Bachmannacare in Lake Elmo: U.S. rep meets the people

Video by Chuck Olsen of The UpTake.

I suppose you could call it democracy in action: the hot issue of the day, the elected rep stating her views, taking questions and feedback from her constituents, all in a junior high auditorium in beautiful Lake Elmo, Minn., on a balmy Thursday afternoon when everyone involved could have been eating from a stick at the State Fair. Kudos to Rep. Michele Bachmann for holding the event (some congressfolk seem to be ducking the opportunity this recess) and to the roughly 1,000 Minnesotans who took the time and trouble (about half of them didn’t fit in the auditorium and watched the proceedings by closed-circuit from the cafeteria).

Yes, there was some booing and more raucous cheering from the overwhelming pro-Bachmann crowd, but it seemed civil compared with what we’ve seen on the tube from other health-care town meetings. Another kudo to the GOP congresswoman who spoke respectfully to the Obamacare supporters and urged her supporters to let the heresies be heard.

No one got hurt. But did anyone get informed? Did anyone hear anything that changed their minds? Maybe so, but I couldn’t find them. I asked about 20 folks in the parking lot how the meeting was for them, and they also said it was some version of pretty good. I asked them all if they heard anything they didn’t already know or learned anything that opened their minds to the other side’s point of view, and they all answered with some version of no, not really.

We all want to believe (anyway, I do) in a self-governing society where facts, arguments, neighborly discussion and shared experience leads to a better-informed citizenry wrestling its way closer to consensus, or if not consensus (OK, forget about consensus, let’s keep this real) closer to a self-governing decision. But it’s very hard. For all the Frank Capra trappings, the Bachmann health-care town hall in Lake Elmo yesterday left me feeling pretty hopeless about a Frank Capra ending where the middle Americans (who, in Act IV, were inflamed by evil self-seeking propagandists into an angry mob) turn back into neighbors, realize that, after all, It’s a Wonderful Life, and send Mr. (or Ms.) Smith back to Washington to represent them better than ever.

But this health care deal is a rough one. It’s really too complicated for most of us to have a truly informed opinion. But it feels very personal. And the “government will reform it” versus “government makes everything worse” battle lines make it a perfect medium for the basic Democrats-are-from-Mars, Republicans-are-from-Venus problem of our general political culture in these times. So, here is one ink-stained wretch’s impressionistic painting of what happened when Bachmann met the people yesterday in Lake Elmo.

Sign-carrying protesters

When I arrive, several hundred are waiting to get in. The audiences seems mostly Bachmann likers. The sign-carrying protesters are mostly for the Obama plan (to the degree that anyone can say what that is). The signs say: “You and your staff have a public option — We want it too,” “Healthy People make a Healthy Nation,” “Love your neighbor, Support Reform,” “Dump Bachmann,” and one bears a Martin Luther King quote: “Of all the forms of inequality and injustice — injustice in health care is the most shocking and inhumane.”

One of the sign-bearers is engaged, fairly shrilly, with one of the line-waiters. It goes something like this: “Get a job and you’ll get health insurance.” “I have a job, I’m worried about people who don’t.” “This is America. It’s about liberty.” “America is about rights and health care is a right.” “It’s not a right if you have to take money out of my pocket to pay for somebody who doesn’t want to pay for it himself. Life, liberty and the pursuit of happiness are rights.” The tone was nasty, but not really ugly, and I noticed they both calmed down immediately once they gave up on each other and moved on.

When they open the doors, the auditorium (capacity 420) fills up quickly and peacefully. Another 400 or so score places in the cafeteria.

It starts late. The moderator, state Rep. Bob Dettmer, R-Forest Lake, introduces himself, mentioning that that his sons are all either on active duty or veterans. Tremendous applause. All afternoon, there will be many references to servicemen, which brings down the house every time. Dettmer leads us in the pledge of allegiance. Dettmer’s wife, Colleen, leads us in the “Star-Spangled Banner,” hitting even those tough high notes. I find myself wondering whether we pledge and sing at Democratic town meetings.

Bachmann’s Minnesota Nice opening statement meanders, then, when she seems to be working on a joke about whether Obama will play golf with Tiger Woods, she starts getting heckled slightly to start talking about health care. She drops the Barack/Tiger theme, but says she can’t really talk about the health care bill until we get the context. The United States is “functionally bankrupt.” The new 10-year deficit project is $9 trillion. Several homey tools to understand that trillion is a really, really big number. Our country continues to spend money with no idea of how we’re going to pay for it. Today’s 19-20 year olds will inherit the debt burden. Obamacare will add trillions more. Question is, is it going to be about putting you in control of your own health care (the Bachmann plan) or putting the government in control (the Obama plan.) Taxes will be 88 percent and more.

Here’s our alternative (to having the government own everything): “You Own Your Health Care.” Thunderous ovation.

I wonder what this really means. Bachmann gives some more facts, but the only one I can understand is that insurance companies can offer policies in all 50 states. This (plus several other aspects that I couldn’t grasp but were very free markety) will create so much competition that you will have choices and you will pretty much find a plan that meets your needs and that you can afford. She mentions such options as high-deductible policies paired with health savings accounts (you own them!).

All health care expenses will be fully deductible from your income taxes!

“Let’s not destroy what truly is the greatest health care system the world has ever known.” (Thunderous applause.)

Turns out there are several ways to get a big ovation here today. Be a veteran. Trash the government option. Trash government in general. Praise liberty and/or freedom. Say that no one in America needs to pay higher taxes. Say that the U.S. health care system is the greatest in the world.

Questions from the audience

U.S. Rep Michael Burgess, a Texas Repub who is also an M.D. and is one of the House Repubs’ health care experts, has come along with Bachmann. He also gives an opening statement. He is shocked that Obama didn’t push health care through earlier, when his approval ratings were high. He emphasizes that the Dems have the votes to do anything they want and that the quarrel in Washington is within the Dem ranks.

Now the questions from the audience begin. What will happen to Medicare Advantage plans? Bachmann: Obama wants to end them. Burgess: Many programs intended to save money within Medicare will disappear with Medicare Advantage.

What about the famous “death panels?” Burgess says the basic idea in the bill is a good one: pay the doctors for a consultation on end-of-life directives, if the patient wants one, when a person first enters Medicare coverage. But later in the bill, Burgess says, there are these comparative effectiveness boards that rate the effectiveness of doctors and of different procedures. Turns out, Burgess says, Medicare doctors are rated more effective if they get more of their patients to undergo this end-of-life counseling. Hmm? Is this true? If so, I suppose it provides a double incentive for docs to encourage this counseling (you get paid for it, and you get rated more effective). Even so, can this be reasonably described as a death panel encouraging euthanasia? Not by me.

Bachmann chooses this moment for one of her cheesiest shticks of the day. She calls attention to a poster she has brought (You can see a version of it here.) purporting to be the bureaucratic scheme of the House Dems’ bill.

The bill creates 53 new bureaucracies, Bachmann says. “It’s a full employment act for bureaucrats,” Bachmann says. And then the emotional capstone of the cheesy shtick: “Put yourself, your children, your elderly parents on one side of that board, put your doctor on the other side of that board, and just recognize that you have to go through these 53 new bureaucracies to connect yourself and your family ….” (I assume the sentence ended with Bachmann saying you had to fight through the 53 bureaucracies to get health care. The hyperbole of the suggestion that 53 bureaucracies were between the patient and the doctor was the first thing that set the anti-Bachmann elements of the audience off to the point that they drowned her out with groans.)

But she bounced back within seconds: If these things worry you as they worry me, she said, the time to ask questions is now before this becomes law. “What Washington is doing a lot right now is saying, ‘Trust me, just trust me.’ The American people are saying, ‘We Don’t Trust You.'” 

Thunderous ovation on that one.

Next question was a minor disaster: A teacher from Blaine, who described himself as “not a racist, not a right-wing extremist, but I have conservative Christian values” (big ovation), segued into what was worrying him, acknowledging that people would think he was a nut. But he is worried that after four years, or even after eight years if Obama were to win a second term (this got a smaller ovation from the pro-Obama elements in the room), the Obama administration might use force or some other unspecified means to stay in power. (This was shouted down by the pro-Obama elements.)

Bachmann rescued the man, rather deftly, by cutting in and interpreting his question to be whether she was concerned about the loss of liberty, which is what this country is founded on. And she is concerned.

And then, even more skillfully, Bachmann steered from freedom to a talking point she has used several times recently. She says the bailouts of late ’08 (and yes, she acknowledged, it started under Bush, but she voted no) and early ’09 have left the federal government with ownership or control over 30 percent of all the private business profits in America. Health care represents another 18 percent of the economy. So if the government takes over health care, that will make 48 percent of the former private sector that is “owned or controlled” by the feds.

Bachmann challenged

The next questioner challenged Bachmann’s statement that U.S. health care is the best in the world, citing the usual talking points that it is the most expensive but not close to producing the best results by commonly used measures.

Bachmann said she and the questioner would just have to disagree and that her goal is that every American be able to “purchase the best type and quantity of health care that we want.” (Once again, this got a big ovation, and again I couldn’t picture the plan that would make this possible.)

For what it’s worth — and I know of complaints that the liberal media won’t talk about the Republican alternatives — here is a summary of what’s described as the plan of the House GOP Health Care Solutions Group.

Bachmann held up a stack of papers that she said documented the horrors of health care in Britain, and mentioned scare stories about women giving birth there. When she got heckled briefly by a man in the crowd, she fired back her biggest punch line of the day: “I’ve given birth probably more than you have, sir.” (Big reaction, laughter and applause.)

My post may not represent this very well, but pro-Obama questioners and commenters did get several turns at the microphones. There was some interesting back and forth across questions. One man, who said he was a Stillwater doctor, accused Bachmann of constantly distorting the Democratic bills and noted that many of her statements have been given a rating of “pants on fire” by the fact-checking website Politifact. (Unfortunately, when he mentioned that he had learned this from CNN, he was hooted at by the conservatives in the crowd. He began his remarks with, “Thank you, Representative Bachmann, for turning a Reagan voter into a DFL activist.”

But he was more than balanced by the woman whose question began with this prologue: “Number one, you’re my hero. I love you.” She was grateful for a recent successful knee surgery she received and wondered “how long she would have had to wait” for the surgery if it was up to government bureaucrats to decide whether she really needed it.

But that comment was balanced by one from an angry Woodbury woman who said she needed surgery, but was denied it by her private insurance company. She described her experience under American health insurance as “I pay what I pay; I get what I get; and it ain’t that great.” She also asked how Bachmann could take the side of the “thieves who deny me care.”

Well, I’ve gone on too long already and covered most of what was said. When the meeting ended, I felt numb and kinda hopeless. To paraphrase the Woodbury woman: I write what I write, and it ain’t all that great. You read what you read, and you can find a way to believe whatever it makes you feel good to believe.

I mentionied at the top that most of those I interviewed after the meeting said they had enjoyed it but hadn’t learned anything. One woman, though, wearing GOP regalia and Bachmann buttons, said she got a deeper understanding of the alternative that Bachmann and other Repubs are promoting. Really, says I, I couldn’t picture how what she wants to do would control costs much or provide access to quality health care for the 40-some million uninsured Americans. (Several people during the meeting, who mentioned the 47 million figure, were booed by the conservatives in the room. Bachmann says the number is a big exaggeration.)

Anyway, when I asked what it would do for those without insurance, the regalia lady looked at me with new suspicion and asked me if I had voted for Obama. I said yes. She exhaled with controlled derision and lost interest in the conversation.

Related: Is Bachmann worried about reelection? By Blois Olson

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Comments (39)

  1. Submitted by Thomas Swift on 08/28/2009 - 09:53 am.

    “One man, who said he was a Stillwater doctor…”

    I assume you’re referring to Ilya Gorodisher, who was quoted by both newspapers today.

    You have to be very careful when dealing with leftists that claim expertise intended to lend credibility, Eric. During the most contentious period of protestations over the Iraq war, you may remember that the left produced countless phony soldiers who stepped up to publicly slime the military.

    Now, the issue at hand is health care and there have been several cases of Obama supporters showing up and claiming to be doctors, only to be proven liars when fact checked.

    Dr. Gorodisher isn’t a liar, per se; but he’s not an MD either.

    Ilya Gorodisher
    scientist, 3M

  2. Submitted by Peder DeFor on 08/28/2009 - 10:11 am.

    I can say without hesitation that I don’t trust Washington to actually fix the health care industry either. It started with the Dem attempt to push something through before recess without any acknowledgment of how complicated this all is.
    The various proposals for Obamacare that I’ve seen are going to be *much* more expensive than the rosy scenarios I’ve heard from it’s supporters. I can only see one real problem that it will fix (the uninsured) while I suspect it will actually make the others worse.
    The best article that I’ve seen (with actual proposed solutions!) is this long one here:

  3. Submitted by Al Juhnke on 08/28/2009 - 10:28 am.

    Wonder no more about Dems and their love of our country…I sat next to Rep. Collin Peterson at his Health Care Town Hall in Willmar two weeks ago. He started the meeting by leading the group in the Pledge of Allegiance.

  4. Submitted by Eileen Weber on 08/28/2009 - 10:43 am.

    As one of the two nurses holding the MLK quote banner outside, would you mind correcting your report on the banner from “Of all the forms of inequality and injustice — health care is the most shocking and inhumane” to what was actually on the banner (and what Dr. King actually said): “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” I think your dashes indicate you knew there was something not quite right in your report.

    For someone who listens when God speaks to her, it’s hard to believe Bachmann could be so misinformed about the truth of Wall Street-based health care, which can be found in Philip Longman’s book: “Best Care Anywhere: Why VA Health Care Is Better Than Yours.” Unlike most books on health care, it’s a quick, easy read and chronicles his experience as a conservative economist with private hc insurance whose wife got cancer and how they made the sad journey through the “best” of American health care until her death.

    To truly make American hc the best in the world, we have to remove the profit motive that runs through it and emphasize the truly world-class science and art of the many hc disciplines that deliver the various forms of care that comprise a bona fide system. Health care must answer to patients, not Wall Street.

  5. Submitted by Joe Johnson on 08/28/2009 - 10:49 am.

    Eric – Thank you for actually posting part of the Republican Health Plan. I think it is the first time for minnpost and it may even stop the Glean from continually saying the Republicans don’t have a plan. Nice post but to bad you fell for the fake M.D.

  6. Submitted by Greg Kapphahn on 08/28/2009 - 10:51 am.

    Perhaps the only way some of us come to realize that health care is something everyone should have is to have a crash in this country so devastating and complete that NO ONE can afford health care.

    “Experience keeps a dear school, but fools will learn in no other.” Benjamin Franklin

    Clearly the only way some of us will come to understand the truth of the Old Testament Prophets – that God judges people and nations on how they treat the poor and unfortunate (“widows and orphans”) is to find themselves orphaned and among the poor.

    This prophecy, of course, is not just true because the prophets said it, but even moreso because it’s the way human societies always work.

    There are several factors at play in every societal system.

    1) No matter the system, some individuals with the gifts to do so (different gifts in different eras and systems), will find a way to game that system, drawing to themselves far more of the society’s resources than their contribution to the system could ever justify. (Current examples are the entire Wall Street investment 401k retirement system and the salaries of CEO’s who, when accused of malfeasance swear, under oath, that they didn’t know anything about the operation of their own companies – and are likely telling the truth.)

    2) Since, at any given moment in time, the sum total of resources available in a society is finite, the fact that a few are able to draw more resources to themselves means that others have less.

    No society was ever built in which numbers 1 and 2 did not come into play. What saves or damns a society is how it deals with factors 1 and 2.

    3) When those with the gifts to accumulate resources share a portion of those resources with the rest who are less gifted, it allows for a society to be stable enough to flourish and last.

    (Contrary to the popular belief among some, there has never been a time in the history of humanity when such sharing, whether voluntary or by government mandate, was so egregiously taxing on those with the most that they ceased to express their inborn gifts to the good of that society.)

    4) When those with the gifts to accumulate resources do not share those resources with the rest who are less gifted, it has an inevitable, cumulative, destabilizing influence on that society – the rich get richer and the poor get poorer until eventually the poor have little to lose and nothing to give to seek to win better circumstances for their children and grandchildren but their own lives.

    5) Societies with sharing are stable and flexible, which encourages creativity, competition, and the risk taking required to support those things and respond to whatever natural or man-made crises that arise. They thrive and last.

    7) Societies without sharing are unstable and brittle. They eventually suppress competition (through too-big-to-fail corporate consolidation and monopolization). They also suppress creativity and risk taking, and move toward authoritarian government as the rich come to fear the more-and-more-restive poor. The quality of life, education and freedom of regular people deteriorates until they start a revolution (for which the rich who created this mess by making the mistake of not sharing always blame the poor).

    In the current debate, the reality is, if we do not learn to share and pool resources so that all of us have health care (and other basic needs), we will by our own stubborn ignorance of the realities of history, usher in the time when none of us have it.

    Are we the type of fools that refuse to learn in any school but the school of sad, sorry, difficult, painful experience? Time will tell.

  7. Submitted by Duke Powell on 08/28/2009 - 10:53 am.

    The basic foundation of what we should do to reform our health care system is to let a free market work in a free society. Allowing people to carry their pocketbook or wallet into a marketplace and purchase care based on quality and price is the single most important thing this nation could do to reign in spirialing costs. Let’s allow the market determine cost. We can argue about details and the appropriate government role but free-market is bedrock.

    As for access issues we first need to agree on the facts. The numbers for Minnesota closely mirror the numbers churned out by the Census Bureau. App.seventy-five percent of all uninsured in this state fall in two categories: Those who can afford insurance but choose not to purchase and those who qualify for one of our public programs but have not bothered to sign up.

    To hold these folks up as the reason we need health care reform seems a bit ridiculous.

  8. Submitted by Jon Erik Kingstad on 08/28/2009 - 11:32 am.

    I was at that Bachmann rally yesterday. Eric does a good and fair job of summarizing what went on.

    Mr. Powell’s argument tracks Bachmann and her foolish Health Care Freedom of Choice Act. I’d like to know where he gets the number of 75% of uninsured basically being uninsured because they don’t want to be covered. That’s a lie or a misinterpretation. Apparently Mr. Powell and other Bachmann sympathyzers have not been paying attention to the heart rending stories of the uninsured and the recently cancelled and denied or the thousands of bankrupts.

    Look, even Bachmann admits “market failure”. Even she admits there is rationing going on. But her proposal to rectify this actually makes this problem worse. Eric mentions “I wonder what this really means. Bachmann gives some more facts, but the only one I can understand is that insurance companies can offer policies in all 50 states. This (plus several other aspects that I couldn’t grasp but were very free markety) will create so much competition that you will have choices and you will pretty much find a plan that meets your needs and that you can afford. She mentions such options as high-deductible policies paired with health savings accounts (you own them!).”

    Bachmann falsely says that “there is a law which prevents insurance companies from operating across state lines.” The only law I can imagine she is referring to is the McCarran-Ferguson Act which does not forbid companies engaged in the “business of insurance” from operating across state lines but exempts insurance companies from antitrust prosecution if they are subject to state regulation. Does her bill propose lifting the antitrust exemption? Would she unleash the antitrust division of the Justice Department upon the private health insurance industry? I don’t see that in her bill.

    As the recent expose by the insurance insider on Bill Moyers show explained a few weeks ago, the reason insurance companies are raking in monopoly profits now is because they can exclude those with pre-existing conditions, deny claims and cancel those with claims they don’t want to pay. In short, improve the medical loss ratio for stockholders and corporate executives, like Bill McGuire. Bachmann’s bill would only make that worse, just like Bush’s privatization idea for Social Security would have made thins much worse for people who thought they might do better investing their life savings in the stock market.

    Bachmann’s bill is a red herring and a dishonest ploy to foment fear to defeat the President in his quest to bring a decent health care system to millions of people in this country. The rally yesterday was a disgrace. To call this rally an example of “participatory democracy” is the basest form of a lie.

  9. Submitted by myles spicer on 08/28/2009 - 11:51 am.

    It is astounding to me that America cannot get an effective health care system — the model is there in front of us in the form of dozens of the industrialized nations that provide sound universal health care for all their citizens. Further, these countries are universally FREE MARKET economies and have no compunction against some government involvement in the health care system (generally a single payer system).

    The tragedy here is between the money invested by the lobbyists, and the Republican’s tactic to obfuscate the issue, and the far rights’ bizarre and off the wall claims, America is left with an inferior, unaffordable, flawed health care system that is immoral and certainly not befitting a great country like ours. And…this condition has gone on too long, the time to make it better is now.

  10. Submitted by Ginny Martin on 08/28/2009 - 11:58 am.

    And those who have an empty pocketbook? Or those who pay and find out their insurance company won’t? Or who can’t get health insurance in the first place because of pre-existing condition?
    Health care is a right, and if we are to save this country from bankrupting itself and driving business out of business by paying for health insurance, we need serious reform that at the least includes public option.

  11. Submitted by Thomas Swift on 08/28/2009 - 12:10 pm.

    According to the Congressional Budget Office, only 21-31 million are uninsured for the whole year: the rest are uninsured for part of the year.

    According to a study from that well known right wing think tank, Standford University, 75% of the uninsured can afford insurance but choose not to spend the money.

    “Is health insurance affordable for the uninsured?”

  12. Submitted by Duke Powell on 08/28/2009 - 12:11 pm.

    Mr Kingstad asks where I came up with the fact that, “75% of uninsured basically being uninsured because they don’t want to be covered.”

    The answer is buried in the methodology of census bureau reports and, more explicitly, in a 2006 report to the Legislature by the MN Dept of Health.

  13. Submitted by Peder DeFor on 08/28/2009 - 12:12 pm.

    Gregg, I’m trying to figure out how your long post doesn’t simply mean ‘from each according to their abilities, to each according to their needs’. We really have had societies try to shape themselves by denying the profit motive. We really have! Even though those societies shared, they weren’t stable or creative. The results weren’t pretty.
    I don’t understand why anyone thinks that we can just wish away economics when it comes to something like health care. Life doesn’t work that way. You can decide that you don’t like the laws of supply and demand but it doesn’t matter. They’ll keep on going anyway.

  14. Submitted by Thomas Swift on 08/28/2009 - 12:55 pm.

    Miles Spicer offered: “It is astounding to me that America cannot get an effective health care system — the model is there in front of us in the form of dozens of the industrialized nations that provide sound universal health care for all their citizens.”

    Miles is 1/2 right. What is astounding to me is that scary smart liberals refuse to consider what those models say about a socialist medical system.

    Canada is just about ready to abandon it….

    19th August 2009

    “Baby boomers will “systematically and massively” turn to the private sector for health care unless the public system vastly improves, the outgoing head of the Canadian Medical Association warned yesterday.”

    “The warning from Dr. Robert Ouellet came as members at the CMA’s annual meeting voted 85% in favour of pressing government to look at market mechanisms — including a role for private enterprise — in delivering publicly funded health care.”

    “Refusing to make profound changes to the health-care system is tantamount to accepting its steady deterioration,” Ouellet told physicians gathered in Saskatoon.”

    Not only because it doesn’t work, but because they can’t afford it.

    17th August 2009

    “Despite all the fanfare in 2004 after the premiers adopted the 10-year plan to strengthen Canada’s health-care system, little has changed.”

    “Many jurisdictions are still woefully short of family doctors and the country need another 16,000 nurses.”

    “Canadians still rely on their own personal finances, or company benefit programs, to pay for their pharmaceuticals.”

    “Emergency rooms remain clogged.”

    “Patients are still waiting agonizing weeks for diagnostic scans to learn if they have cancer.”

    “Rural and northern communities are concerned about their access to services.”

    “We still lack an efficient electronic health records system.”

    “Yet we are continually spending more.”

    “According to Statistics Canada, the federal government, provinces and territories will spend a combined $121 billion on health care for Canadians this year, an increase of 28% since 2005.”

    What, exactly, do scary smart liberals see here that they want?

  15. Submitted by Bernice Vetsch on 08/28/2009 - 01:32 pm.

    (1) Peder D (#13). You seem to be assuming that Greg K. (#6) is advocating socialism when he talks about sharing. I think what he is talking about is explained nicely by Fred Block in an essay called “The Thing Economy and the Care Economy.”

    Block recognizes and praises capitalism (the Thing Economy) as the engine and source of wealth. He notes, however, as John Kenneth Galbraith and others before him, that those who benefit most from that wealth creation must recognize that society has made their success possible by providing the physical infrastructure; health care, the education of workers and their families; amenities like the arts, parks and recreational facilities that make life both decent and pleasant.

    All the things that the wealth created must support are components of the Care Economy without which none of us, rich or poor, can exist. Chief among them in the current discussion are the health care providers, hospitals and nursing homes that make it possible to raise healthy children, to maintain that health so as to be productive as adults, and to care for the elderly when they can no longer do for themselves.

    (2) There is regular fee-for-service traditional Medicare and there are Medicare Advantage programs like HMOs that receive slightly more Medicare funding than fee-for-service providers by providing more services for the elderly. And then there are PRIVATE-Fee-For-Service providers who get something like 17 percent more funding, not to provide more care but to lure healthy, younger seniors away from traditional Medicare into plans that provide things like gym membership. Funding to these private groups is probably what will be reduced.

    (3) Re: selling insurance across state lines. The various states have, over the past half century or so, gradually instituted mandates to prevent insurance companies from saying things like, “Oh, you must not have read your policy. We don’t cover cancer.” Companies cannot sell within a state without meeting that state’s mandates, but if they could sell everywhere the mandates might become meaningless. Bad for us, good for the companies’ bottom lines.

  16. Submitted by John E Iacono on 08/28/2009 - 02:42 pm.

    Greg says:
    “In the current debate, the reality is, if we do not learn to share and pool resources so that all of us have health care (and other basic needs), we will by our own stubborn ignorance of the realities of history, usher in the time when none of us have it.”

    I’m afraid I believe the argument presented ignores some significant distinctions.

    I have a friend, call him Bill. We both worked for many years.

    But I worked my way through college, while he got a girl pregnant and “had” to get married. I stayed home Friday nights, while he always went to a bar and spent half his paycheck.

    I bought a house, watched my purchases, and saved regularly. He lived paycheck to paycheck. He bought a house, but it went to his wife who left him over his drinking and constant anger.

    We are both retired now, and he has a pension and social security. I have social security and my investments.

    We both have some health issues, but he is on a dozen medications for his, while I take two, one of which is a generic. His medical expenses are much greater than mine.

    When someone suggests that I should “share” those investments with him, by gift or taxation, I am reminded of the little red hen and the grasshoppers.

    In sum, unqualified calls to “sharing” do not sit well with me.

  17. Submitted by Ginny Martin on 08/28/2009 - 02:45 pm.

    Boo! From a scary liberal!
    Fear rules.

  18. Submitted by Jon Erik Kingstad on 08/28/2009 - 03:08 pm.

    Thanks for the reply Mr. Powell. But it would be helpful if you could provide a more direct source or link.

    Like this link that rebuts the false reports of the imminent demise of the Canadian Medicate system being hysterically bandied about in the US debate:

    The “public option” is not my preferred option, which is single payer, a system that works quite well, with private insurance components in France, Germany, Switzerland, Norway, Sweden, and many other advanced industrialized countries. But the public option would offer citizens in this country an improvement and a real choice over the broken system we have for paying for health care. I’m very dubious about horror stories about health care in the UK, Canada or other countries. If these systems aren’t perfect, we have a long way to go before we have a right to criticize given 47 million uninsured and the price we pay for the health care we have.

    A lot of skeptics mock him because he is fat, but Michael Moore offered a very accurate, if not balanced, portrait of what other countries offer their citizens in health care in “Sicko.”

  19. Submitted by myles spicer on 08/28/2009 - 03:15 pm.

    Tom Swift’s comments are plain BS regarding the Canadian health care system. I do not know who Dr. Ouellet is or his politics, or the position of the Canadian Medical Assoc (sounds a bit like the AMA here). What is important is that the Candians REALLY LIKE THEIR SYSTEM, AND WOULD NOT TRADE IT FOR OURS! Note the recent poll below:

    “The Canadian Medical Association (CMA) is trying to persuade Canadians that their public health care system should be privatised, but a new poll conducted by the Toronto-based Nanos Research points to overwhelming support — 86.2 percent — for strengthening public health care rather than expanding for-profit services.
    “With more than 8 in 10 Canadians supporting public solutions to make public health care stronger, there is compelling evidence that Canadians across all demographics would prefer a public over a for-profit health care system,” said Nik Nanos, president of Nanos Research.
    Nanos Research was commissioned by the Canadian Health Coalition (CHC), a nonpartisan group that supports Canada’s public health system, to conduct a random telephone survey of 1,001 Canadians between April 25 and May 3”

    My own personal Canadian friends give me the same story over and over again.

    Regarding those who ELECT to remain without insurance, having everyone insured is a critical part of reform for two reasons. First, by mixing in younger folks, the actuarial costs are reduced for all. Additionally, while the young may not be as sick or need as much care…when you are prying a couple of young people out of their wrecked car to air evac them to the nearest trauma hospital, you better damn well hope they have insurance.

  20. Submitted by Rich Goldsmith on 08/28/2009 - 03:32 pm.

    I’m glad Mr. Kingstad mentioned the Scandinavian countries and their healthcare system. It’s a single payer system that has contributed to some of the best life expectancies in the world — exceeding those in the U.S. by 2 years or more.

  21. Submitted by Howard Miller on 08/28/2009 - 03:46 pm.

    Sometimes it seems that the differences between Democrats and Republicans boil down to a simple philosophical difference

    The speaker says freedom! Dems and Reps applaud

    The speaker says soldiers! Dems and Reps applaud

    The speaker says let’s help the less fortunate!

    Dems applaud

    Republicans murmur socialist but they’re really criticizing a core value of the ministry of Jesus … something along the lines of love your neighbor or something

    do not let it stand when a political leader claims it’s Gods will to block health care insurance for our neighbors currently without

  22. Submitted by Thomas Swift on 08/28/2009 - 03:47 pm.

    “It’s a single payer system that has contributed to some of the best life expectancies in the world — exceeding those in the U.S. by 2 years or more.”

    Remove accidental death from that stastic and you’ll turn it upside down.

    Americans are a pretty daring bunch…we jump off bridges tied to rubber bands, ride fast motorcycles, fly on big kites.

    Risk and danger often come with the freedom to do as you will.

  23. Submitted by Greg Kapphahn on 08/28/2009 - 04:07 pm.

    So… Jon, in your “hypothetical” straw men argument, you compare Jesus Christ to Satan and question why Jesus should be expected to help the devil.

    Let me lay it out for you. It is to the advantage of society if all the “devils” out there stay on their medications and have sufficient medical care to stay as healthy as possible (obviously Jesus doesn’t need help with such things).

    If the “Satans” do not do so, or do not have the resources available to do so, they end up at the emergency rooms of hospitals when they’ve fallen desperately ill and end up costing society a great deal more money.

    It’s strange to me that, in your example, “Jesus” clearly envies “Satan” because he thinks “Satan” seems to be getting something for nothing, but let me assure you that the Jesus of the Gospels would be helping to look after his old acquaintance, helping him stay healthy, and maybe even teaching him what he knows about how to do so, which I suspect your “Jesus” having become aware of “Satan’s” difficult situation, is being called by God to do and angrily refusing.

    Certainly Jesus would not be whining like an adolescent about how “it’s not fair!”

    Perhaps your “Jesus” needs to grow up.

  24. Submitted by Bogart Stewart on 08/28/2009 - 04:08 pm.

    Raised in a conservative christian republican home, like most kids I followed my parents belief system… which lead me to register and vote Republican for most of my adult life. But at the age of 34 and after just two years of G.W. Bush, I had had enough. Enough of Bush. Enough of the GOP. Enough of the lies. Enough of the fear-mongering. Enough of politicians inability to speak w/o the use of party talking points. Enough of the power grabbing from both sides. Enough of Washington bureaucrats in general. We live in a corporatocracy. Corporations own Washington, D.C. There’s no way they’ll ever allow a “government takeover”, but it helps them to have people like Bachmann, Limbaugh and the Glenn Beck’s of the world drumming up fear and panic with people who aren’t paying attention or get their news solely from Fox News. I barely trust the Dems more than the GOP to come up with a health care solution. No matter what happens, the insurance and pharma industries will be just fine. Unfortunately, the congressional halls are full of (insert whatever word you use for “whack jobs”) like Bachmann. So we’ll continue to get what we get as long as we continue to elect who we elect. We need to get rid of the clowns and find people who actually want to govern. The silver lining in this whole mess is that I don’t live in Bachmann’s district. Please vote her out. She’s an embarrassment.

  25. Submitted by Thomas Swift on 08/28/2009 - 04:27 pm.

    I provide links to a couple of very recent stories from Canadian newspapers quoting the head of the Canadian AMA.

    The scary smart rebuttal is an unsourced poll conducted by fans of socialized health care, and anectodal support by anonymous friends.


    Let’s try again.

    “..a Supreme Court ruling last June found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

    “The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services,” the court ruled.”

    This deserves repeating…”suffering and even dying on waiting lists”

    Does anyone care to rebut the Supreme Court of Canada?

    The socialized medical system in Canada denies, by law, the chance for people to save their own lives at any cost.

    They *had* to make a law…because the pubilc system couldn’t compete.

    When Canada forced an end to the private medical system, it also forced a collapse of the infrastructure and pipeline of new doctors and nurses.

    Now, you’re hard pressed to save the lives of yourself and your loved ones at any price….there is nothing left to buy.

  26. Submitted by Greg Kapphahn on 08/28/2009 - 04:45 pm.

    Ah… Sorry Jon! Wrong John.

  27. Submitted by John Roach on 08/28/2009 - 05:18 pm.

    As usual, Mr. Swift is working hard to forward some of the distorted right wing memes in the health debate.

    Dr. Ouellet has always made his comments about Canadian health care within the context of a universal health care delivery system. He has worked hard to find ways to improve that universal system. He has taken ideas from five different European countries to this end.

    He considers nothing about the US system to be worth considering for Canada. This is from his farewell address just a few days ago:

    “Our idea that wait times should not be the price to pay for universal care has made inroads. The same holds true for the idea that changes are possible to the system without compromising that same universality.”

    The Canadian system has nothing to do with what is being considered in this country, but the right distorts and misrepresents its problems and then insinuates that this is what we will have. They do this because they cannot argue the facts.

    Mr. Swift continues with a claim that US life expectancy numbers are improperly used as a comparison when our rates of accidental death are so much higher than everyone else’s. This is false. I debunk it here:

  28. Submitted by Thomas Swift on 08/28/2009 - 07:50 pm.

    If anyone thinks it a bit fishy that fans of ObamaCare seem prone to base their arguments on unsubstantiated statements, anecdotal stories attributed to anonymous sources and unsourced quotations, you’re not alone.

    For instance, in the most recent attempt to rebut the factual truth, we see a quote attributed to outgoing CMA director Dr. Ouellet.

    We’re assured that “He considers nothing about the US system to be worth considering for Canada.”

    The problem is that the statement and quote are just out there hanging in mid air; let me provide a tether:

    Here’s the quote in context:

    “Almost everywhere, stakeholders have joined in spreading the message, convinced that the current situation is unacceptable and that it needs to be changed. All were convinced that:

    * waiting 15 hours in an emergency room is unacceptable
    * waiting 4 hours in a doctor’s office just to renew a prescription is unacceptable
    * waiting 6 months or more for a hip replacement is unacceptable.

    In short, the past year has been a success in raising awareness among our stakeholders and I’m proud of the work that we have done. Elected officials are now more open to the changes that we are proposing. The media, which in the past were so critical, are increasingly being won over to our point of view. And Canadians are also becoming more and more receptive to the need for change.

    Finally, our idea that wait times should not be the price to pay for universal health care has made inroads. The same holds true for the idea that changes are possible to the system without compromising that universality.”

    The US medical system is not mentioned in any context, anywhere in the speech, in case you’re wondering…..

    So, after 47 years, the Canadian socialized medical system has finally realized that waiting in an emergency room for 15 hours just won’t do, eh?…and they’re starting to make inroads.

    Best of all, the Canadian Supreme Court has ruled that the state can’t force you to die waiting for your universal health care. Sweet!

    Those Canadians are pretty crafty, I’m guessing they’ll have those wait times down to 10 hours in five or six years.

    Finally, I have to admit that as a “debunking”, “You’re wrong” leaves me a bit unimpressed. But then again I’m not a scary smart liberal. *Shrug*

  29. Submitted by Jon Erik Kingstad on 08/28/2009 - 10:26 pm.

    Mr. Swift: on people representing themselves as “doctor”, be advised that Michele Bachmann represented herself as “Dr. Michele Bachmann” first in 1999 on a Maple River Coalition released tape on children and education and again at a 2004 American Legislative Exchange Council (ALEC) conference on the Defense of Marriage Act (DOMA) and other times I haven’t heard of. Bachmann has a “juris doctor” degree like me. I don’t tell people I’m a doctor. Please don’t try to lecture us about people misrepresenting themselves as “doctors.”

    On the Canadian Supreme Court decision, I wouldn’t argue with the Canadian Supreme Court about whether the Quebec health Insurance Act unfairly and unlawfully prevents people from buying private health insurance. But where is that an issue with HR 3200?? Bachmann’s scare literature which I picked up at her “town forum” yesterday, criticizes the “Democrat plan” for putting insurance companies out of business because it is too cheap!! Bachmann tries to claim that HR 3200 “prevents people from buying private insurance” and she points to p. 19 of the bill. I looked at what she said and can challenge you to explaining to me where it says that. What it says is: “individual health insurance coverage that is not grandfathered under subsection (a) may only be offered or after the first day of Y1 as an Exchange participating health benefits plan.” That only means private options have to be approved, not that they are forbidden.

  30. Submitted by John Roach on 08/28/2009 - 11:02 pm.

    Mr. Swift,

    I understand that being publicly wrong is difficult for you, and as a result you focus on that rather than on why you are wrong, which has been explained in detail many times. Dr. Ouellet also says this about the US health care reform effort:

    “It’s good to have someone like President Obama who wants to fix things.”

    Dr. Ouellet understands what you apparently do not; that the Canadian system can be better, but it also does the job it is supposed to do; unlike our current system in the US. Another of his quotes:

    “To say that the system is a complete failure is not fair. When people go to the hospital they get good quality medical care. … People are not dying on the street.” —-Which does in fact happen in the US every day.

    And once again, the US is not considering a Canadian system or anything even close to it, so when the right keeps bringing it up it is a meaningless distraction. Is that why you also keep bringing it up?

    It is also evident that mathematical arguments are not something you are good at. I will try to simplify it for you:

    Sam has six apples. Claude has four apples. If Sam loses two apples and Claude loses one apple, how many apples does Sam have? How many apples does Claude have? (Hint: Any answer that says Claude now has more than four apples is wrong, even if it is published by a right wing think tank.)

    Have a nice weekend.

  31. Submitted by Peder DeFor on 08/29/2009 - 06:19 am.

    Bernice, the idea that the wealthy should pay more for society isn’t a new one. My question to you is whether there is a limit to that support or not? The top ten percent pay an overwhelming amount of federal taxes. At some point there is an opposite effect where poorer segments are cut from feeling any financial trade off from more and increasingly large public works. I think we’re closer to the former spot.
    And to all of the grand pronouncements about how much society must share/whether health care can be profit based/etc., please read some history. We actually had a free market health care system before the Great Society. Regular people could afford things like giving birth or using a hospital room overnight.
    And (you can look this up) we actually had a society before we decided that the rich must provide parks, arts and health care for the unfortunate. It really did happen.

  32. Submitted by Bernice Vetsch on 08/29/2009 - 03:36 pm.

    Peder (#32). The question is not whether the rich, in aggregate, pay more than the poor in aggregate, but whether everyone pays an amount in proportion to their income in support of the common good.

    The rich do not by themselves finance the common good. We all do, even the poorest of us, by paying not just income taxes but property taxes (on owned property or as part of rent), sales taxes, taxes on gasoline and phone bills and utilities.

    In Minnesota, the middle class pays over 11 percent in various state taxes, including income tax, while the wealthy pay only about 9 percent. So who really pays more to support our state? Yes, the middle class. Fair? No.

  33. Submitted by Peder DeFor on 08/29/2009 - 06:12 pm.

    Bernice, if you want to go to some kind of flat tax, I’m fine with that. The current situation where a continually smaller percentage of people actually pay federal taxes is a bad one. It disconnects large segments of society from understanding that federal programs have trade offs. We’re getting seriously into bread and circuses territory.

  34. Submitted by Ann Richards on 08/30/2009 - 12:12 am.

    I want to take issue with a point the Representative made about health care…..that we should have all the choices we want…that has contributed to the mess we are in….we have more CAT scans, more hysterectomies, C sections, and more invasive surgery at end of life than the other industrialized countries. It drives up the cost but does not add to outcome of quality of life. We need to look at best practices, but the right has distorted this into rationed care and Sen Grassley’s comment ‘pulling the plug on Grandma.’ When my husband was dying and in a nursing home for his last few weeks, he was required to have a dental exam, physical therapy, and other things I was able to successfully object to, only because I was right there. I had good insurance, but those procedures and services were not necessary and would not have been available if we used ‘best practices.’ Americans are very poor consumers when it comes to health care. My friends in Germany say we are not smart enough to solve our health care crisis because we don’t have a mindset to limit our needs. When I see how many here are triggering their own diseases by lifestyle choices, I have to wonder…

  35. Submitted by Richard Schulze on 08/30/2009 - 03:01 pm.

    Dr. Robert Ouelett, Former. Pres., Canadian Medical Association was on c-span’s Washington Journal this morning.

    I have to say that Dr. Oeulett does not at all come across as Mr. Swift is characterizing him on this subject. Quite the contrary actually.

    Mr. Roach by all measures does a much better job truthfully characterizing Dr. Oeulett’s message and statements regarding Canadian health care as well as our health care debate in America.

    Clearly Dr. Oeulett has a message that differs from Mr. Swift’s dogma and ideology. Which is not to excuse Mr. Swift from presenting Dr. Quelett’s statements accurately. The to this program is below:

  36. Submitted by Thomas Swift on 08/31/2009 - 09:48 am.

    I saw the C-Span interview as well. It was very informative.

    Dr. Oeulett did indeed go to great lengths to defend Canadian socialized medicine (he assured the audience that Canadians weren’t dropping dead in the streets), but to his credit, he wasn’t willing to whitewash the obvious, and well documented failures of the system.

    Readers can follow Richard’s link and come to their own conclusions, but what I took away was that in order to provide “universal” coverage, the Canadians elected to accept high taxes, lengthy wait times and limited services in rural areas.

    In other words, they exchanged one set of problems for another and added government control on top, with everything that brings with it.

    Oh, and for folks that hate wealthy people; you should know that Dr. Oeulett admitted that people with money often grease the skids and “jump the queue”, and that special agencies have sprung up to hook Canadians up with US medical services…for a fee.

  37. Submitted by Richard Schulze on 08/31/2009 - 05:19 pm.

    I have to give you credit M. Swift, you still spin the outcome. Although you did suggest that individuals see for themselves. For that a “tip of the hat”

  38. Submitted by Colin Lee on 09/02/2009 - 03:20 pm.

    I’m going to respond to all the right-wingers here in the words of governor Tim Pawlenty when the FDA asked him to stop importing Canadian drugs, “Show me the dead Canadians!” Studies show that the preventable mortality rate in American hospitals is higher because Americans skip necessary care when they’re unsure how important it is.

    We pay over twice the cost per person that every industrialized country on Earth pays for single payer healthcare for all citizens. 60% of that is government money. Doesn’t that make our status quo the most socialist health care system on Earth? And Michelle is right about one thing– it IS bankrupting our citizens and our companies.

    The problem with eliminating mandates and selling across borders is that the Republican model states which have the fewest mandates also have the most expensive health care in the country. Consumer-directed plans like Michelle proposes result in much higher uncompensated costs because fewer procedures are covered and more consumers go bankrupt even with insurance.

    Duke Powell says 75% of the uninsured don’t want to be insured. The right wing U.S. Chamber of Commerce (which gave $10.5K to Norm Coleman) says 60% of the uninsured are that way because they work for small businesses that don’t provide health coverage and while these folks may be able to afford high deductible policies, those policies only waste money.

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