Shots - Health Blog
5:56 am
Sat March 24, 2012

In Conservative California, Confusion And Contempt For Health Law

Originally published on Sun March 25, 2012 5:40 pm

To reach Oakhurst, Calif., drive away from the green fields of the Central Valley, past miles of pistachio trees showing their spring buds and up toward the snow-topped peaks of the Sierra Nevada.

Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama's signature initiative.

"Obamacare is absolutely horrible, horrible, horrible," Joe Stern, owner of a local water-conditioning company, says as he sips a glass of pinot noir. "It should be struck down immediately."

By 5 o'clock on most weekday evenings, the Sweetwater bar is hopping, and locals, like Stern, stop by to josh and jest. Stern is a registered Republican. He's 66 years old and covered by Medicare, a program Stern says he is thankful for. Before he qualified for the federal program, Stern, who is single, used to pay $670 a month for insurance — more than $8,000 a year.

"I thought it was pretty brutal," he says, "but I was still against Obamacare by far."

Oakhurst caps the eastern end of Madera County, a largely conservative and agricultural region where unemployment runs stubbornly high, at 14.7 percent, and 32 percent of people have no health insurance.

By and large, conservative voters in the county despise the federal health law's mandate that all Americans have health coverage, and many suspect the health insurance system isn't really all that broken.

Reflecting a common sentiment, Stern says, "I don't know of anyone that was left on the street to bleed to death. I don't know anyone that is really left out."

It's not that Stern doesn't know people who don't have insurance. He cheerfully introduces his friend, Mary Westover, who is sitting next to him at the bar. Westover is a registered Republican and a self-employed artist and businesswoman who says she can't afford health insurance. She's been uninsured for 17 years — she hasn't had a pap smear in all that time — and is among the 13 percent of Americans who are uninsured and opposed to the health law.

Westover, too, is against the individual mandate, but wasn't aware the federal government would give subsidies to people like her — whose incomes are below 400 percent of the federal poverty level — to buy a policy. That's once that part of the law kicks in, in 2014.

"If it were subsidized, if it were made, you know, manageable, I would want that," she says, adding that she doesn't know how people who can afford it "can sit there and say that we shouldn't have that — because there are a lot more of us, than them."

Although many here in Madera County say they want the U.S. Supreme Court to throw the federal law — and all of its big government mandates — out, they are struggling to reconcile their political ideologies with the basic need for health insurance and protection from financial calamity.

Paul Ruffino, the manager of Chateau du Sureau, a five-star, luxury inn overlooking the mountains of Yosemite, is uninsured for the first time in his life.

"It's probably when I need it the most," he says, sitting in the inn's salon, with its fresco-painted ceilings and roaring fire.

Ruffino says the health insurance policies he's looked at are expensive and won't cover his pre-existing conditions. Still, he says it was his decision to leave a previous job in Southern California that came with insurance and move to Oakhurst. As a Libertarian (the GOP is too liberal, he says), he doesn't think he should have help in getting insurance: "Do I make the government responsible for my choices? I made the choice. I knew beforehand."

Ruffino seems torn between his unsparing self-reliance and a sense that the insurance industry is unfair. He thinks insurance companies should not be allowed to pick out only the healthy and leave guys like him behind. He says there is a role for government in setting some of the rules, but he's uncertain just how far he wants to go.

"Does there come a time when government has to get involved and at what levels? But when you are distrustful of the system in whole it makes it difficult," he says. "I go back and forth. I ping-pong on this issue all the time."

It doesn't surprise Oakhurst insurance agent Doug Macaulay that many people are torn.

Macaulay, who is also Republican, says people get mad at the insurance companies, but they don't see "Obamacare," as they derisively call it, as the answer: "You're complaining over here that you don't have health insurance and you can't buy it. And over here [the government is] trying to provide you with it but that's the worst thing ever. So there seems to be a disconnect in the thinking there."

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

SCOTT SIMON, HOST:

Supreme Court arguments over President Obama's health law are set to begin Monday. A central issue, of course, is the stipulation that by 2014 everyone should have health coverage

Reporter Sarah Varney of member station KQED in San Francisco, traveled to Madera County, California this week, where one in every three people lacks health coverage and political views are often conservative.

SARAH VARNEY, BYLINE: To reach Oakhurst, California, drive away from the green fields of the Central Valley, pass miles of pistachio trees showing their spring buds and up toward the snow-topped peaks of the Sierra Nevada.

(SOUNDBITE OF OUTDOORS SOUNDBITE OF OUTDOORS)

VARNEY: Here, just a few miles from the entrance to Yosemite National Park is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama's signature initiative.

JOE STERN: But Obamacare is absolutely horrible, horrible, horrible. And it should be struck down.

VARNEY: By 5 o'clock on most week day evenings, the bar is hopping. Locals like Joe Stern stopped by to josh and jest. Stern sips on a glass of pinot noir. He's 66 years old, a registered Republican and owns a small water conditioning company. Stern is covered by Medicare, and he says he's thankful for the program. Before he turned 65, Stern paid mightily for his health insurance.

STERN: I, a single person, was paying $670 a month. So I thought it was pretty brutal but I was still against Obamacare by far.

VARNEY: Why is that?

STERN: Oh, 'cause I saw how they did it in the middle of the night. It was just totally, it's not how you do a radical change like that. You do it slowly.

VARNEY: If at all. Like many conservative voters I interviewed in Madera County, Stern despises the individual mandate included in the law, the requirement that all Americans have health coverage. There is a lot of suspicion here about whether the health insurance system is really all that broken. Stern says many people choose to be uninsured and no one is denied medical care.

STERN: I don't know of anyone that's just, you know, that was left on the street to bleed to death. I don't know anyone that really is left out.

VARNEY: I asked Stern if he knew anyone at the bar who is uninsured. He turns cheerfully to his friend, Mary Westover, sitting next to him. She's a registered Republican and self-employed artist and businesswoman. She's been uninsured for 17 years.

MARY WESTOVER: When I was married I had insurance through my husband. But since we got divorced, you know, I was self-employed, I just couldn't afford it.

VARNEY: It's been nearly two decades since Westover has had a pap smear. She's opposed to the individual mandate but says she wasn't aware the federal government would give subsidies to people like her to buy a policy.

WESTOVER: If it were subsidized, if it was made, you know, manageable, I would want that. And I don't know how people who can afford it, can sit there and say that we shouldn't have that, because there's a lot more of us than them.

VARNEY: Doug Macaulay, a Republican, has sold insurance here for nearly three decades, and in that role has heard just about everyone's opinion of the federal health law.

DOUG MACAULAY: I think there's just a certain lack of knowledge of how health care works.

VARNEY: Macaulay says people get mad at the insurance companies, but they don't see Obamacare, as they derisively call it, as the answer.

MACAULAY: I get this all the time where there's not really a connection between, OK, here's what the government is trying to do for you. You're complaining over here that you don't have health insurance and you can't buy it. And over here they're trying to provide you with it but, you know, that's the worst thing ever.

(SOUNDBITE OF DRIVING CAR)

VARNEY: Down the road from Doug Macaulay's office, meanwhile, Paul Ruffino is preparing to welcome guests to Chateau du Sureau, a luxury inn overlooking the mountains of Yosemite. Ruffino, the inn's manager, is 55 years old. He's a Libertarian.

PAUL RUFFINO: I'm uninsured. I'm uninsured. It's the first time in my life and it's probably when I need it the most.

VARNEY: Ruffino says the policies he's looked at are expensive and won't cover his pre-existing conditions. Still, he says it was his decision to leave a previous job that came with insurance.

RUFFINO: Do I make the government responsible for my choices? I mean I made the choice. I knew beforehand. I knew what was going on.

VARNEY: Ruffino seems torn between his unsparing self-reliance and a sense that the insurance industry is unfair. He thinks the insurance companies should not be allowed to insure only the healthy and leave guys like him behind.

RUFFINO: And that's where I have to then ask: Does there come a time when government has to get involved and at what levels? But when you are distrustful of the system in whole it makes it difficult to - I mean I go back and forth. I ping-pong on this issue all the time.

VARNEY: These conflicts, both personal and political, will be amplified next week when the Supreme Court considers just what role, if any, the government should play in re-making the country's health insurance system.

For NPR News, I'm Sarah Varney. Transcript provided by NPR, Copyright NPR.