As top Democrats debate health care in Atlanta, 2 rural Georgians tell CNN why they’re ready for universal health care

In Georgia — where state officials say 60 counties have no pediatrician, 76 counties have no obstetrician-gynecologist and nine counties have no doctor at all — frustration over access to health care is apparent. Even in reliably conservative strongholds, some say they’re ready to ditch a system built on private insurance.

When 10 Democratic presidential candidates gather Wednesday on an Atlanta stage, the topic is sure to come up, from Sen. Elizabeth Warren’s and Sen. Bernie Sanders’ “Medicare for All” proposals to more moderate candidates’ plans to forge a government-run option while letting people keep private insurance they like.

Among those watching the conversation closely will be David Broad, a sociology professor at the University of North Georgia, and Marisa Pyle, a 21-year-old with an autoimmune disease. Both residents of rural Lumpkin County, Georgia — about 70 miles north of Atlanta — have struggled in recent years to secure the health care they need and want using insurance options available in today’s market.

Beyond broad ideas, both want details about Democrats’ plans for a more universal option. They also want to know how the candidates would turn their health care campaign promises into reality.

Stuck between his doctors and his insurance provider

“I have seen the enemy,” Broad told CNN, “and private health care is it.”

A self-described fiscal conservative who has always voted along Republican Party lines, Broad is one of several thousand people in Lumpkin County whose providers fell out of their insurance network at the end of September, when a contract between Anthem/Blue Cross Blue Shield and Northeast Georgia Hospital System expired. The sides have yet to come to an agreement.

Broad and his wife decided to stay with Anthem in 2020, which means the drive to their new doctor will be 45 minutes without traffic. The insurance coverage limbo has been a blow to their closely connected town, where Broad has known his family’s former physicians through community theater and considered them friends.

When some progressive Democrats (“Bless their hearts, as we say in Georgia,” Broad sidelined) recently brought up the idea of Medicare for All, his conservative friends balked at the notion.

“A lot of people around here are conservative people, and they are my people,” he said. “They thought that’s bad because they would take away your private health care.”

Then, the contract dispute kicked into gear, he said, and “the private providers have taken it away.”

The parties in the Georgia insurance dispute have responded in much the way that anyone who’s been caught up in a similar quarrel would recognize: by publicly trading bureaucratic potshots.

“It’s a shame that we’ve been negotiating since January, yet Anthem refuses to budge on language that takes decisions about care out of the hands of patients, physicians and other clinicians,” reads part of a statement from Steve McNeilly, Northeast Georgia Hospital System vice president of managed care.

“Anthem demands the ability to change our contract at any time, including refusing payment for emergency room visits or telling patients where they must go for things like MRIs or CT scans,” it states. “For example: Anthem recently refused to cover a patient’s visit to our emergency department, even though she had a gunshot through her hand, because they believe she should have gone to an urgent care clinic.”

Anthem, meantime, has made numerous comprises, a spokesperson told CNN in a statement. “Although NGHS walked away from the negotiating table in late September, leaders from both sides recently sat down to talk,” it reads. “It is our hope they will re-engage with negotiations so we can get back to putting the focus where it belongs — the consumer.”

But even as Broad shakes his head at the private insurance predicament, he also has concerns about Democrats’ proposals. He hasn’t seen or heard any convincing plan to transition to a nationalized system, he said. And he wants Democrats to reach across the aisle so Republicans also participate in the conversation.

Broad said he’s had positive experiences with nationalized health care systems in other countries where he’s lived. And he was looking around online at the Top 25 countries for Americans to retire, he said, just before talking health care with CNN.

‘It is a life-or-death issue for me’

In the same Georgia county, Marisa Pyle said her family switched health care providers some five times in the past three years after various insurers dropped doctors or treatment options that they’d previously supported for her conditions, celiac and Crohn’s diseases.

Without insurance, she estimates her family would pay about $150,000 a year out of pocket to treat her symptoms, which could be life-threatening, she said.

“It is not an exaggeration to say that it is a life-or-death issue for me,” said Pyle, who organizes for progressive causes in Lumpkin County.

Pyle’s whole family has secured insurance coverage since at least 2014 through the Affordable Care Act, the health care overhaul that former President Barack Obama signed into law in 2010. That includes her father, who is in remission after a cancer diagnosis five years ago.

At one point, her insurance plan did not cover immune suppressants Pyle needs. Without insurance, it would have cost $24,000 for treatment every eight weeks. Her family opted to wait two months until their new insurance plan kicked in, during which time she had trouble walking and suffered severe pain.

While Pyle struggles with access to care and affordability, she looks forward to what she believes the nation eventually will adopt: a long-term universal health care system.

“People like their doctors, they like having their primary care physician, but nobody likes their insurance,” she said. “I have never heard anyone say, ‘I’m looking forward to calling my insurance company.”

Candidates debating in Atlanta need to know that any health care fix must include special attention to rural areas and the often-scant access to doctors, she said.

When she watches the debate Wednesday, Pyle said she’ll be listening beyond broad strokes.

“I think that details show the people that the candidates are serious,,” she said. “I think it’s not enough to say that ‘I want to implement Medicare for all who want it, or Medicare for All.’ I think you have to have a plan for how you’re going to do that.”