Front lines of healthcare battle

On Monday, San Jose saw what may have been its first and last healthcare town hall of the 2009 congressional recess. Rep. Zoe Lofgren (D-San Jose) came to Almaden in south San Jose, the GOP pocket in her safely Democrat district. As far as I know, the appearance was announced only via email and word-of-mouth. This is the email I saw

Almaden Valley Community Association
Informed Citizens Organized for Constructive Action

Our speaker has requested 7:00 to 7:45. Please be on time.
Monday, August 10th
7:00 to 9:00 PM

Speaker: Zoe Lofgren

Subject: Questions & Answers

Location: Almaden Community Center
6445 Camden Avenue, San Jose 95120

At 6:40, the hall was at its 200 rated capacity and the doors were closed, but as the 100 people left outside became increasingly restless, the doors were re-opened for standing room under the watchful eyes of four SJPD officers.

Rep. Lofgren’s 10 minute opening statement mentioned energy policy (although not “cap and trade” by name), paygo, and her hopes for immigration reform, clearly the House’s plan for health care reform was what brought out the huge crowd — almost 1% of the community.

It’s not clear why she bothered, since as a reliable social liberal it was clear the seven-term incumbent was not interested in considering changes to her strong support for HR 3200. The noisy audience was similarly unpersuaded.

Still several speakers (as I would) praised her for holding a town hall at a time when many of her Democrat colleagues are running from similar (“un-American”) confrontations. In fact, Sunday’s Mercury News flatly (and incorrectly) predicted no face to face meetings by Lofgren or her two Democrat colleagues, Reps. Mike Honda and Ann Eshoo, even though Honda “held four live town-hall meetings during the August recess in 2007.”

Based on applause, the audience seemed to be about 75% opposed to the health care plan. (The rest were either for it or being quiet). Some of the big applause lines were:

• against healthcare for illegal aliens
• expansion of government control
• Congress should fix Medicare and Social Security first before launching into healthcare reform
• eliminating existing plans (which Lofgren argued was to require plans to expand benefits to cover existing conditions and cap total payments).

The crowd showed derision for many of the Congresswoman’s arguments, especially the assertion that US healthcare was inferior to other countries. Although the crowd was angry and sometimes rude, it was never “violent.” It was clearly a room full of people with their own strongly held beliefs rather than “radical fringe Astroturf”.

The biggest applause, however, came with the question that (roughly) asked:

Since 85% Americans are happy with their health insurance why don’t you just change healthcare for the 45 million uninsured and leave the rest of us alone?

It was quite clear that the room was divided between those who most trust their doctor, and those who trust the government to protect them from their doctor (or insurance company or employer or …).

In fact, this is the stark divide between Americans for and against the House plan, as demonstrated by the July 21-22 Fox News poll. In the poll, Republicans demonstrated an unshakable trust in the existing system while Democrats and independents aren’t sure:

If you were sick or seriously ill, would you rather be in a government-run health care system or the current privately-run health care system?

	Government-run	Privately-run	(Either)	(Don’t know)
everyone	19%	64%	8%	9%
Democrats	32%	45%	11%	13%
Republicans	4%	90%	2%	3%
Independents	20%	59%	12%	10%

I didn’t get a chance to ask my question, but here’s what I was going to ask.

Currently about 81 million of 308 million Americans are on government run healthcare. If (as you said tonight) the goal is to reduce the uninsured to about 5%, that would mean that government-run healthcare would increase about 42% to 115 million Americans.

Right now, the federal government pays on average (as best I can tell) 25-30% below market rates, thus forcing each American with private health insurance to subsidize the government by $440 a year.

How will we keep our existing health providers if they are expected to subsidize an increasing proportion of money-losing government-funded patients? And how will private health insurance compete with the government option which is paying below market rates?