Social Security benefits, noting that people are staying in jobs longer, but that doesn’t free up jobs for younger people who need them. “People stay because they have to,” she said. “I would go out at sixty-two if I had the income. It’s getting more and more difficult to work.”
The day before we met, she had left work at one o’clock because a migraine was getting the best of her. “Who wants to raise the retirement age?” she asked rhetorically. “The old guys who have money and don’t care and want to stay in office longer. Would somebody tell me what happened to people fall off employment and don’t have jobs. Things didn’t improve. They just stopped counting them. Tell the politicians to stop lying to me.”
The woman had strong opinions about Medicare privatization, too. She had heard of Paul Ryan’s plan, but didn’t know all the details. “It limits options for someone if they don’t have money to buy what they want,” she explained. She talked some about the health insurance she has now, which is provided by the bank. She explained that when Wachovia bank became Wells Fargo, employees had to pay more for their coverage. In the last five years, she has been hospitalized three times for her severe headaches and feels the pinch of higher copays and deductibles. Health insurance is a big reason why she says she will remain in the workforce. She knows she can’t swing it on her own.
For more from Trudy Lieberman on Social Security and entitlement reform, click here.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.