By George Miller
U.S. Congress Rep. Lois Capps held a series of three Health Care Town Hall meetings in her 200 mile long, hyper-gerrymandered coastal Congressional district. I went to the final one Friday night, in downtown Oxnard. Observations and opinions here are strictly my own personal ones.
The "Panel" (Lois Capps on left)
The police presence was large-- at least nine units, including marked and unmarked cars, a motorcycle and foot patrolmen.
AME Church provided excellent hosting and had very nice people in attendance. The panel was 100% pro-ObamaCare:
- Lois Capps, 23rd District House “Representative” (more on this later);
- Robert Gonzalez, Medical Director, Ventura County Health Care Agency;
- Katherine Raley, Program Manager, Ventura Area Agency on Aging.
There was no doubt at all in my mind that all these people are highly committed to health care, but I question some of their objectives and means of arriving there, at least legislatively speaking.
The moderator, former Ventura Star Editor Tim Gallagher, started with a patronizing lecture on rules of conduct. He seemed to be unaware that the anger of TAXPAYERS at being ignored and poorly served by Congress is what led to the tumultuous August Town Halls that made the news and effectively stalled the ObamaCare bill. Now we hope that our concerns about this and runaway, incompetent big government in general will be addressed, or there will be a lot of new representatives in DC after the 2010 elections.
Capps held this meeting on very short notice (at least to us), on the eve of a major holiday weekend, at a low income area church (but a very nice one), in a low income neighborhood (all designed to maximize support), with rules designed to limit bi-directional communication (no signs, no talking, no interaction, no booing or even clapping—that didn’t last long).
Carla estimated that the crowd was about 50-50 pro vs. anti-Obama care. Carol and others thought that there were even more HR 3200 opponents. I should make the point that the vast majority of us anti-ObamaCare people do support some “reforms,” and even overlap somewhat with the pro’s, but differ greatly with them on the extent of socialist Government control, extent of financing that would be required to carry out HR 3200 and certain other highly objectionable provisions. We also disagree that it is even Constitutional, which trumps all other arguments, in our humble opinions.
It was evident from the vocal crowd responses that many were not at all happy with much of what was being said.
Each panel member made a brief statement in support of HR 3200. No dissenting members were invited to be on the panel.
Lois did a 20 minute overview of the bill and her positions on it, which was informative, but differed somewhat from our perceptions of the content and interpretation of the bill posted on the Internet -- some of us are better informed than she appeared to be on portions of the bill. She also pointed out some amendments in progress that we hadn’t seen yet, mostly retreats from some positions that have raised huge outcries.
Lois’ positions (only summarized some key highlights and pain points here):
- Can keep present coverage. She failed to mention time limits, no changes rule.
- Can’t be dropped from plans for any reason. Good, but what will it cost to achieve that? I seem to remember reading that you would be forced to a public option if you left a job, stopped coverage or after a certain time period.
- People can’t handle rising cost of care, insurance. Amen. But some of this is due to malpractice costs, regulations, greater choices in new therapies, higher expectations, longer life spans, more aggressive care and most importantly—lifestyle choices- obesity, drugs, stress, demographics, etc.
- Plan will lower cost. Whose cost? Explanations of how were highly unconvincing. She said $500BB would be reduced in fraud, waste and abuse. Our question: why aren’t they doing that NOW with the current failed programs of Medicare, Medicaid, VA?
- Mandatory coverage rule will lower insurance costs, because uninsured people will be non-existent and greater economies of scale will lower costs. Sounds logical, but a shortage of resources may actually increase costs (Capps: meet law of supply and demand).
- Certain rule exemptions for small businesses under $500K, profit under $280-350K.
- National Health Exchange in 2013, offering multiple choices of Private and Public option. Unclear how this would work.
- No $ caps on coverage, limit out of pocket, 85% of insurance company expenses must be care, not admin. All sounds good on paper, but how will it be paid for?
- Obamacare will be “deficit neutral,” paid for by insurance premiums, efficiency savings and “surtax” on only 1.2% of population (people will vote themselves money from the treasury if they think they won’t have to pay for it). That will need to be one HELL of a “surtax!” Efficiency savings from the government that brought you The Post Office (bankrupt), AMTRAK (bankrupt), Social Security (bankrupt in 3-5 years)), Medicare (bankrupt), VA hospitals (awful). Need I say more?
- New Public Insurance Option” will create competition for insurance companies and reduce costs. Really? The government will be that efficient, huh, or will they have their own set of rule, including care standards, no lawsuits allowed, and additional subsidies?
- An estimated 10-11 million will choose public option in 2013, 16MM new people will join private insurance plans by then.
- Medicaid subject to 133% of poverty line for eligibility.
- Govt. will do existing science review, best practices review, recommended improvements. Will train more professionals, award more scholarships, repay student loans, offer training programs. Where will the money come from?
- Will plug “donut hole” of missing coverage, provide 50% discount on drugs, (with missing money?.
- Sec’y of Health will negotiate drug prices. No preventive medicine co-pays. Additional low income person subsidies. This might actually work, as reduced sickness could pay for it.
- Pay on quality of care, not quantity. Will be tricky to manage, but theoretically possible. My own experience is that the protagonists usually find loopholes that you keep having to plug.
- 55% of small businesses don’t provide health care. No wonder, since big business gets corporate welfare and is offered FAR lower insurance prices. This could be somewhat remedied by insurance risk pools instead of individual corporate contracts.
- No one will be forced on public option. We have heard otherwise that some will be pressured, some will be forced.
- No one will be denied any care. I heard contractions on foregoing care and rationing. Sounded like doubletalk to me.
- “:Absolutely no :death panels”, no mandatory end of life counseling. Then she and one panel member spent quite a bit of time explaining why end of life counseling is desirable, even necessary. I agree that when we run out of money, it will indeed become necessary and believe that patient and family only should decide when it is desirable, without BIG BROTHER pressure.
- Illegal immigrants not eligible for care per sec.246.” A question and audience reaction pointed out that provisions for an enforcement amendment were killed by Democrats.
- Propose to pay for all of this by:
o Eliminating corporate offshore “tax havens. How will they do this and why didn’t they do it years ago?
o Public option. THAT will reduce costs?
o Eliminate $500BB in fraud, waste and abuse. How will they do this and why didn’t they do it years ago for Medicare/Medicaid?
o Negotiate drug prices (now forbidden)
- Claimed abortions would not be covered by “private money.” She doesn’t seem to recognize that nearly all “public money comes from private money. Also, people have pointed out various loopholes.
Submitted questions (some are covered above)
Audience members were not allowed to talk, ask questions, only to submit them in writing. League of Women voters selected about 20+ questions out of a reported approx. 160 submitted from audience of about 250. They did select some tough questions.
- What about Tort reform? Lois admitted that it’s a big issue. Had no real answer. It’s not addressed in the bill. Some say the trial lawyers' special interests once again blocked this. Lois sort of admitted her desire for the status quo by saying that “wrongs must be addressed, without conceding that the system is abused. Robert mentioned that the defensive actions of providers are sometimes detrimental in that they take disproportionate action to cover themselves. Lois mentioned that “not everything is a federal issue,” which got HUGE applause, for a different reason than she likely intended.
- When does private insurance become impossible? Lois asserted that public and private are the same, except one is government, which drew a lot of hostile moans from the audience.
- Will there be age limits on procedures? Lois said no, although Emmanuel’s bioethicist” brother who is involved in this has publicly stated there should be and bill language is not definitive.
- Although she already addressed undocumented immigrant coverage, it was asked here too. She and Robert both said a case for undocumented agreement coverage could be made to address contagious diseases. She again ducked the illegal immigrant denial enforcement issue and completely ignored the deportment requirement. Gonzales additionally claimed it doesn’t belong in the bill. REALLY? Requiring any aliens here to have insurance wasn’t addressed, even though I know multiple LEGAL aliens here who say they are REQUIRED to have private insurance.
- Why not have private assigned risk insurance pools instead of public option? Good question and I heard no real answer.
- Disabled Medicaid coverage? I think Lois said yes.
- What about govt. having direct access to my bank account? She flatly denied it was in the bill, although multiple audience members shouted their disagreement.
- What do you think about Obama having radical Communists in his administration? Declined to answer.
- High COBRA cost? There will be “affordable” plan.
- Preventive medicine approach? Yes.
- SCHIP to public option? Yes. That doesn’t explain how hybrid families with children covered and parents on private care would be addressed. Lois did say that if children are covered, why not the parents, too. We saw that coming long before tonight.
- Medicaid home care? Yes, it will be addressed, with more reimbursement.
- Will Congress be covered by HR 3200? She ducked the question, claiming she had “an employer-provided plan.” In other words, she won’t be joining us peons.
Most Important Questions of the Evening
Is Federal Health Care Coverage a legitimate Constitutional activity?
Lois stammered through that without answering it and finally, she incredibly claimed it fell under “health, liberty and the pursuit of happiness!” What a B.S. answer. At least she didn’t invoke the commerce clause, though.
An “aha” point in the meeting was when the moderator read the other most important question of the night, namely:
Would you vote for a bill with a public option, even though a majority of your constituents opposed it?
She failed the test miserably. At least she didn't try to lie that a majority wanted it, though. Basically what she said is that she would vote for it anyway, while attempting to spin the answer in glowing terms of “a vote of conscience. ” At that point I had proof that I really DON’T have a representative in Congress, just a partisan hack with her own agenda. VOTERS PLEASE TAKE NOTE and impose de facto term limits soon.