Like many others here, I was disgusted (but not shocked) to see what might have been a promising town hall with the President on the subject of health care devolve into the health industry taking potshots at the President. The effort to obfuscate and disseminate right wing talking points was obvious to anyone watching.
While I believe the President did a good (if not great) job defending reform, including the public option, ABC did not give him a fair deal last night.
The questioning started out with this humdinger (transcript here):
DR. ORRIN DEVINSKY, EPILEPSY SPECIALIST: Yes, in the past, politicians who have sought to reform health care have tried to limit costs by reducing tests, access to specialists, but they've not been good at taking their own medicine. When they or their family members get sick, they often get extremely expensive evaluations and expert care. If a national health plan was approved and your family participated, and, President Obama, if your wife or your doctor became seriously ill, and things were not going well, and the plan physicians told you they were doing everything that reasonably could be done, and you sought out opinions from some medical leaders and major centers, and they said there's another option that you should -- should pursue, but it was not covered in the plan, would you potentially sacrifice the health of your family for the greater good of insuring millions? Or would you do everything you possibly could as a father and husband to get the best health care and outcome for your family?
It's a real misnomer of a question, and the President's response shows why: the biggest issue here is unnecessary tests, not the choices of a family to keep care going. For every Terri Schiavo-esque extension of life, there are many MRIs ordered that should not have been. It is a right-wing framing of this issue; essentially, this specialist was trying to insinuate that patients won't have the choice to follow their own end-of-life beliefs at death under a reformed system.
What he should have known is that many today lack that very choice. I have personally worked with a number cancer patients that have stopped fighting because they ran out of money, deciding to die rather than burden their families further with medical debt. For those with the courage to fight to the end, I have also personally known individuals who went to their grave thinking they had bankrupted their family. That's no way to die.
But it really wasn't until Diane Sawyer decided to speak up that I knew we were in for a special treat from corporate wingnuttia last night:
SAWYER: Mr. President, you mentioned the Mayo Clinic, and I'm going to cross as I talk here, if you don't mind. But I've been reading a lot of the e-mail questions that we've been getting online. They've been saying the Mayo Clinic is exactly the point. They're doing it. Private industry is doing it. Private hospitals are doing it. The Safeway company is taking action. Why get the government involved in something that is being done already in the private sector and, with the right initiative and impetus, could be done in the private sector without government involvement?
One hospital did it, so there's no need for the government to make EVERYBODY do it. The sheer vapidity of this question stuns the mind. And yet dear, dear Diane really made the best argument for a public option possible. Private industry as a whole COULD be doing this type of stuff, but they don't. And they've had years to get on the train. But they haven't. That "right incentive and impetus" she talks about? That would be the public option. Because if insurers don't change, the government will run them out of business. Nothing short of that threat will force them to do so, because no mere tax break or wimpy, half-hearted regulation is going to make it an economic necessity for them to improve. Nor will local co-ops.
Perhaps realizing how effectively the President had schooled them, Gibson and Sawyer let a nursing student talk for a bit, before breaking back into it with the president of the AMA. A voice of eminent reason and compassion for patients everywhere (gag), he had this to ask:
DR. J. JAMES ROHACK, PRESIDENT, AMERICAN MEDICAL ASSOCIATION: Thank you. Mr. President, clearly, when you spoke to us last week, you said that we entered the medical profession not to be bean counters, not to be paper pushers, but to be healers. And we totally agree.
How are you going to assure the American public that medical decisions will still be between the patient and the physician and not some bureaucracy that will make decisions on cost and not really what the patient needs?
This is another insinuation that somehow doctors will lack the total freedom they apparently have today to decide with the patient what care they will receive. Anyone who has ever been ill knows that the mythical "doctor sits down with patient and determines the standard of care free from any outside influence" meeting that the right wing of this country clings to so tightly is a complete farce today. The health insurer is butting its head into care decisions from the moment the patient walks through the door. Doctors are regularly vetoed by authorization denials on coverage.
Health care reform with a REAL public option would arguably increase doctor-patient freedom of decision, because when the financial constraints are alleviated, doctors no longer need to go through the infuriating mental process of eliminating better options they know the insurance won't cover them.
Still, the questions up through this point were cleverly veiled right wing talking points, not the usual bluster we are all used to. Apparently they were saving the bluster all for Charlie Gibson last night, who blustered at a near-Limbaugh level:
GIBSON: We're going to take one more commercial break, Mr. President. When we come back, we're going to get into the issue of whether or not in a reform measure there should government insurance for people, because a lot of people are very uncomfortable with that idea. "Prescription for America" continues.
A lot of people being 24% of the American public? Charlie, more people think the American government assisted in the 9/11 plot. The 24% that are left questioning the government's role in providing a public option are basically the political equivalent of this lady:
Which actually is insulting to real crazy cat ladies, because I find many of them to be nice people in need of quality health care too.
Then things turned to debt. I actually support the President on deficit issues as they relate to reform, because frankly he's probably the sanest voice on how to pay for it thus far:
About a third of the costs will come from new revenue. And so what I've proposed is, is that we cap the itemized deductions that the top 2 or 3 percent get, people making over 250 a year, me and Charlie, so that our item -- so that we're itemizing our deductions at the same level at -- as most middle class families are.
This is hardly soaking the rich. And yet, Charlie Gibson's ears perked up like a dog hearing a can opener when these words came out of Obama's mouth. And that is really one of the most dangerous right-wing memes at work here- because ultimately, many in that group would rather keep the privileges they have than give up a small portion of said privilege and come down to the level the rest of us are at in terms of ability to deduct charitable contributions, in order to lessen the suffering of millions of families.
Things really just kind of spiraled out of control at that point. Aside from the fact that Obama had already answered the costs question a couple times, Diane scampered over to hand the microphone to the woman who ran Medicare during the Bush years. My thoughts at that point were a cross between "WTF" and "how is a Bush administration official an expert on ANYTHING?" Those thoughts were validated when she essentially asked the same question as half the others before her - "how are we going to be budget-neutral?"
After the half-hour break for local news, I thought maybe the Obama team would take Charlie Gibson into the back room and kick the crap out of him for a bit so he'd shut up for the last half hour and let the President answer actual questions from real people. Alas, it just gave Charlie Gibson more time to drink the right wing kool-aid and get all hopped up for the last corporate hurrah of the night. Some 'greatest hits':
GIBSON: Well, Diane is here with the head -- with the head of a major insurance company.
Yes, because the American public really cares about what they have to say about things. The actual question from the CEO was more tame than I thought it would be, on whether a public option would out-compete based on the fact that it's the equivalent of one player having rulemaking power over all the other players (a talking point Obama deftly shot down), but come on. Really?
Another gem:
GIBSON: Which would be millions of people going over to public insurance. You keep saying, if you have what you like, you can keep it, but if your employer goes over to the government program, maybe you can't keep what you have.
The premise behind the collective corporate whine that "everybody will go on the public plan!" is at once remarkable in its boldness and utterly infuriating.
What they are essentially saying is, a public option is bad because it's taking a person's choice of coverage away due to their employer putting them on the public option. In making this claim, Gibson, his brain addled by rage at the thought that he might be able to deduct a bit less on his taxes next year, must not have considered the fact that for most people, the choice of coverage is already dictated by the employer's whims (and sometimes by the employer's caprice/greed). Employees don't get to vote on who covers them, for the most part. What usually ends up happening is the HR rep takes a look around the market every couple years and whatever looks like the best(that is to say, cheapest) deal, they get. The sacred cow of the right, the ability to see the doctor you like no matter what, FOREVAR, is slaughtered every day in this country. I've had to change doctors several times in my life, some of whom I have liked very much, because the employer got a cheaper plan with a different network.
Further, President Obama hit the head on this point: why is it a bad thing if the public option is such a good deal that everyone wants to use it? If more people are getting better insurance for cheaper, what's the issue? The right will never answer this question, because in doing so they would be admitting that the only possible reason it could be a bad thing is because the health insurance companies' profits would take a hit. Which, in wingnuttia, is more important than the happiness and health of millions of individuals.
Ultimately, the President did more than I expected to defend the public option. However, ABC did the country a disservice by validating the voices of the 24% rump of American society over those of the 76% that want to hear more about the specifics of a public option. Those that are struggling with insurance right now I am sure would love to ask some questions about how their lives could be improved by a public option. What they got was Charlie Freaking Gibson and Aetna's CEO.
And their lives would be improved with a public option, in many ways. Please take this opportunity to stand with Dr. Dean or show your support by signing the petition Sens. Durbin, Leahy, and Schumer have started for a real public option. E-mail your representative in the house and your senators.
Last night's industry-fueled, Charlie Gibson-led hounding of the President should not stand. We need a public option, and lives depend on it. I know many have asked this already, but it can't be said enough: PLEASE do what you can to see that this gets through. Even if health care isn't 'your issue,' or you don't have a ton of time to get involved. It's that important.