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.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.