Friday, August 21, 2009

Pictures from a Town Hall Meeting.

I went to the Town Hall (literally) in Warwick on Wednesday night to try to hear Representative Langevin speak on the prospects of health reform, and instead found a wild group of LaRouchites (with Obama as Hitler posters), "Government can't do anything" folks, Democrats, Union supporters, medical students and the odd pediatrician standing around, outside the Hall, trying to convince the the media of their importance. It was an interesting scene; I met few there who had not yet already made up their minds and many who enjoyed shouting and chanting. As a singer, I sort of get that- their is value in the human cameraderie that goes along with a good chant. In this case, however, it made it difficult to engage in a meaningful discussion with the folks who had serious doubts about the legislation, which is why I was there. But I tried.

I would say that the folks who were present broke down
into three groups. First were the supporters of reform; largely professionals, Obama supporters and union folk. Tended to be younger, tended to be less loud- these folks were often single-payor supporters, and were very much in favor of the inclusion of the public plan in the mix of things to come out of this process. In talking to them, I was concerned that they were too focused on the public plan; for many, the loss of the public plan would mean that we had failed in our effort, even if more people were covered and the insurance industry is dragged into a process other than ruthless competition to fund the care that people need. You all have probably guessed that I think that this process is essential; the "free" market as currently structured is likely to oscillate and collapse unless we are able to realign the structure in which it operates. Kind of like the stock market, except this bubble really does kill people directly. So "our side" needs to convince its own people that 3/4 of a loaf is an acceptable outcome.

Second were the ideologues, the folks who think that the government is simultaneously incompetent and unable to accomplish anything AND evil, conspiratorial and able to focus in and ruin their lives in a really personal way. It is interesting to talk to them; the arguments tend to be circular and to focus back on personal attributes of the one that they are trying to convince. I was asked over and over again, "Have you read the bill?" Well, yes, but, unless you are an attorney, reading the bill doesn't really tell you very much. The language is there, but the meaning of the language is steeped in prior legislation, numerous Court decisions and the policies and procedures of the Department of Health and Human Services. We are all, in many ways, dependent on our colleagues in the legal professions to tell us what this bloody thing means, and sometimes they don't even know until it is passed. Smart people think that this thing will get more people covered, support the move to quality improvement and allow me to take care of children without worrying about their coverage all of the time- that is actually good enough for me. The bill is hundreds of pages long (double spaced, though), and is worth a look through.
The biggie for me is that it extends EPSDT to children on the Children's Medical Security Plan- that is a huge boon to families of children with special needs and I am absolutely for it.

Third were the critics with ideas, and there were a lot of them. People who think that things need to change, but that this bill (the House Bill being the only one on the table at the present time), is not good enough. I spoke with one IT guy who was worried that the system would be too permeated with politics- he favored removing this from the political process. Another person was a hospice worker, concerned that they would mess up the regulation of the transition from treatment to end of life care. A couple with seven kids gets their health care through a Christian health cooperative- they were concerned that they wouldn't be able to continue in this form of insurance that worked so well for them. These are folks that we can talk to- they may never support the reform, but they won't blow up the country to keep it from happening.

The one thing that was clear that evening was that people on all sides of this debate care deeply about how this thing happens- inside the room, the session went on for several hours, and we stood out there without a speaker, talking and yelling and arguing and waving signs and engaging in the political process that makes us who we are: Americans. My side has not yet closed the deal on this thing, but neither has the opposition run it off of the cliff. It is time, though, for all of us to weigh in and figure out which side we are on.

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