Saturday, August 08, 2009

August 8 John Shadegg Health Care Town Hall

On Saturday I attended a town hall meeting in Arcadia. Pretty interesting both from a topic perspective as well as a people watching perspective. Even though I was there 45 minutes before show time the seating capacity of 200 was 80% full and by the time of the start of the event there were 500 people flowing out the doors.

John Shadegg Health Care Town Hall

Arcadia Neighborhood Learning Center

Summary: John Shadegg hosted about 500 people in the Arcadia Learning Center to discuss the current health care plan “HR 3200”, his perspective and his responses to as many questions from the public as possible.

The meeting started at 11AM and at about 12:20 the Phoenix police and fire marshal asked for volunteers to leave as the room was only designed to hold 200. I took that as an opportunity to depart.

Overall I found the congressman to be quite engaging and totally in command of the subject throughout his statements and responses to questions. After listening to him respond and knowing his background and sponsorship of other health care initiatives I cannot imagine that there are too many people in the congress that could do such a masterful job. That being said … he is totally against the democratic plan and his (and republican) alternative theme of personal freedom and “choice” as the answer rang a little hollow considering the financial debacle we are currently experiencing. The less than stellar aptitude that so many Americans displayed in choosing mortgage products and we expect putting health care choices in the hands of the 20% of our US population that are functionally illiterate is going to produce better results … gives me reason to pause that the republicans have the answer.

Throughout the session John reminded the crowd of the need to be civil and that all view points should be respected. He got to lead by example and display a civil attitude himself as several people went way off topic pontificating and making pointed observations. He was so good at taking each of those moments and injecting humor and turning the topic around to his advantage to make a point.

Congressman Shadegg’s web site: http://johnshadegg.house.gov/

HR3200: http://thomas.loc.gov/

A recent NY Times Article highlighting the reality many young americans are facing: http://www.nytimes.com/2009/08/11/opinion/11herbert.html?_r=2&ref=opinion

Some General Comments made by Shadegg: HR3200 is a big bill … in excess of 1000 pages likely growing to 1500 pages after committee markups and reconciliation of committee versions of the bill. There are actually at the present time multiple versions of this bill being marked up by various committees that need to be consolidated in the “Rules” Committee. HR3200 sets out to ensure a minimum level of coverage for all Americans through employer and individual mandates. Within five years all public or private healthcare offerings must meet government established minimums … the republican issue with the bill is that it presumes that putting government in the middle of the equation to guide the offerings and the choices people make will provide overall lower costs for America. The republicans are offering four different bills of their own that focus on freedom and choice with the presumption that putting choice in the hands of everyone … from a congressman to a homeless person will control demand and costs. The republican usage of the word “Choice” being a euphemism for moving away from the government or employers limiting peoples choices for health care coverage and the individual taking on the risks inherent with selecting the appropriate coverage and deductible for their needs. This would also include programs like Medicare, Medicaid, Government Employee Healthcare, and S-Chip.

There are two basic areas that democrats and republicans agree that health care must be reformed before either of their approaches can succeed:

v Pre-existing conditions

Ø No one should have to go bankrupt due to pre-existing conditions

Ø Three years ago Shadegg sponsored a bill written into law authorizing states to set up high risk insurance pools to cover pre-existing conditions. Only 22 states have adopted it … not Arizona

Ø One man came forward to provide an example … he has set up his own business and is successfully managing it but because of a PEC he cannot get healthcare coverage for the condition. So far it has cost him $40K out of pocket to treat the condition and it threatens to bankrupt him. The democratic plan offers him a solution … the republican plan does not

Ø John agreed that this is unacceptable and is the type of example that illustrates the system has some broken areas that must be fixed.

v Universality

Ø Everyone should be eligible to buy a minimum plan through employer, individual, and if not affordable then tax credits provided

Ø Individuals currently cannot purchase insurance across state lines … this must change

Ø If you are not satisfied with your employer health care plan you currently cannot use those tax preferentially treated dollars to procure another plan. This must change allowing individuals to freely move their coverage to the plan that best suits them

Ø We choose our banks, auto insurance, and homeowners insurance from national level companies … and we fire them when we are not satisfied … why not health insurance?

Beyond these two basic areas it boils down (to me) whether we trust government to run our health care choices or let the free market determine our choices.

I won’t go into the details of the individual questions … there were about 15+ questions asked by the time I left and many of the answers were covered by my comments above regarding PEC and Universality.

A few others comments by Shadegg in response to questions:

v Earmarks are where there is corruption. Jeff Flake’s pursuit of this subject has uncovered numerous instances of improper behavior by elected officials that corrode public confidence. Republicans need to stand for no earmarks.

v In response to a question whether the government has the authority given under the constitution to nationalize healthcare or create socialized medicine … John reminded everyone that we already have taken big steps in that direction with Medicaid and Medicare and prior healthcare mandates that govern how healthcare is provided nationally. It may not be constitutional but we have been doing it for years.

I ended up sitting in a row of wingnuts so I was getting an earful from two consecutive people about every right wing conspiracy imaginable … and there were many other people carrying signs and images defacing Barrack Obama … but those intellectually bereft images and conspiracy theorists aside I found the event to be very helpful in educating me. I was impressed with John Shadegg and his mastery of the topic, his ability to control a large somewhat unruly group, and his recognition that we have a huge issue confronting America that we must address together and not let the entrenched interests (insurance and pharmaceuticals) dictate the solution. Citizens must step forward and exercise their opinions and be educated on the subject.

Given the electoral makeup it was Shadegg’s position that the republicans cannot stop HR3200 from being passed unless citizens are able to sway their democratic elected officials to hold off on voting for HR3200.

Below are the main topics addressed by HR3200:

(1) IN GENERAL- The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending.

(2) BUILDING ON CURRENT SYSTEM- This division achieves this purpose by building on what works in today's health care system, while repairing the aspects that are broken.

(3) INSURANCE REFORMS- This division--

(A) enacts strong insurance market reforms;

(B) creates a new Health Insurance Exchange, with a public health insurance option alongside private plans;

(C) includes sliding scale affordability credits; and

(D) initiates shared responsibility among workers, employers, and the government;

so that all Americans have coverage of essential health benefits.

(4) HEALTH DELIVERY REFORM- This division institutes health delivery system reforms both to increase quality and to reduce growth in health spending so that health care becomes more affordable for businesses, families, and government.

2 comments:

6:12 said...

Bo- hmmm no comments yet. leave it to 612 to start the huge wave of comments once again!
thanks for blogging this though. this health care debate is amazing. obviously a tough topic.
612 has been longtime supporter of Shaddeg - so I agree with the positives you state about him. 612 is amazed that Shaddeg stayed with it rather than retiring. 612 does not know the total solution on health, but he does know that if you want it to be more expensive and worse care and more bureaucracy then go govt. 612 says go free enterprise !!

DJRRyan said...

612 ... I agree ... this is kind of like starting the wave at a football game. I voted for Shadegg as well and am impressed with persistence on a very difficult subject. I don't think there is a one size fits all solution ... my put would be to; a) make healthcare coverage portable (universality), and b) address the pre-existing condition issue at a national level. I think this would set off a wave of innovation in health coverage products and make people more personally responsible for wise usage of their health care coverage. This does not address the 20% of the population that I think are functionally illiterate ... seems like we need some way of providing them basic coverage. We do it now through emergency rooms.