Health Care Issues Motivate Iowa Voters To Turn Out For Caucuses

Health care consistently polls as the top issue Iowa voters care about. In the western part of the state, one doctor faces growing debt as he sometimes treats patients without coverage for free.

DAVID GREENE, HOST:

We are just a few days away from Monday's caucuses.

How you doing?

We got this reminder that even in these bitter partisan times, there are still very human relationships.

GLENN HURST: Which knee do you want me to inject, the right - the left one?

LYLE RODENBURG: The one that hurts. The one that hurts.

HURST: Yeah (laughter), well, I can tell that real easy.

GREENE: We were at an assisted living facility in Council Bluffs, Iowa, in Lyle Rodenberg's apartment. He is 90 years old. And we had come here with his doctor, Glenn Hurst, who is giving that steroid injection, also just checking in. Lyle remembers the day he first met his doctor 10 years ago. He was really sick.

RODENBURG: I don't know, some kind of pneumonia. But I was having chills - is what I was. Rosalie said, you are going to the doctor today. And I said, OK.

GREENE: Lyle and Rosalie, his wife, got in their Ford Ranger pickup, drove to a clinic, and Dr. Glenn Hurst was there.

RODENBURG: He said three words to me - you are going to the hospital.

GREENE: You remember this?

HURST: Oh. Oh, I remember it well...

RODENBURG: And I said...

HURST: ...Because the gurgling of Lyle's lungs could be heard in the hallway.

RODENBURG: He said, you are going to the hospital. I said, the hell I am. And he said, the hell you ain't. He said, I'm going to call the squad. And I said, well, have a nice trip. If I got to go to the hospital, Rosalie and I are going to get in the truck and go to the hospital. Well, he said, you can't drive. And I said, how do you think we got down here? But anyway, I got in the truck, and we went to the hospital.

GREENE: (Laughter) You drove yourself to the hospital?

RODENBURG: You betcha (ph). And Rosalie went with me.

GREENE: Lyle and Rosalie had been together for 60 years. She died two years ago.

RODENBURG: She had two heart attacks, and they finally got her. And that was terrible.

GREENE: Here in the apartment, Lyle keeps photos of Rosalie and other family, and also of Glenn, his doctor. They are clearly friends, though they do differ on politics. Glenn is the local Democratic Party chair. Lyle is a Republican who has supported President Trump.

RODENBURG: He's done a lot of great things. And he's done some things that should have been done a long time ago.

GREENE: Like getting tough on trade with China, Lyle said. He just wishes Trump would tweet less.

(SOUNDBITE OF CAR DOOR SHUTTING)

HURST: I bought this car in June...

GREENE: We met Lyle and some other patients as we drove around with Glenn, who actually never dreamed of being a doctor as a kid. But he eventually took a job placing doctors in small towns. And he would take these flights over farm country and look out the window.

HURST: And you'd see a combine here in one field and another guy working in another field, completely separated from each other but all kind of interdependent. And it just moved me. And to see the physicians in those communities helping those people stay in their fields, helping those people's families be safe - I decided that I wanted to be part of something rural. And I wanted to be part of health care.

GREENE: Glenn has since started running his own clinic here in rural western Iowa, where it sometimes takes a while to get to a doctor. Sometimes he treats farmers who will get injured and then sew themselves up with fishing wire just so they won't lose hours of work during harvest.

Distance is not the only struggle for Glenn. Another has been the privatization of Medicaid in Iowa. That's the federal program that covers millions of low income and disabled people. Republicans promise privatizing it would save taxpayers money, and there has been disagreement over whether that's worked.

For his part, Glenn says many legitimate Medicaid claims are denied by private insurance companies. As a result, he'll treat patients not knowing if he's going to get paid. He's actually had to take out $15,000 in loans to keep his clinic going. But he says he's just going to make this work.

HURST: I don't do anything I don't love. I don't waste a moment of my breath on this earth doing things that I'm not passionate about. I'm going to do what I love, and I love being a rural family physician.

GREENE: Do you ever face a dilemma where you're going to see a patient and you are knowing that you're not going to get paid for this because...

HURST: Only when Al (ph) or Rachel (ph) or Tricia's (ph) paycheck are at risk.

GREENE: Those are your employees that...

HURST: Yeah, every second Friday (laughter). Right. Every second Friday I worry about that.

GREENE: So Glenn is a firm believer that single-payer, government-run health care is the best option for his patients and for him. He says he wants a president who will get the country there as quickly as possible.

(SOUNDBITE OF PIANO PLAYING)

GREENE: One other place we visited with Glenn was a nursing home where he's on contract as the medical director. It was lunchtime. Residents were finishing these delicious pieces of chocolate cake. They were playing dice games, listening to the resident pianist. Much of what happens here is planned by Pat Coffman. She's the activities director. And she's been through her own struggles with health care.

PAT COFFMAN: I'm one of the underinsured. I have insurance through my job, but the deductible is $6,600, so...

GREENE: So that's out-of-pocket up...

COFFMAN: ...Out-of-pocket everything...

GREENE: ...To $6,600 every year?

COFFMAN: Yes, yes.

GREENE: Can you afford that?

COFFMAN: No, absolutely not.

GREENE: And here's what that means. Pat has this chronic illness. She's supposed to go see a gastro specialist regularly. But she can't afford it often, and she's been taking out loans to try to get there. And then came this freak accident last summer - she fell down the stairs at her sister's house, and she was rushed to a trauma center.

COFFMAN: I had a fracture, and I broke my nose in three places.

GREENE: Ow.

COFFMAN: I had a terrible concussion, 75 stitches in my head. It's there - some scars...

GREENE: So that...

COFFMAN: ...Luckily, the wrinkles cover that up.

GREENE: So that was three - that was - you had to pay for the ambulance fee.

COFFMAN: Three thousand dollars there. I think it was $30,000, all told.

GREENE: And so insurance covered most of that. But she was still on the line for more than 6,000 last year, and that's in addition to the loans she was still paying off. So she feels like it's just too much. And the candidate who's really convinced her that he'd help is Bernie Sanders. She believes in a single-payer system and believes that he will fight for one.

COFFMAN: I like the perseverance and the dedication he's shown to it. And I just feel like he's very genuine about it.

GREENE: You're planning on caucusing for him?

COFFMAN: Yes.

GREENE: OK.

COFFMAN: Yes. But I'd be grateful that any of them - I mean, I like them all. Don't get me wrong.

GREENE: You'd be just as happy with a Joe Biden, an Amy Klobuchar. People...

COFFMAN: Not just as happy, but I'd be happy that it wasn't Donald Trump.

GREENE: I don't know if you've heard this from any friends or other Democrats, but when people say that Joe Biden has a better shot at beating Trump, as appealing as Bernie Sanders is, if people say that to you, I mean, what - how does that conversation go?

COFFMAN: Well, I can see where they'd say it, but - and I've liked Joe Biden for a long time. Joe Biden, he would definitely get some working man's vote, maybe the black vote. But I think what we're seeing is going to surprise everybody with Bernie. He's not just some millennial's candidate promising things that he can't deliver on. I think we can definitely do what he says we can do.

GREENE: So on this Monday night, Pat is going to go into her caucus, she's going to tell her story, and she's going to make the case for Sanders.

COFFMAN: I don't know how that will go. And if all else fails, I'll bring cookies (laughter).

GREENE: And she's not totally kidding there. The way caucuses go here in Iowa, neighbors can get pretty creative with how to win people over.

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