Sunday, September 27, 2009

When a Town Hall is Not a Town Hall



I went to a so-called town hall meeting last night on health care reform. The first guy to speak from the audience began by saying something like, "You're a politician and there are three things I know about all politicians. First, you're a liar. . ." I think the second one was that Begich was a lapdog of the administration. And I don't think he ever got to the third thing. Then he said the first thing that needs to happen is tort reform.

Hello? Tort reform? How did tort reform become a populist issue? How is this guy affected by the lack of tort reform? He didn't say. I just know that tort reform is one of the rightwing's key issues and so I'm guessing this guy came pumped up by talk radio and Fox News. (He's the first guy on the video by the way if you want to see him.)




As the evening went by, an idea began to clarify in my brain. This isn't a town meeting. Town meetings happened in small towns where everyone knew each other. You knew all about everyone who spoke. You knew if they paid their bills, kept their house in good shape, if their kids were polite or wild, if they spent their spare time drinking or reading, if they were bullies or people who helped their neighbors, and probably if they beat their wives or not. But at these meetings, we have no context for judging the comments of others. We don't know if this is the guy who shoots up highway signs, dumps his trash on the side of the road, regularly drinks and drives, or whether this is someone who has grown up and takes responsibility for his actions.

Some people judge based on whether the person said something that is logical, reasonably thought out, and based on what we know to be facts or not. So, those people who yelled at Begich about being for single payer or for having his own special Senate health care plan - after Begich had already said two or three times that he was against single payer and that he was looking into opening the Federal Government health plan [he repeatedly said there was no special Senate plan] - didn't seem very together to logical thinkers.




Some people judge based on whether the person is for what they are for.

Some people just seemed angry and Begich would make a good target if they couldn't go after the person they were angry at, or if they couldn't figure out exactly what they were angry at.



Some people wanted to be counted as being for particular positions.


This was basically a meeting of strangers - though it turned out that three people right next to us were people we knew.




But just to be sure I wasn't acting off some long ago picked up myth about town halls, I did google around. I couldn't find much that actually answered my key question - how big were the towns that had town meetings and did everyone really know everyone? But here are a couple of indicators that I am headed in the right direction.

The Secretary of State for Massachusetts website has a whole page on town halls - they are still used in smaller towns.
How is it determined whether a town has an open Town Meeting or a representative Town Meeting?

Towns with fewer than 6,000 inhabitants must have an open Town Meeting. Towns with more than 6,000 inhabitants may adopt either form of Town Meeting at their discretion.









The Boston Globe had an article by Howard Frank Mosher about what a real town hall is like:

Come early to see folks drifting into the hall to greet old friends, eyeball enemies across the room, stash covered dishes in the kitchen for the big noon meal. About 9 a.m. the donnybrook begins. For the next three hours, neighbors who would never dream of not pulling one another's car out of ditches or cheering on one another's kids at Friday night basketball games will argue fiercely over paving roads, paying schoolteachers, zoning main streets, donating a few hundred bucks to the local senior center. Tempers flare. Fistfights are not unheard of. Many of the debaters -- and on this special day everyone is an orator -- detest each other. Yet no one is excluded, even the clan from Hatfield Hill or their blood enemies for five generations from McCoy Hollow.

At lunch, a temporary cease-fire is declared. Everyone seems ready for it. After all, it's hard to be too angry at someone who's enjoying your wife's baked beans laced with this year's maple syrup. Then the battle is rejoined until late afternoon when everyone goes home mad and grimly satisfied.


How would these town hall meetings go if when someone stood up to speak, we'd all get an instant background report on the person? Arrest record, conviction record, what his neighbors say about him, what his superiors, co-workers, subordinates at work say. How many times has he been married? How are his kids doing? What contributions does he make to his community, what volunteer work does he do?

Life's not easy for everyone, and I'm not judging them as people based on these criteria, but I do want to know how much weight we should put on their comments. Are these perennial complainers who never create anything of value? Or do they have a good record, but they have just now gotten fed up?

Absent a real town hall's familiarity with the people speaking, we can only judge by what they say and how they say it. I heard a few pretty belligerent folks making comments last night, people I wouldn't want to have to deal with on a regular basis. I don't think the meeting solved any of their problems. They got to vent a bit.

It would be really nice to have enough time to let them talk themselves out. For Begich to have been able to question them specifically about the claims they made and the bases for their anger about this program or that.

As it turned out, I would say the Fox news folks made up a sizable minority. When they cheered it was loud, but not that widespread. When the pro-health care reform people applauded, it seemed to come from a lot more people. That's just my sense of it and certainly not a scientific measure.

In some cases, I thought there was amazing balance. One high school student read a prepared piece on socialism about an econ teacher doing an experiment in 'socialism' by averaging everyone's grades and how the class eventually slid down to everyone getting F's. And why this showed how socialized health care was bad. It really stretched my patience listening to her. But the very next person explained that she was in a wheel chair because her family's private insurance refused her treatment until it was too late. She might only be telling us part of the story. But she did cite a law case. She said to look it up - I still have to do that. [It appears the Alaska Supreme Court turned her down in one case. and in the second. These cases are about a car accident, not sure how it relates to her wheel chair story. It goes to demonstrate that we really don't know the background of people and their reliability.]

Someone else claimed his health care hasn't gone up in price in ten years and that he hasn't been denied coverage though he's changed jobs, but his property taxes have doubled in that time period. (Maybe it's true because he doesn't have health insurance or because he's a veteran, Begich didn't ask what health plan he was on.)

But the next person was a woman who was happy for him, but she'd had cancer and was dropped for a preexisting condition by her private health insurer when she was unemployed for a week between jobs, even though it was the same insurance company.

Another person answered Begich's question about why so many veterans (1.3 million or so) did not claim their health insurance. He said he was a vet but he was self-sufficient and didn't want anything from the government. He didn't have health insurance and didn't need it. He was self sufficient.

But we know he's one of the people who we will all pay for if he does have a serious health problem. My son's overnight stay at the Stanford University Hospital after he was hit by a car in May was billed at $40,000! Fortunately, not only does my son have health insurance, but the driver was also insured. (We also learned through this that the hospital bill is just the beginning of a negotiation and that the insurance company will pay a lot less. But if you don't have attorneys on your side, you might not get the bill lowered.)

While I do believe that no massive change in policy can be done without loopholes, without someone slipping in a great benefit for their clients, and without immunity from human error or greed, that the health care system we currently have has to be changed and what Obama is trying to do will result in a better system than what we have.

So, yes, there are some legitimate issues for people to raise with the bill - both people from the left and the right. Small businesses have real concerns. Large business has real concerns. A part of General Motors' problems had to do with health care for retirees and current employees. Those are expenses GM's foreign competitors don't have to worry about because their employees are covered by national health care plans.

But I also heard people last night who were talking nonsense. Their issues were non-issues. Their research would appear to be Fox News.

3 comments:

  1. The teabaggers applauding when someone suggested all Americans get the same health care plan the senator does was a classic. They didn't realize they were off message and were patting themselves on the back for it. lol

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  2. Tort reform is not a right wingnut preoccupation. See www.MDWhistleblower.blogspot.com under Legal Quality. While I am not a leftist Obamaphile, I am a centrist physician who has been unfairly tortured from time to time by our distorted and unfair medical malpractice system. Those who support it don't have to endure it.

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  3. Michael K. I'm not saying that doctors don't have issues with tort reform, but it is one of the issues that anti-health reform campaign is using. I was simply questioning how this particular citizen got to the point where tort reform was his number one issue. I would wager he isn't a doctor and that his life isn't particularly affected by tort reform.

    Attorneys tell me that tort reform was passed some years ago and it hasn't affected the doctors' malpractice insurance costs.

    And there has to be something better than doctors monitoring their own to deal with doctors who hurt patients through carelessness or greed. On the other hand, good doctors should not have to fear bankruptcy because of crank patients and rapacious attorneys either.

    I'll see what you have to say on your blog about this.

    ReplyDelete

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