Ill Will

Congresswoman Gabrielle Giffords brought a secret weapon to her
health-care town hall in Sierra Vista on Monday night (Aug. 31):
Richard Carmona, the Tucson doctor who served as surgeon general in the
Bush administration.

It was Carmona who made the case for reform at the start of the
meeting, telling the capacity crowd of 1,300 concerned citizens that
health-care costs were rising out of control, and that an estimated 50
million Americans lacked health insurance.

“Most of them are working poor,” Carmona said, “not as they’ve been
characterized as deadbeats. Most of them are working poor who are
struggling every day just to put bread on the table and keep their
houses and keep their kids in school.”

Carmona concluded with a call for civility at the town-hall
meeting.

“I’ve been around the country with other elected officials and
watched the debates,” Carmona said, “and I’m hurt by how often they
degrade into shouting matches.”

The crowd responded with a loud chorus of boos, with one man
yelling: “You’re the only one talking!”

Some rowdy behavior continued through the meeting—a pair of
girls in a back corner booed and screamed “liar!” nearly every time
Giffords had anything to say—but the crowd appeared split between
those who supported reform and those who were opposed.

Giffords said at the start of the meeting that she had not sponsored
health-care legislation and didn’t sit on any of the committees that
were hearing the bills, but that she was there to listen to what her
constituents had to say.

Speakers, who were chosen by a random drawing, alternatively argued
for reform of a failing system and against government expansion.

Many of those opposed to the Democratic proposals for health-care
reform expressed skepticism about the ability of government to handle
anything.

Jake Kimball, a registered independent who said he had mixed
feelings about Giffords’ voting record, said he’d rather see costs
brought down through tort reform and the deregulation of insurance
companies so they could do business across state lines.

“It has been my experience that the federal government is
unbelievably inadequate in taking care of business,” said Kimball, who
sat through about 90 minutes of the two-hour town hall before getting
up to leave. The meeting did little to change his mind about
health-care reform.

“It needs a hell of a lot of work before it ever comes out of
committee,” he said.

Roberta Atlas, 70, said she understood that some kind of reform was
necessary.

“Definitely some tweaking needs to be done,” Atlas said. “But why
throw the baby out with the bathwater?”

Atlas, who said she was happy with her Medicare coverage, added that
she was concerned that giving more people health-insurance coverage
would lead to cuts in what she receives. She was particularly opposed
to a single-payer system that would insure all Americans through the
government.

Giffords herself opposes a single-payer system. She supports a
“public option,” which would create a government-run insurance program
that would compete with private insurers.

As envisioned in HR 3200, the major health-care reform legislation
moving through Congress, the government would create a new Health
Insurance Exchange where insurance companies would offer to sell
coverage to people who can’t get insurance through their employers and
who aren’t already covered by Medicare or Medicaid. In competition with
private insurers, the government would offer health-care coverage
policies that people could buy, according to OpenCongress (www.opencongress.org), a Web-based
resource that tracks legislation.

As polling pundit Nate Silver pointed out last week at fivethirtyeight.com, support for the
public option has ranged from a low of 35 percent to a high of 83 in
various polls, with the result often dependent on how the public option
was described.

Silver concludes that much of the public is confused by what a
public option actually entails, although he notes that supporters of
the public option “should have little to fret about; the most neutrally
and accurately worded polls on the public option … suggest that their
position is in the majority, with 56-62 percent of the public
supporting the public option, and 33-36 percent opposed.”

Giffords says she “strongly supports” such a public option, as does
Congressman Raul Grijalva. (Grijalva has gone so far as to say he would
oppose any reform that doesn’t include a public option; he considers
this a compromise from his preferred policy of a single-payer
system.)

Critics of the public option say that it will put private insurers
out of business, because a government program will undercut private
businesses, which will lead to a single-payer system that will provide
substandard health care.

Carmona, however, argued at the start of the meeting that the United
States needed to reform the current system to get costs under
control.

“The legacy we will leave our children and our grandchildren is
unsustainable unless, at this critical juncture in our history, we take
some bold steps to make the system more responsive to your needs,” he
said.

This article appears in Sep 3-9, 2009.