Maeve Reston Reporting from Hugo, Oklahoma: Obamacare Meets Extra Resistance: The View from the Roasterie XII: October 16, 2013: Coffee: Full Vengeance Blend
Maeve Reston reminds me of a conversation from 1993, reconstructed and reimagined from my memory, after an OEOB Ira Magaziner health care reform meeting:
Another Treasury Deputy Assistant Secretary: "You've lived in California; Washington, DC; and Massachusetts. You don't really understand the rest of the country--you don't understand the South; you don't understand Texas."
Me: Half my extended family lives in Florida...
ATDAS: "That's not the South..."
Me: Three of my four grandparents come from Ohio, Illinois, and Missouri...
ATDAS: "The Midwest is not the South, or Texas..."
Me: One of my great-great-great grandfathers is buried in Wichita...
ATDAS: "And Wichita is not Texas.
Me: True...
ATDAS: "You don't understand the Republicans we have in the South, and in Texas. You know of Northeastern and Left Coast Republicans. Even Midwestern Republicans--especially Bob Dole--actually think that sick and disabled people, even if they are poor, should be able to get the health care that is good for them, without having to beg. That's not the case with Republicans down in Texas. Republicans in Texas think that if you can't pay the doctor out of what is in your pocket and from the insurance policy you bought, then you need to go beg at your church. And only after you have begged at your church, and begged sincerely and abjectly enough, might your church find itself paying for you out of Christian charity--the benefit of which is to save their souls, not your body!"
Me: But...
ATDAS: "They don't like Medicaid. They don't like Medicaid because it short-circuits this process. You get treated but you don't have to beg for it. The only reason they vote for Medicaid--and Texas only votes for grinchy Medicaid--is that the rich doctors of Dallas and Houston who contribute so much to the Republican Party think that Medicaid means that they don't have to dig into the pockets of their practices to support charity care."
Me: But what if you don't have a church!
ATDAS: "Then you should go join one, shouldn't you? That's a benefit..."
Me: But...
ATDAS: "You listen to Moynihan talk about how Texas taxes pay for only half of federal Medicaid dollars that go to Texas, and you think Medicaid should be popular even among Texas Republicans for the same reason that Fort Hood and the Johnson Space Flight Center are popular among Texas Republicans? But Medicaid is unpopular in Texas--not because rich Texans know their federal taxes go to it, and not because state taxes have to be raised to pay for the state match, but because it short-circuits the begging process..."
Me: But Ralph Yarborough is a Texas Baptist preacher!
ATDAS: "The Good but Inscrutable LORD ain't makin' many Texas Baptists like Ralph Yarborough anymore, and damned few of those He does make are Republicans..."
The scary thing is, increasingly, Wichita is at least 50% Texas--and Oklahoma's Texas quotient is frighteningly high...
Maeve Reston: Obamacare meets extra resistance in Oklahoma:
The nation's healthcare law was written with the residents of rural counties like Choctaw in mind. A quarter of the Oklahomans who live in the ranch country near the southeastern corner of the state are uninsured…. But that does not mean people here want Obamacare…. At the Hugo livestock auction, the busiest spot in town last Friday, owner David Minyard waved his hand in disgust when asked about the law. If what he's heard about it is true, he said, "I'm going to have to lock up and shut my door. There isn't nobody who's read it or understood it," Minyard said as ranchers pulled up their cattle trailers to unload in the yard outside. "No two people comprehend it the same way. You're hearing one thing. I'm hearing another. He's hearing another. "Forty-thousand pages?" he said, vastly exaggerating its size. "Hell yes, it'll be confusion."
Minyard, a respected business owner in Hugo, says that no one--from his neighbors to his ranch hands--is turned away when they go to the local emergency rooms. "If they need medical care, they're going to have it," he said. "Why force somebody to do something they don't want?" Standing silently nearby was 26-year-old Chad Austin, who is coordinating the navigators working in 63 Oklahoma counties. Austin is trying to stay clear of the politics. But he knows what he's up against. "Bad news travels, and to a lot of Oklahomans right now, this is bad news," said the former high school baseball coach, who worked until recently at a local funeral home. "We're not offering any opinion on that; our goal is to help our community members."
As the Obama administration and its emissaries began coaxing Americans to sign up for health insurance this week, they were facing not just countless misconceptions about the law in red states like Oklahoma, but also a stigma — its attachment to a president unpopular here — that may drive potential consumers away. States like California are spending millions to promote the law, but here it is difficult to find a trace of information about it beyond cable news. Officials at two organizations that received grants for outreach say they are still training navigators on what they can and cannot do. There are no billboards along the highways, no public service announcements on the radio. At a number of health clinics, there were no fliers last week about the law's insurance marketplaces. That's just fine with many leaders in a state where Obama lost every county. During an interview at his office facing the state Capitol, Atty. Gen. Scott Pruitt, a Republican, said he was more concerned about "public protection" and privacy concerns related to the law than whether people know where to sign up for insurance.
