Nobody compared President Obama to Hitler, but tonight marked the first of Oregon Congressman Earl Blumenauer's two telephone health care town halls. Blumenauer's last health care town hall took place at Portland Community College in North Portland back in June. There's a lot of misinformation about health care flying around, so I thought you might find it helpful if I just posted all the Q&As after the jump.
The idea of doing tonight's telephone town hall, according to Blumenauer's staffers, was to reach out to more Oregonians than he could in a single face-to-face event. Tonight, more than 42,000 people were invited to participate, and to ask a question, they just had to hit "star three" on their telephone. "The equivalent of three Memorial Coliseums" had been invited tonight, said Blumenauer.
There's another one of these on Friday. If you'd like to participate, sign up on the website.
"This is the right time to try to shift through all the static," said Blumenauer, opening the discussion, arguing that Portland's Metro area could avoid 1000 bankruptcies a year by reforming its health care system, and give more than 100,000 people in the state access to health care who can't afford it, currently. Callers were limited to one minute per question, and Blumenauer said he would limit his responses to a minute, too. Spellings of the questioners are approximate and phonetic. Here goes:
"I'm wondering why everybody seems to be ignoring the prediction of how much this is going to cost and where the money is going to come from, which is in the trillions of dollars," said Jenny Brewster, a senior citizen on Medicare, opening the discussion.
"Let's deal with the big piece, in terms of cost," said Blumenauer, who said he appreciated Brewster's question. "The estimates are from the Congressional Budget Office, it's not the politicians or their staff that are doing this. The estimates are that this will cost just over $1 trillion, but the savings are going to be $1.48 trillion. It will generate slightly more revenue than the bill will cost. It is essentially budget neutral."
"I'm happy with what I have now, but I was wondering how if we're having trouble paying for it right now, how are we going to cover a lot more people and it's not going to be a problem?" asked Dixie Brechard.
"Currently we have some problems because there isn't, there hasn't been an increased funding source for Medicare. It's running a deficit," said Blumenauer. "What this bill will do is it will levy a tax on approximately 2 percent of the population, will pay a higher income tax. The second is there will be changes in terms of how the Medicare system itself is administered—including some very aggressive work to deal with some abuses going on."
Check out the rest after the jump.
"We had a coworker at our store who was 59 years old and had liver disease, and he couldn't quit working because he needed health care," said Rita Coots. "He should have been able to quit working and have some peace but he had to keep showing up and suffering."
"Part of what we need to establish is to make the insurance more affordable so that people aren't tied to a job," said Blumenauer. "We find a number of people that are trapped that way. The bill that we are working on would free them from being dependent on a job they don't actually like."
"I would like to know if you have read the bill in its entirety, and if you haven't, why not?" asked Ralph Hatley.
"Not only have I read the bill I've also had the opportunity to write the bill," the congressman responded. "There's been more attention to this bill than I've personally seen in 12 years that I've been in congress."
The next question asked whether seniors with cancer would be given health care, or suggested they have an "end of life" conversation instead.
"I'm really glad that you said that, because nothing could be further from the truth," said Blumenauer. "We are working so that senior citizens and their families get the information they want and need. Right now Medicare will pay for all the tests you need and probe, but it currently doesn't pay for people to have a conversation about their choices. We have hundreds of doctors, the AARP, nurses and people in the faith community who know that seniors need the basic information to think about this."
"The notion that somehow anything in this bill would somehow reduce or deny opportunities is really missing the mark," he continued, citing the Veterans' health care system as an example of successful socialized medicine.
Blumenauer also did a poll: He asked callers to share their stories of having had problems with health coverage—how broad that experience is. "If you or someone you know has had serious problems with getting health insurance," he said, "press one now." People who didn't think there were problems were invited to push two.
"Will Medicare be changed? And who will be included?" asked Judy Chris.
It would stay the same, said Blumeanuer.
"I have Chrones disease and I work for the State of Oregon so I have good insurance, but my insurance has denied my medication four years in a row," said Mara Danielson. "What's going to change?"
"One of the concerns we've heard is that there are these gaps," Blumenauer said. "One of the items that is most important in this legislation is that it would no longer permit insurance to be denied to people because of a pre-existing condition. This is across the board." "I really am sorry to hear of your situation, and that's exactly why we have made efforts to fix it."
"After working for as long as I have in direct patient care, I know that health care reform also includes training," said Patch Thurman. "How will you encourage more people to come into the field of health care?"
"We are facing a crisis right now, there are a bunch of us geezer baby boomers who are moving on career-wise, and we have shortages for a wide variety of medical professionals," Blumenauer responded. "There are efforts to deal with expanding opportunities, it includes physician assistants, the dental work force, and this is one of the few areas where there is bipartisan support."
"Can you guarantee I won't lose my coverage? I'm with Kaiser right now, and I fairly well like it," said the next caller. "Is there a guarantee?"
"Yes, absolutely. First of all let me just say that there is no guarantee now that people who have coverage through their employer are going to have coverage tomorrow," Blumenauer said. "But the bill is predicated on the assumption that people who like the insurance they have now will keep it, and the other options are choices. There is no provision in the bill that forces people to do anything. It is about providing people with more choices."
"In many parts of America right now, Americans don't have any choice," Blumenauer continued. "In 25 states, one company has 50 percent or more, and in the vast majority of states there's no meaningful competition. That's why part of the plan that's being developed is to provide a public health insurance plan to give people more choices."
The congressman also did a second poll, asking how many of the callers supported the creation of a public insurance option.
"Do you think taxes are really the answer because taxes are so high already?" asked Ann Bryant.
"This is an area of controversy as well," said Blumenauer. "Over 95% of the American public actually got a tax reduction in the recovery package that we passed in January. There is no interest in gratuitously increasing taxes, but as a practical matter, if we are going to provide health care for almost 50 million Americans, these things cost money. The proposal in this legislation would increase taxes on approximately two percent of the population. This is a group of taxpayers that have seen dramatic reduction in their tax burden over the years as their income has gone up very high. This would return the tax rates to about what they were in the Clinton administration when the economy was humming along and we created 22 million jobs."
Blumenauer did a third telephone poll, asking people if they supported increasing taxes on people owning more than $350,000 a year, the top 2 percent of earners.
"My understanding is, health care reform will not go into effect until 2013. Why would it take so long?"asked Pam Moser.
"We are talking about making the most fundamental change in health care in history," said Blumenauer. "It is going to take some time and attention, and we want to make sure that it is done right."
He said it would take time to set up a health insurance exchange, financing, and to strengthen Medicare.
"The ones that we can do sooner, we will," Blumenauer said.
"Three questions, I was an emergency room nurse for a number of years. Is this going to help in the emergency rooms in terms of being clogged up for people that are non emergency?" asked Helen Norwood. "Is this going to stop hospitals from competing with each other and wasting money, and are we going to be covering illegal immigrants in this bill, also?"
"First of all, the bill explicitly excludes coverage for illegal immigrants," said Blumenauer. "Second, a lot of people are going to emergency rooms as a last resort. We've got people coming in with things that should be taken care of routinely and in fact if they had insurance they would have seen a doctor. That's not the way it should be—it's expensive, it's inefficient, and it greatly complicates the situation for people who have genuine emergencies. The last problem is that we have hospitals competing with each other—hospitals get a lot more money by running people through and doing things. We have a fee for service system that isn't actually tied to results, and part of what we are working very hard with is to provide incentives for groups of doctors to focus on the quality of care, not just the volume of care." "We're very interested in stopping the readmission of people to the hospital a month after they have been discharged," he continued.
"Why are you in such a hurry to back this bill that is presently going to cost us trillions, instead of backing Ron Wyden's bill where it will keep it in the private sector and the cost to us will be a lot more minimal," asked Linda Seaton.
"I did some work with Ron Wyden in the past, and I actually co-sponsored a version of Ron's bill," said Blumenauer. "This bill is not government providing the services. Government pays for the service, but it is provided through private doctors. The bill that we are working on in the house is the same as what would happen with Senator Wyden's proposal. The difference is that what Senator Wyden is proposing would basically eliminate a lot of employer-provided health insurance. Some people think that's fine—that people will just pay what they are paying now, and people will be responsible for getting their own insurance. There are three reservations I have with that. First of all, lots of employers are going to stop providing insurance. If you take away the tax benefits then employers are going to get out of the health insurance business. Second, we were talking about more competition, giving people choices. People would have to pick between one or two insurance companies and have to pick, without the muscle of the employer negotiating, and they might not get an insurance package that is as desirable. Finally, it's just a practical consideration. If you're going to have a system that is going to take away employer-sponsored health insurance, it's going to get harder to get that passed. I respect Ron, as I say, but I think this is a much better approach for the people I am representing."
"I thought I would just call to lend my support," said 'Taylor'. "I have been wondering why Americans have been so resistant to socialized medicine, I feel like it's more expensive to keep things the way they are. It's just turned into a huge corporation, a money-making machine. Isn't it more expensive how we have it right now? Aren't people going to get better care if it's not a money-making machine, and the third question is are employers going to start cutting back on what they're offering?"
"The Federal government currently pays for two thirds of the health care in the nation for one third of the population," said Blumenauer. "People say keep my government's hands off my Medicare, forgetting that it wouldn't exist if government hadn't passed that law in the mid 1960s. We can do this. It's been tough sledding, it's been one of the most difficult things I've ever worked on, but I'm convinced that together we can refine a program. Will everybody agree? No. There are still some people who think that we didn't actually land on the moon, that that happened in Paramount Studios. I can't help that. We'll continue working with Oregonians in the months ahead to make sure that we're answering your questions."
If all of that was a little too reasoned for you, well, have a little dose of Glenn Beck—who I am starting to think must be getting paid by the left to put out this kind of stuff, for all the good it is going to do his cause...