While emotions can boil over at health-care reform town-hall meetings patients at doctors' offices in Fresno have a calmer view: They agree that the system must change.
But few know details of the complex plans that inspired fierce political debate.
Instead, they're focused on their own health problems.
For example, if you ask Carla Goodloe of Clovis about health-care reform while she is waiting to see an allergist in upper middle-class northeast Fresno, she is open to a plan that would expand health insurance to everyone.
But don't mess with her own coverage. The 39-year-old college student has insurance through her husband's employer. She can pick her doctors.
Carlos De Leon 29, a part-time auto detailer says he is happy with Medi-Cal, state-federal insurance for the poor.
Lucy Tapia, 52, must drive two hours to Bakersfield to see a specialist who will accept her Medi-Cal insurance.
Jack Clements, a retired dime-store businessman, and his wife, Carol, have Medicare and a supplemental insurance policy that cover most of their health-care expenses.
Carla Goodloe, 39, a college student, has insurance through her husband’s employer.
"I know there are issues and problems, but for those of us who have insurance we like and enjoy, I don't see why that should change," Goodloe says.
At a clinic for the lower-income in downtown Fresno, Carlos De Leon thinks the same. The 29-year-old part-time auto detailer says he is happy with Medi-Cal, the state-federal insurance for the poor. "Just figure out some kind of low-payment plan for everyone," he says.
The debate over health-care reform has drawn angry protests across the country -- with one man strapping a gun to his thigh outside a town hall meeting in New Hampshire this month.
But in Fresno, waiting-room discussions gravitate toward concrete concerns: how to pay for prescriptions and get appointments with specialists.
Indeed, the intensity of emotions seen at town hall meetings don't reflect the public at large, said Mollyann Brodie of the Henry J. Kaiser Family Foundation. "Town hall meetings have historically drawn the most vehement," she said.
And the public has yet to be given a clear-cut plan for reform, Brodie said. "We're smack in the middle of a policy debate, where the policy makers are still doing their work," she said.
It makes sense that the complexities are not widely understood, she said. "It's more surprising when you have an average person who grasps all these details," Brodie said.
Paying for care a worry
Let policy makers argue the merits of a government-run "public option" versus nonprofit health-care cooperatives to compete with private insurers, said Paul Archuleta, 65, of Fresno.
"That's politics, and I'm not really into politics," Archuleta said.
A retired welder, Archuleta said he worries about paying for insulin. He has diabetes. Medi-Cal and Medicare, the federal insurance for the aged, blind and disabled, pays for much of his medical care.
But on a limited income of about $1,200 a month, he struggles to pay his share.
"It makes it hard for low-income people to make it," he said last week at a doctor's appointment at a Clinica Sierra Vista health center in downtown Fresno. What Archuleta wants from health-care reform: Make medicine affordable.
He's not alone, said Brodie. Paying medical bills trumps health-reform issues for most people, she said.
"People are really worried about paying for and getting the health care they need," Brodie said.
About half of Americans told Kaiser poll takers in July that someone in the family had skipped or postponed care of some kind because of cost in the past 12 months, Brodie said.
Kaiser -- a nonprofit, nonpartisan health-research foundation based in Menlo Park -- conducts monthly nationwide tracking polls on health-care reform. Results from the latest poll are due to be released soon. The foundation is not affiliated with Kaiser Permanente.
Jobless lose coverage
With unemployment rates in the Valley in the double digits, people are losing employer-sponsored health insurance in ever-greater numbers. More than 25% of people younger than 65 who live between Stockton and Fresno are without health insurance, according to the Center for Health Policy Research at the University of California at Los Angeles.
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