HEALTH -- April 23, 2012 at 2:09 PM EDT
Health Reform on the Brink: Nervous in New Mexico
Editor's Note: This story is part of a series profiling the views of ordinary Americans and their experiences -- good, bad or indifferent -- with the health care reform law. To capture the essence of the opinions expressed, the stories are told from the perspectives of the interviewees. They do not reflect the views of the PBS NewsHour.
They came unexpectedly and one after the other -- two massive heart attacks, the first in a hay field, the second in a hospital bed. Ron Castle was only 12 years old when he watched his father die.
It surprised Ron just as much as the rest of Frederick, Md. Dairy farmers usually didn't go like that, especially not so young, at age 37.
The Castle family farm was sold a short time thereafter, and Ron went to work part-time at another dairy farm to help support his mother and two younger siblings.
It was the start of 54 years of hard work and the first of many moments of chaos -- a year of gunfire in Vietnam, a failed marriage, and three decades' worth of drinking to forget -- that helped shape his current view of the world.
Now retired from 33 years of military service and 15 years of teaching, Ron is concerned America has lost some of that perseverance and work ethic. He sees too many "intelligent and capable people out there who have learned how to work the system." Government expansion is partially to blame for that, he says. "And it's not the answer to our problems."
That's primarily why Ron opposes the health care reform law. He worries the Medicaid expansion, in particular, will lead to more laziness, less productivity and an erosion of Medicare -- "a system I need now and one I paid into my entire life" -- to help fund the whole thing.
"Already, I see rampant abuse and the full law hasn't even gone into effect yet," he said. "We need to get back to the values I learned when I was a child. Everyone needs to contribute, and then everyone can benefit."
"We Wanted to Work"
Morning came early in Frederick, Md. From six years old and up, Ron's job started at 5:30 a.m, feeding calves and hogs before the sun rose. He learned how to drive the family pick-up truck at the age of eight to help out with some of the bigger errands.
"And I wasn't an anomaly -- that's the way we all were. Everybody I knew grew up that way," he said. "It was just expected, and we wanted to work."
Something else that bound most of the community was a complete lack of health insurance. "I don't know of anybody that had it," Ron said. When someone got sick, they simply went to the doctor and paid the bill, out-of-pocket.
After his father passed away, Ron's farm skills landed him a job at a neighboring farm for $10 per week. A few years later, he received "a major promotion" to $15 per week, and a few years after that came graduation, the military and war in southeast Asia.
A total of 250 men flew to Vietnam with Ron in December of 1967. Twelve months later, 95 of them flew back.
In the Third Brigade, Fourth Infantry Division, "you were killing or being killed," Ron said. "That's basically it. We took a lot of direct fire." In the blurred memories of gunfire that remain, he thinks most often of the Tet Offensive, when "they had a direct hit on our tent," Ron said. For a week -- day in, day out -- he and his buddies took several rounds of mortar rocket fire and a constant barrage of small arms fire. He still can't forget the blood.
When Ron returned home, he tried to forget the memories by focusing on all the trappings of domestic life in Mt. Airy, Md. -- marriage, a home, two children. And when that didn't work, he attempted to dull them with alcohol -- round after round of it until, he said, the years started blurring together and he stopped caring about the kind of a man he wanted to be.
"I just stayed drunk," he said. "My daughters, who just turned 40 and 36, haven't spoken to me in 30 years because of the way I acted when they were young."
There was no diagnosis of Post-Traumatic Stress in those years, and Ron didn't have any health insurance. So the Castle family remained uncovered, both physically and emotionally.
The marriage officially fell apart in the late 1970s, and Ron moved to Parsons, W.Va., to open an electronics store. And it's there that he found two things that would transform his life: the woman who would become his second wife and -- once again -- the military.
His brother was a member of the local National Guard unit, and he urged Ron to rejoin. "He recognized I had a lot of issues, but that I still had a love of the military way of life," he said. After several months of persuasion, Ron caved.
It was a medical unit, "just like MASH on TV," he said. "And seven of us were Vietnam veterans and so we were like our own therapists," he said. "And after about 10 or 12 years working together, we got ourselves straightened out."
The Golden Years?
Thirty three years, seven months and four days. All told, that's how long Ron Castle served in the military.
He followed it up with master's degrees in education and educational technology and concluded his career in the classroom -- 15 years of instruction at the elementary, middle- and high school levels. Today, he's comfortably retired in a small town in New Mexico, where he was deployed during Operation Desert Storm and decided to stay for the warm weather.
For several years now, Ron has received a combined total of $1,600 from his Social Security and military pension checks. Since he turned 65 last year, he has paid $100 per month for Medicare benefits, and since his 60th birthday, he's also qualified for Tricare, the health care program for uniformed services members. For the PTSD and hearing loss he developed while serving in Vietnam, he receives treatment from the U.S. Department of Veterans Affairs -- treatment he admits would have been available to him earlier if he would have overcome the stigma of seeking help.
Though Ron didn't feel he needed health insurance for much of his life, he now wants it to be handy for the high cholesterol and heart trouble that runs in his family.
He considers all of these programs "deserved" and none of them an "entitlement."
"I've been paying into them for most of my life and now it's my turn to enjoy them," he said.
From Ron's perspective, health care reform means less, not more. He worries that the scope of the law will force politicians to dramatically drive up Medicare premiums in the years ahead.
While the Obama Administration says that reform will help and not hurt seniors -- by offering millions of them free wellness check-ups, lower out-of-pocket costs and an eventual end to the doughnut hole -- Ron believes that federal funds should be going toward ensuring that seniors "actually receive the benefits they were promised," he said. "There shouldn't be a question."
Instead, he said, many millions will be spent on a Medicaid expansion to bring 16 million more low-income Americans into the system. And Ron worries that some of it will be "wasted" on people like the man he knew who had children to multiple women and "didn't pay a cent for them -- he just let the government pick up the tab for their health care," he said. Or some of his former high school students who told him they planned to stay single and have children out of wedlock so they could receive "free health care."
Ron knows from personal experience that people make mistakes and sometimes need help. But his own addiction and recovery convinced him that transforming that help into self-reliance is the best answer to life's problems.
"We've got something really way out of whack here when intelligent people -- people with jobs and nothing wrong with them -- have figured out the system and know the best way to take advantage of it," he said. "We need to get back to the idea of hard work and contribution. It's fine for benefits to be spread around, but everyone should be contributing something."
While he supports some of the ideas behind health care reform -- help for those facing catastrophic conditions or those dealing with legitimately dire circumstances, for instance -- the logic behind the law itself doesn't entirely make sense to him. For example, if 32 million Americans are going to be added to the ranks of the insured, "where are all the extra doctors going to come from?"
"My doctor won't be able to pay as much attention. For those who have paid and served, there will be cost increases across the board and decreased levels of care for everyone," he said.
How can he be so sure? One of his grandfather's sayings works well in this situation, he says.
"Figures don't lie, but liars can figure,'" he said. "The numbers here just don't add up."
Do you agree with Ron Castle? Or more with health care reform supporter Lisa Hill? In the weeks ahead on the PBS NewsHour's Health Page, we'll share the stories of ordinary Americans who love, hate, and feel indifferent about the Affordable Care Act. As the Supreme Court decides the fate of the law, we want to hear your verdict. Share your opinions here.
Photos courtesy of Ron Castle. From top, the Castle family farm in the 1950s; Castle at his high school graduation; in the military; and after retirement.