August 20, 2009

The Last of the Hot Summer Town Halls: How We've All Been Fooled By The Health Care Debate

The only thing that should be more boring than attending a town hall meeting on health care is reading about somebody attending a town hall meeting on health care. At best, town hall meetings are preposterous theater. Elected officials stand before the sort of people who have time to be at an event at 1:30 p.m. on a weekday. For one hour they are hit with all-encompassing philosophical questions about incredibly complex issues. In return, the candidates answer the question they wanted to be asked.

injury

Evidencing the bullshit of these events is the fact that, Rick Gion, Dorgan's very nice communications coordinator, handed me a press release that comprehensively summed up the event, in the past tense, before the event began. There are even specific quotes from the senator and everything: "'This water project is an investment in the future of Trail Country, because clean, safe, drinking water spurs development…,' said Dorgan."

And yet, here you are, reading this. Why?

Footage of riotous behavior and gun-toting, death-declaring nincompoops at town halls is in heavy rotation. It doesn't matter what side you're on because it all feeds the beast. Kill the bill, the media wins. Pass it, the media wins. Dorgan's opening line tries to shame us into keeping it that way: "Who does this stuff?" After a pause, Dorgan drills it: "Not the North Dakotans I know."

The mic got passed. The topics were almost exclusively health care. The outliers were a church leader who asks for help getting visas for African women wanting education (Ha! Loser!) and several cap and trade tax opponents. The main concerns about health care reform are illegal immigration, covering abortion, "death panels," euthanasia, paying for "it," why the hell the thing has to be 1,000 pages long, and why it's all happening so fast ("It should take longer than it took for Obama to choose a dog" is said several times).

Senator Dorgan didn't know who this "Ezekiel Emmanuel" guy is. I recognized several people from the tea party a few days earlier.

By in large, there was no yelling or spittle or "Sic semper tyrannises." A few people boo. Everyone generally cheered for stuff they support (i.e. no funding for abortion). Nobody drowned anyone else out. It's ratings poison civility. Far more reporters were here than usual town hall events. And in the one or two instances when it looked like somebody was about to go off the rails, I could hear their puckered sphincters clench with excitement. In Casselton, the stop Dorgan made before I saw him in Mayville, there was a little more hullabaloo. The Forum, the local news organ, immediately ran a headline claiming the crowd was "yelling and screaming." After (justifiable) complaints from the right and video proof, it was changed (with no note) to "gets vocal."

Mayville

Many concerned enough about heath care to show up for these things aren't very healthy looking. And despite all the "we" language thrown around, there appears to be no intention for "the people" to pony up anything in this overhaul. Demands are made on insurers, government, hospitals, physicians and other disembodied players; but nobody seems to point out that diabetes is the fastest growing affliction in the nation with diabetics accounting for one third of all Medicare expenses—even though a half-hour walk five days a week would cut diabetes by 40 percent. Elgin, the largest (in terms of human waistband size!) city in Illinois, where 50% of school children are obese, has not seen a single grant request to spend the $48,000 it offered for individual health programs.

Yet tort reform is a top concern. "We have to put a cap on these frivolous lawsuits," cautioned one man in Mayville. Of the $2.5 trillion spent on healthcare annually, less than 2 percent is malpractice premiums or malpractice payouts.

 
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33 Comments / Post a new comment

  1. HiredGoons [#603]

    Pleats are morally suspect, yes.

  2. DorothyMantooth [#69]

    This was really, really good, Abe.

  3. KenWheaton [#401]

    Another good piece. Liked it so much I even Tweeted it. Though as it's missing the usual shouting points, I don't know that the shouting shouters to my right or left will get past page one.

    Now, would you please buy my new line of t-shirts. On the front, they read "Ken Wheaton: One-Man Death Panel" On the back, they read, "I'm the Decider."

    For a small fee, the shirt can be customized with your name.

  4. SarahHeartburn [#70]

    Shoot me, please. I've said this time and again on Gawker, Jez, Wordsmoker, Buttercup, The NY Times, Salon,Slate, your grandmother's sideboard….oh hell.

    If America's reputation wasn't already eroded/rotted/clotted with slime mold/cracked by stress fracture….etc…etc…after 8 years of Bush…what do you think the world thinks of you now? People too stupid to take take of themselves. People literally too stupid to understand that maybe wiping their asses and washing their hands after they shit might be a good idea. People who will be keeling over coughing blood in subway-crowded ER's as the flu gets them in a way in shouldn't have, had the right precaution been taken.

    I had something funny to say. But I can't now. 'Night.

  5. ecgroom [#570]

    I Tweeted it before you! ;)

  6. mattymatt [#495]

    Oh I was pleased to discover that this article continues after the first page — I was reading the RSS feed and it just cuts off at "death panels." You might want to consider putting an indication in the RSS feed that the post continues at such-and-such URL.

  7. zidaane [#373]

    Excellent again. Charles Kuralt with attitude.

  8. cdnpoof [#233]

    I really liked that. I can't say that I have much hope for u poor bastards. It is just so fundamentally bizarre that you don't have a national health system that I can't even wrap my head around it.

    I am mighty suspicious of this canadian that went south for health care he couldnt get here. If he cant get it here then its gonna cost shitloads in the states. Was this a rich guy? Cuz rich people (around the world) are always travelling for health care. Farah went to germany (germany!) for god's sake.

    Allz i know iz: canadians dont like to pay for healthcare and if we do decide to do it we can do it here. We actually have private clinics. So take that FreedomWorks. Makes u wonder why this canadian didnt just go to a private clinic or hospital here.

    Harumph.

  9. valet of the dolls [#1087]

    This is so good, I feel kind of bad about pointing out that it's 'by AND large', not 'by IN large'.
    But what's good for Robert Gibbs is good for Abram Sauer.

  10. Ron Obvious [#351]

    "I think we will look back in 10 years and say we should not have done this, but we did because we forgot the lessons of the past.” Your naivete is touching, Senator.

  11. Flashman [#418]

    Yup, these reports from ND keep getting better and better. I really appreciate the obvious respect you have for all of these people, even the crazies.

    North Dakota has a strange place in my heart, as I was thrown in jail there for 3 days (Montrail County Courthouse in Raymond); it is the last bit of US soil I set foot on, and unless I apply for a waiver it will be the last. I was driving home for Christmas 1997 and intending to take a shortcut from Sask. down to Ontario. The border guards found an old baggie with some weed *dust* in it, and that was it. The funny thing was, they were totally fucking me over for life but were just so *nice* about it. A surreal experience – strip search, cold shower, orange jumpsuit, the works.
    Jail was really just damn boring, but the food was good – homecooked by the old ladies who watched over us at night. And the only reason it was 3 days was because they wouldn't let me call my bank in Montreal to raise my daily withdrawal limit, so I had to be taken 3 times to the *one* ATM in town, at a gas station on the edge of town, in my orange jumpsuit and prison flipflops, to take out money for my $1300 fine, 100 dollars at a time. Then, finally, once I'd paid it off they took me back up to the border, wherupon I drove 36 hours NONSTOP over Lake Superior to make it back to the family home in time for Christmas Day – got there at 3AM on the 25th.
    Such a sad, bleak and empty place, but yeah, good people.

    • Abe Sauer [#148]

      Polite, yes. "Good?" Not all. And weed. Lord. ND hs the highest rate of binge and teen drinking and the highest DUI rates in the US but you even mention weed and… People react like it's crack. A recent frisbee golf event used a "420" joke in its promotion and when the locals were told what that meant they went ape. sigh.

    • Abe Sauer [#148]

      BTW: to prove my point. here is, no joke, a story from today's local paper. it's #1 on the most rread list:

      "Police recovered a lone marijuana plant this morning along the Red River in south Grand Forks.

      "It's really just one plant, not like a major grow or anything," Sgt. Dwight Love said. Officers responded around 8 a.m. after receiving a call that someone had found the plant in a pot by the river near the lift station on the east end of Desiree Drive. Love did not provide any other details. Police are investigating, but Love wasn't optimistic about solving the case.

      "We really don't have much," he said.

      • Mindpowered [#948]

        There's a potted pot plant joke in there.

      • Flashman [#418]

        Yeah – I was even mentioned on the local TV news the next night, along with some kids from Florida who were also busted the same day, on the way back down south from Vancouver.
        I still have nightmares from time to time involving accidentally (getting on the wrong train, or being on a plane that's diverted) winding up at a US border crossing. Jail in ND was I guess as pleasant as it could be, but feeling so tiny, powerless and humiliated sure sticks with you.

  12. KarenUhOh [#19]

    Christ. Allow me to let you folks in on a secret:

    The insurance industry is the ultimate and only winner of any health care policy that does not run all or part of itself through the government. And even with government involvement, the insurance industry wins.

    Let me ask you: do you trust the insurance industry more than the government? Yeah? You DO? When was the last time you voted for anyone in the insurance industry?

    Every last ounce and inch of this is abject silliness. All bullshit. Health care is fucked up because there are too many people, too many sick people, not enough resources, too high costs, too much demand for the services of professionals who charge ridiculous sums for their work.

    Do they deserve these ridic sums? Probably. It's impossible work. Do malpractice suits drive up costs? Sure. But not nearly as much as you're led to believe.

    This is a problem based on too many fucking people fighting for too few fucking resources. No amount of jimmy-jammy with the "health care system" and "cost" is going to solve or save it. None.

    Christ. You don't need death panels. The market will handle that.

    And, as for "paying for 'it'"? That's pretty darn American Way.

    • BoHan [#29]

      Karen, I don't have the background in MalMed that you do, but I would question a shortage of resources. I think what you mean to say is that there is a shortage of resources that will voluntarily work within the current cost structure to provide the services that are needed most. And that is what insurance reform should address. Anedoctally, I do not want to ever meet another ex-nurse shilling as a pharmaceutical sales rep when he or she should be working the trauma unit at the County Hostpital, and on my 20 mile drive to drive every day, I do not want to see another billboard for liposuction, bariatric surgery, expensive heart disease treatments that can be paid for only by millionaires, cosmetic dentistry, or snoring issues. There may be a shortage of general care, but it has been created by the insurance industry driving medical professionals out of the treatment areas where they can do the most good.

      • KarenUhOh [#19]

        I agree with this assessment. Accords with my experience.

      • Abe Sauer [#148]

        I agree too. But there is a true shortage of resources in some ways. For example, rural clinics are striving to stay open and serving areas that are hundreds of miles from a true trauma center. Women drive 150 miles for an OB visit or prenatal care. To he tune of thousands of $ many rural hospitals fly in "locums," or docs that will do ER work for a week or so at a time. There will always be some kind of shortage because as an economic "system" there is no end to the "need."

    • brent_cox [#40]

      Take the posterboard slogans from the Shouty Weepy Angry Righteous People at the Town Hall/Howard Beale Parties and strike "government" and insert "insurance industry". Like, "Do you want the insurance industry making decisions over your health care?" or "No way I'm letting the insurance industry accessing my bank account!" Or just take out "insurance industry" and insert "unimaginably scary thing" and hope it's Happy Hour.

  13. Abe Sauer [#148]

    I know it's going into the weekend but I wanted to add an addendum here:

    Regardless if any of this sickly nation gets healthcare, one group that loves all this right/left socialism "Freedom!" hullaballoo is the crooked regional operators whose corruption largely goes unchecked because everyone's too concerned with the paranoid fantasy of whether or not we'll be the Soviet Union tomorrow. A perfect local example is former North Dakota Insurance commissioner Jim Poolman. In 2007 Poolman resigned to go private after, according to the Washington Post, taking thousands in contributions from an insurance industry PAC just before, coincidentally, pushing "the coalition's efforts to… alter long-standing prescriptions for how much money insurers must keep in reserve — a crucial variable that can influence their profits." Not surprisingly these changes would leave the insurance policy holders in a weaker position when filing claims. Of course, this WaPo story came out in June 2009, two years too late. The national legislation Poolman helped push is still being shepherded toward passage by many other similar regional insurance commissions and such. Of course, because local papers are devoting reporters and inches to "Health Care Town Hall Mobs!" these guys are robbing the unwatched hen house.

    I linked to two things in this piece that I cannot recommend highly enough. One is the Biz Week piece demonstrating the nuts and bolts of EXACTLY how United Health and similar groups have insured they win either way and the Atlantic piece from a guy who lost his father laying out a consumer-based approach and how our divorce from ever seeing bills is so important.
    http://www.businessweek.com/magazine/content/09_33/b4143034820260.htm
    http://www.theatlantic.com/doc/200909/health-care

    Print them out and read them on the beach over the weekend and cry yourself to sleep.

  14. joeclark [#651]

    Again: We don’t do paginated articles in the modern Web. Find another way not to earn money.

  15. Bittersweet [#765]

    Excellent article, Abe. I always enjoy reading your stuff. Even though it taxes my brain to have to turn pages online. *whimper*

 

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