What a concept. There was a health-care conversation held Tuesday evening, without chants and banners and tumult and shouting.
During what was billed as a “teletownhall” meeting, U.S. Rep. Tim Walz and Kathleen Sebelius, the secretary of Health and Human Services, were able to field some aggressive questions but still calmly sell the notion that the nation needs substantive health care reform. They also made it clear that the next few months will only mark the start.
One other point was constantly made during the hour-long session in which callers from Minnesota’s 1st Congressional District asked questions of Walz, who was in Mankato, and Sebelius, who was in Washington.
“We cannot afford to do nothing,” Walz repeatedly said.
Sebelius back-pedals on abandoning ‘public option’
During the session, Sebelius seemed to back away from the headline-making comments she made on Sunday morning news shows when she suggested that the public-option plan that President Obama has been supporting might be supplanted by some sort of non-profit setup.
“Unfortunately, Sunday must have been a slow news day,” Sebelius said. “I basically said what I’ve said for months. The key principles are giving customers a choice and creating competition that keeps costs down. … The president and I continue to believe that a public option is the best way to hold down costs.”
The format — in which the people and the pols were separated by a phone line — seemed to breathe life into the idea that substantive reform actually can happen. In this civil format — one person asking a question, another person answering it — we in the media couldn’t write the easy story about people yelling at officials.
Certainly, there were hard questions. Angry ones, too.
A man identifying himself as Jonathan, from Rochester, expressed a question favored by the reform naysayers.
“Under this [public option] plan, will coverage be extended to people who are in the country illegally?”
But, unlike the town-hall forums where questions such as this are accompanied by angry chants, there was only a quick response from Sebelius.
“Both the House and Senate bills make it clear that there is no coverage for anyone not in the country legally,” she said.
Another of the questions that usually is accompanied by jeers and hollers from the anti-reform crowd came from a man who identified himself as Dave of Fairmont.
“If this plan is so good, why not require members of Congress to use it?” he asked Walz. “Will you [Walz] pledge to use this plan?”
“Absolutely,” said Walz, who went on to explain that as a member of the House he currently chooses a Blue Cross/Blue Shield family plan that costs him $356 a month, plus 25 percent of the costs of medications.
The best health plan he ever had, Walz said, was when he was on active duty as a member of the National Guard. Health insurance plans for those on active duty and veterans, he said, are only getting better.
Several times during the session, Walz bemoaned “the amount of disinformation” that’s being labeled as fact. Even the Congressional Budget Office’s study, which showed that reform as initially proposed would cost $10 trillion over the next 10 years, lacked context, Walz said.
“The Congressional Budget Office assumes that if we do nothing, there is no cost increase,” Walz said. And that’s not even close to an accurate picture of reality, both Walz and Sebelius said.
Without screams, a dose of reality
Absent the screaming, the two pols were able to bring the health care discussion back to reality.
Since 2000, Sebelius said, health care premiums for Minnesotans have gone up 90 percent. Young women pay more than men of the same age, because insurance companies are trying to duck the costs of pregnancies. Those who have been sick often can’t get insurance.
And, she said, one of the biggest problems is that under the current system, the cost of health insurance has gone so high that many small businesses no longer can afford to insure their employees.
“At one time, 63 percent of the mom-and-pop shops provided coverage,” Sebelius said. “We’re down to 40 percent now, and it’s dropping every day. It’s not because they don’t want to cover their employees; they can’t afford to. You either pay the mortgage or provide coverage.”
Every day, Sebelius said, small-business owners lose talented employees, “because they go down the street to work someplace where insurance is provided.”
The plight of small businesses, she said, is “a huge part of why reform is so necessary.”
It should be noted that the edgy questions were not only from the right side of the spectrum. There were also those wondering about why the president and Congress were aiming so low.
Carl, from Eagle Lake, wondered why the president and Congress don’t simplify everything and “allow everybody into the Medicare pool?”
“I know that idea,” Sebelius said, suggesting that it had been discussed in the administration. “But no one [in the administration] wanted to dismantle the current employee-based system.”
A woman from Caledonia wondered why there was such a big spot at the reform table for the insurance monopolies that have profited so mightily under the current system.
“We’re trying to find a solution,” said Walz. “I would not characterize that as giving in. If there are ways to improve the system, we want to hear it. It’s not caving in, it’s working to find solutions. But I’m not so naïve as to say that they [the insurance companies] don’t want the same profits at the end of the day.”
Sebelius made it clear that there WILL be reforms from the current system. Before this round of reform is complete, the industry no longer will be able to eliminate people with pre-existing conditions. Other cost-containments also will be created, she predicted.
Those goals sounded awfully modest, like someone trying to lower expectations.
But she also had a message for the naysayers in Congress.
“A few weeks ago, we had the 44th anniversary of Medicare,” she said. “Medicare change the lives of people in this country forever. When you look back at that vote, Medicare only passed by 45 votes, which shows that change is always tough. But now, if you tried to get rid of it, Republicans and Democrats would be up in arms. Now, we have an opportunity to have that same security for all Americans.”
And so the discussion went. There may have been people on phone lines across the 1st District screaming, “Socialism!” but for this hour, their voices could not be heard.
Doug Grow writes about public affairs, state politics and other topics. He can be reached at dgrow [at] minnpost [dot] com.