At a recent meeting Jim Valenti, president and CEO of University Medical Center, gave a presentation illustrating his stance on the health care debate -- in favor of reform -- to a group of about 225 with a decisive stance on the other side of the debate.
One exchange embodied the dilemma faced by policy-makers and by the public.
"Can we afford reform?" Valenti asked. The audience answered with a strong "No!"
Valenti then asked, "Can we afford the status quo?" He got the same answer, "No."
This exchange appeared to be the norm, as shown by a Harvard University study indicating a conflict among Americans, the majority of whom want reform but are not comfortable with the government proposals.
President Barack Obama is due to speak tonight, Congress is now back in session, and the town halls have passed. With Labor Day behind us, the long period dubbed the Summer of Hate (a juxtaposition of the 1969 Summer of Love that is also being dubbed the Summer of Death) is inching toward its final days. But the political news cycle topic of the year -- health care reform -- will prevail until members of Congress cast their votes, and likely for the months to follow.
Divergent views
The health care debate seems to crystallize the two opposing American political ideologies -- perhaps the reason why the debates have sparked so much ire, with vows to "shed blood" if necessary and weapons worn to health care town halls. There seems to be a high level of vitriol despite (or because of) a lack of background knowledge.
Studies indicate that most Americans want reform, but the general public opinion is conflicted as to what that means or how to get there. The study from 22 opinion polls conducted by the Harvard School of Public Health stated: "Currently, a majority of Americans are highly critical of the health care system (HSPH June 17), believe it requires major change (CBS July 24), and are very concerned about the problems facing the uninsured (CBS June 12).
"At the same time, most Americans are satisfied ("very" or "somewhat") with the quality of the health care they receive (CNN July 31) and most insured Americans are satisfied with their own health insurance coverage (ABC June 18). Even when asked about their own health care costs, more than half say they are satisfied (ABC June 18). In contrast, the uninsured report more problems than insured Americans with their care and with health care costs (HSPH June 17)."
A review of the public opinion of health care reform over the last 50 years by the Harvard study's authors, Robert J. Blendon and John M. Benson, stated that while Americans "report much dissatisfaction with the health care system and with private health insurance and managed care companies, and they indicate general support of a national health plan," they also "remain satisfied with their current medical arrangements, do not trust the federal government to do what is right, and do not favor a single-payer type of national health plan."
According to a recent Gallup poll, public opinion is not so much lopsided as it is divided. Of those polled, 39 percent said they would urge their representative to vote against a health care reform bill, 37 percent said they would advise a vote in favor, and 24 percent had no opinion. Sixty-four percent said that the vote would be a major factor in the 2010 elections, with 82 percent of those siding against health care reform saying it would factor into who they would vote for in the 2010 elections.
While the national debate may become further entrenched, there are a few areas of common ground. Some points of consensus compiled by the Salt Lake City Tribune include not allowing insurance companies to deny for pre-existing conditions, emphasis on preventive care, bonus pay and scholarships for primary care physicians, subsidies for lower-income families and health insurance exchanges. Firm areas of disagreement include the public option debate and the source of payment for the plan, estimated to cost about $1 trillion over 10 years.
Diverse interpretations
The bill was split down party lines from the get-go, with the Senate Health, Education, Labor and Pensions Committee approving the bill down the rigid party line. Slate's Christopher Beam wrote that the two parties don't seem to agree on many aspects of the bill or whether there's even a health care crisis that would warrant health care reform.
Although Obama has become the face of the debate and has been the subject of unflattering Photoshopped portraits from anti-reform activists, many have said that he has not been "hands on", or he has not effectively sold reform to Americans. Markos Moulitsas of the Daily Kos asserted on MSNBC's Countdown with Keith Olbermann that the Obama administration was attempting to learn from the past mistakes of the Clinton administration, when they were accused of being too "hands on."
Three of the top stories on one topic gave very diverse answers to a simple keyword entry, inviting the need for a discerning search on information. After Googling "health care bankruptcy," the first link is of the National Coalition on Health Care's entry on health insurance costs. The second entry is from Real Clear Markets, in which Diana Furchtgott-Roth, citing a Himmelstein study, writes the following: "But fewer than one percent of Americans enter bankruptcy each year. Of those, only three to five percent are plausibly bankrupt due to medical debt."
The next entry is a blog for Consumer Reports, which cited a study from the American Journal of Medicine that stated: "The researchers found that illness or medical bills contributed to nearly two thirds, or 62 percent, of all bankruptcies in 2007 -- before the major impact of the housing collapse and current economic downturn. That's a 50 percent increase over a similar survey in 2001 by the same researchers."
The vast topic might account for the lack of context among some Americans, who may gather their information through a filter of news sources. Aspects of the bill seem to be open to interpretation, particularly influenced by ideology. For example, the Daily Show appearance of Betsy McCaughey, who is the former lieutenant governor of New York and the reported source of the coined phrase "death panel," demonstrated that ideology can render significantly different interpretations of the bill.
(You can see the segment here.)
The comparatively even-keeled debates that have dealt with issues such as tort reform, a conservative platform and the issue where the American Medical Association parts with the president (even though he supports the House bill and the push toward reform), were difficult to hear those over the chatter of death panels that the media favored. When considering the ad nauseum coverage of the shouts of "Heil Hitler," the gun brandishing outside town halls, Glenn Beck's tears, Barney Frank's insults, and John Mackey, it is evident that much coverage of the policy gave way to sound bites and hyperbolic political theater.
El Paso's participants in the national debate
The reform discussion is of particular interest in El Paso given the number of uninsured (an estimated 230,000). El Paso's political leadership is firmly on board with the proposed reforms, with U.S. Rep. Silvestre Reyes saying at Monday's Labor Day breakfast that it was time to push forward.
His comments came after several weeks of town halls and breakfast forums, from the raucous Ray Pearson Forum at Bowie High School on Aug. 22 to the town hall organized by Conservative Grassroots on Sept. 2 (to which Reyes was invited but declined to attend). Reyes was quoted in the El Paso Times as saying: "There are those that have confronted me and demanded a town hall meeting. I'm not going to give people a stage to perform. I think this issue is too important to allow people to disrupt."
Instead, Reyes was present at political breakfast meetings and other events, including the large Ray Pearson Forum town hall meeting on Aug. 22 at Bowie High School in the Fine Arts Theater.
More than 60 people at Bowie High School, amid shouts or cheers (depending on the point of view expressed) among the crowd of 800, came to the podium, some to air grievances with the congressman, some to offer him support and some to make disparaging comments about the opposing political ideology.
Some did share their concerns of how the government would pay for the bill considering the current national debt, particularly after the Congressional Budget Office estimated it would increase the federal deficit by $239 billion over the next 10 years. Reyes said that the bill would be revenue neutral and all the costs would be off-set. Others, both pro- and anti-reform, asked whether the bill would include a public option.
Several asked if undocumented immigrants were covered, while others asked if abortion was covered under the bill; each topic was brought up repeatedly. Reyes answered that if the bill included abortion coverage in any way, he would not vote for it. He also said that undocumented immigrants would not be covered.
El Paso Grassroots organizer Xavier Miranda gave his take on the event here.
The Conservative Grassroots town hall (Conservative Grassroots grew as a counter to El Paso Grassroots) featured a panel including Hank Hernandez, CEO of Las Palmas Medical Center; John Harris, president & CEO of Sierra Providence Health Network and Valenti.
The individual presentations were followed by a Q&A session with the audience. The panelists gave diverse opinions and presentation formats, with Harris speaking on the need for reform but cautioning that "we need to fix what is wrong without destroying what is right." He also said, "A single-payer system will not work."
Hernandez shared his opinions as a private citizen, which were received well in the conservative audience, saying that the need for reform need not be rushed. Valenti said he favors "a public option with choice."
Throughout the discussion that followed, the final slide from Valenti's presentation remained lit, reading: "Take a deep breath."
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A working compilation of resources on the issue
Here is a copy of H.R. 3200. It was the proposed bill from which much of the debate stems.
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Here is a chart of health care as share of the GDP. In 2008, it was at 16.6%. By 2017, it is estimated to be at 19.5%.
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Here are census figures from 2007 of Americans covered by health insurance, stating that the 45.7 million uninsured was down from the previous census figure of 47 million in 2006.
[Link]
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NPR compiled a list of international health care costs. Rather than regurgitating heresay, the interactive graphic offers readable comparisons with concise descriptions of each country?s health care system. Not comprehensive, but a good starting point.
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Here is a compilation of myths about H.R 3200 from FactCheck.org.
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Compiled sources:
While other sites such as the New York Times offers a compilation of their articles on the topic, Slate opens their guide to the health care debate with the bill and the amendments that were voted on. It rounds up bloggers and columnists from other sites who write on health care reform and summarizes their stance on the issue. It also includes, news sites, think tanks, and letters from the Congressional Budget Office.
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Health care coverage on news sites and blogs:
New York Times
Politico
CNN
Wall Street Journal
