Rep. Allen Boyd, a Blue Dog Democrat whose district re-elected him while also favoring John McCain in 2008, came to Live Oak, FL, on Wednesday, August 12, 2009, for a town hall meeting on the pending health care legislation. The venue was changed the day before the meeting, reportedly in anticipation of a large crowd, but even so only about 150 of the approximate 500 people who turned out could fit in the City Hall meeting room. More stood in the lobby area, listening on loudspeakers, while even more stood outside, unable to hear at all. With the doors to the lobby open and so many people inside, the indoor temperature rose to what one police officer said must be over 100 degrees, but very few people left. This crowd, whose sentiment was decidedly against the pending legislation, constituted approximately 7% of Live Oak’s entire population, indicating the level of interest in the community. The meeting took place at 1:30 on a week-day afternoon, so most had to take time off from work to attend. About 20 or 25 minutes or so into the 80-minute event, I began counting the number of times Rep. Boyd shushed the crowd after it became very obvious that he felt forced to do a lot of shushing. I counted 41 times, even though I counted his “Sh-sh-sh-sh’s” as only one “Sh.”
I may have missed the first minute or two of Rep. Boyd’s remarks, as I worked my way into the lobby. He began with a sort of stump speech in which he said that Live Oak had gained $7.4 million from the stimulus bill through a $5.5 million loan and $1.8 million to stabilize funding in education. Moving on to health care, he said that problems with our current health care system include cost, access, loss of coverage, and inefficiency. Because people are forced to drop expensive insurance coverage, we all pay the cost when they utilize emergency rooms for primary care. He went on to say that denial of coverage for pre-existing conditions and rises in insurance premiums above inflation are also problems, contributing to the national debt and resulting in 46 million uninsured, threatening the long-term economic stability of the U.S.
He said that good, responsible health care reform would include the following four principles:
1) Wring out savings in the current system; stabilize or lower insurance premiums
2) Ensure patient choice; allow people to keep their current plans
3) Improve access to coverage for the uninsured
4) Be paid for, not adding to the deficit.
He said that there are five bills pending in Congress and that he could not vote for H.R. 3200, the bill he said most of the audience was likely concerned with, as it is currently written.
He then opened the floor to questions and answers. I likely missed some of the early discussion as a search was made for a microphone for the audience so that those in the lobby could hear the questioners and not just Rep. Boyd. In the opinions of those around me and of those I overheard in the grocery later that day and of others who were quoted in local news stories about the meeting, Rep. Boyd didn’t really answer any of the questions posed to him.
One questioner said that FEHBP, the health insurance program for government employees, including legislators, should simply be opened to everyone. Rep. Boyd responded by describing FEHBP (a ‘menu’ of private insurance options from which the employee can choose, based on desired coverage and expense).
One woman, who made a point of describing herself as a local Live Oak woman who was not paid or asked to be there by anyone else, read her comments and questions, likely in order to be sure not to stumble over her words or leave out part of what she wanted to say; they sounded like her own words to me. Her questions included whether he would support exclusion of abortion coverage and support forcing members of Congress to participate in any public option. In his somewhat snarky response, he thanked her for focusing on deficits, said that he will try to get a bill that will improve our lives, and thanked her for reading a statement.
In reply to another question from someone concerned with prevention of chronic illness, he expressed concern that health care as a proportion of GDP has risen from 8-9% 15-20 years ago to 17% today. A man standing near me commented that medicine has much more capability now than it did 15-20 years ago, so of course it will cost more. (As an aside, someone I know has been diagnosed with an illness that can be treated with transfusions of medicine that cost $2,000 per week. Some treatments are indeed costly in money, but the alternative is to be costly in lives.) My thought while listening to Rep. Boyd cite these statistics was about how adding millions of now-aging baby boomers to the patient rolls impacts health care spending. Neither of these situations, costly but effective new treatments and demographics, are amenable to legislative solutions. In his response, Rep. Boyd also said that there is a long way to go in the legislative process and that he’s trying to listen to us and get it right.
A person said that about 80% of the uninsured are eligible for existing programs, such as Medicaid, so there isn’t really a need for a restructuring of our health care system.
Another quoted from H.R. 3200 about the 27-member board that would be created that would control benefits and urged not re-wording the bill but killing it (cheers all around).
To a question that couldn’t be heard in the lobby, Rep. Boyd replied that illegal immigrants will not be covered in any legislation (jeers from the audience).
A woman said that no politician has yet told her who will pay for the cost of this bill and that she can’t pay any more in taxes. Rep. Boyd said that deficit spending is resulting in borrowing from the Chinese; that her generation will end up paying; and that “we’ll try to stop it.”
One person came from Tallahassee, part of the district but not close enough to make sense attending this particular town hall, to say that she supports a single-payer system. Rep. Boyd responded that there is no single-payer plan on the table; that there are advantages and disadvantages to single payer; and that we should take the good parts of the current system and current health plans to stop the rise in costs. He then paused to ask people to show respect and not shout or interrupt.
A woman said that welfare and Medicaid fraud should be fixed and that when she thinks of government she thinks of the aftermath of Hurricane Katrina, including the corruption that made the government-built levees; nothing but the privately-built and –run oil wells worked in the aftermath. She also advocated tort reform. His response was that we should wring out waste from the current system and work on tort reform.
A woman asked where the money is coming from for this legislation; he said our money is going to prosecute the war and mentioned that China is borrowing our money to fund spending, which he doesn’t support.
Asked why the financial and auto bailouts bills and now this one have to be rushed through while the President took 6 months to decide on what dog to get as a pet, Rep. Boyd said that we have to understand the facts and do better.
A man who worked in the health care industry on medical devices pointed out that development of pulse oximetry (a real-time way to test for oxygen in the blood) so decreased poor outcomes in surgery that malpractice rates for anesthesiologists dropped dramatically after its development. He also said that Britain employs 1.4 million health care workers for its National Health program even though it has a small population, and its death rates are higher. The U.S. population is aging and revenue dropped last year; how will we fund this legislation for even 10 years? Rep. Boyd responded that it should be deficit-neutral, a principle he has used throughout his career. He said the Blue Dogs asked CBO and others to draw up a list of items to cut costs in the current system, but he’s not sure if the country is willing to step up with additional revenue.
A couple of people suggested opening up state borders for health insurance; one said we could give money directly to the uninsured and it would cost a fraction of what the pending legislation is expected to cost.
A woman said we have the best health care in the world, why revamp it when the problem is with insurance costs and not health care providers? Rep. Boyd said she hit the nail on the head, that 46 million people can’t get health insurance and the cost of premiums is a problem; defensive medicine, tort reform.
Asked whether he believed health care is an entitlement, Rep. Boyd seemed to want to act as if he didn’t quite understand the question. He then went on to talk about how we can’t compete in the world with an unhealthy population and that if we don’t solve this problem young people won’t have the same place in the world as the questioner does. He went on to say that arbitrary timelines aren’t important, that we’ve got to get the legislation right. The Blue Dogs kept the bill from reaching the House floor before the recess. (Jeers).
Exeunt.
For other coverage of this event, see http://www.suwanneedemocrat.com/.
Fla Mom
