A Town Hall Meeting That Worked: Sta. Clara, CA

I was heartened by Rep. Mike Honda's civil, orderly town hall meeting at Santa Clara University at 1 pm in Sunday. There were about 400 advocates for health reform, including a strong public option, and about a dozen or so opponents. At about 12:45, they showed a videotape of 3 local residents with health care stories, interspersed with facts about the number and percent of people in the country and the district who are suffering from lack of coverage, health-related bankruptcies, etc. I saw 2 of the people from the video in the crowd. They included: A retired county worker with an uninsured son; a woman whose grown son could not get coverage, having developed juvenile diabetes early in life; a man who identified himself as a Republican, and whose wife had a serious chronic condition that would never be covered if he lost his job and insurance.

Rep. Honda opened the meeting with a welcome, and a request for mutual respect. He called on constituents to submit written questions on index cards, including name and address; questions from constituents were chosen at random; he then invited the constituents to stand and pose their questions. Reflecting the crowd, most of the questioners spoke in favor of a strong public option, or a single payer. A few were opposed. We cheered every time he responded that he supported a strong public option, and had no plans to compromise on that; the dozen booed. We cheered for a brave young Latina who works in reproductive rights, and said that coverage for abortion was important to her; the dozen booed. (The cheers and boo's took a few seconds, then stopped; we all respected Rep. Honda's request for respect.) A few times Mike pointed out that the present system of private insurance had had quite a bit of time to work, if it was going to, and that too many people were hurting financially and physically (he gave details); it was time for a change. We all cheered. No one booed. The final 2 questioners asked how we could afford the President's health proposal, since similar socialistic systems like Great Britain are facing financial shortfalls. Mike said there is a way to do it, and we would. He promised to respond in writing to the remaining questions. That was it.

Outside an older man approached a younger fellow giving out water and wearing a pro-reform button. Tell me one government program that works! he demanded. Medicare, was the response. End of conversation.

Pickpockets and the Public Plan

Ever had your pocket picked? Chances are they charmed you, scared you, surrounded you - in short, distracted you while they grabbed your wallet. Enough said.

So let's get back to the important issue in health reform: the Public Plan. You can have health coverage that is better than what you have, that is more affordable, covers many more of us, and improves quality You need a strong public plan.

The Congressional Progressive Caucus isn't calling for a strong public plan, really. They should.

People who say a public plan can't work are wrong. They should reconsider.

A strong public plan should be open to everyone who's not on Medicare, beginning in 2010.

The House bill says it would start in 2013 - after the next presidential election - and include only a few of us - self-employed, unemployed, employees of small businesses.

The Senate is proposing to have no public plan at all - just a straight cash transfer to your friendly neighborhood insurance conglomerate. (Which is really a way of making sure nothing passes.)

Why does this matter? The public plan needs to have enough people in it so that it can do what Medicare does: influence how the rest of the system works. Bend the cost curve. Improve quality. Provide your doctor, nurse practitioner and acupuncturist with comparative effectiveness studies so you get better care on the first visit. This will scare some of the teabaggers and it apparently scares the hell out of the insurance industry.

This, however, is change we can believe in.

That plus one more thing: we need a state option for single payer, so we can take the next step towards truly universal coverage.

People are mobilizing in remarkable ways to demonstrate why we need real health reform now. Giving out free care to long lines of people in desperate need. Showing up in scrubs at Town Hall meetings. Explaining that Medicare is a government program and we like it.

We need to do one more thing: make it worth it when we win. Take a picket sign for a Real Public Plan. Tell your neighbors. Tell your member of Congress. Tell your talk shows. The insurance industry and their pickpockets do not speak for us. We need real health reform, and this is the time to fight for it.

Need some talking points? Go to www.centerforpolicyanalysis.org/id42.html

thugs and health policy

Missing the point: Facing down the gangs disrupting her Town Hall on health reform last week with cries against the "government takeover," HHS Secretary Kathleen Sebelius responded, "But this isn't a single payer plan!"

Single payer advocates, recognizing that our gold standard cannot pass this year, taunt supporters of a public plan for saying that our gold standard cannot pass this year.

Meanwhile, the economic stagnation that gripped the poor in the 1990s and never let up is nipping at the heels of the middle class. The financial and housing meltdowns are taking place at a time when countervailing forces to corporate power are hard to find. Private sector unionization rates hover at about 7.6% (the public sector is over 40%; 16 million of America's 130 million wage workers belong to a union).

The public may be favorably disposed toward a public health plan, but probably fewer than 100 can describe how it would work, when it would start (2013), or what it would mean to them personally (would likely help). Meanwhile, right wing blogs and the Republican party are succeeding in whipping up fury on an issue even wonks think of as arcane. Let's assume most of these people are operatives, as were the Bush v. Gore mobs in 2000. The point is, they have organized, well-funded leaders, with a stake in the direction of this wobbly nation and our increasingly ethereal economy.

Maybe we need to rethink the conversation we need to be thinking about.