Healthcare Town Hall... Not So Much

Quite a different event, Congressman Patrick Kennedy's version of the healthcare forum. Whereas Congressman Langevin placed himself bare before a roiling theater setting and Senators Whitehouse and Reed rolled up their sleeves for a folksy round of after-dinner discussion (somewhat more controlled, but with agreement and disagreement), Kennedy is participating as a "special guest" in an AARP "health care reform forum." He's one of four panelists, the others being:

• RI State Nurses Association Executive Director Donna Policastro
• AARP-RI Executive Council Member Ann Gardella
• RI State Medical Society Former President Nick Tsiongas

Sadly, nobody is outside in the parking lot protesting either Kennedy's position on this issue or his version of "meeting with constituents."

9:07 a.m.

Lots of suspicious looks from the party folks and the other members of the media with whom I'm sharing the back of the room. I'm not the only small-camcorder tripod operator, either, although I take it that's not necessarily an indication of citizen journalism, any longer.

Kennedy's making the rounds. Were I a politician, apart from discomfort with the room-working, I have to say I'd be annoyed at the constant camera presence. Guess you learn to live with it.

9:21 a.m.

Well, the event is scheduled from 9:00 to 11:00, and the breakfasts were just served. So, we seem to be looking at an hour or so presentation shared by four panelists. Even if the congressman fights for equal time, that's a total of about 15 minutes in the hot seat. We probably shouldn't expect much depth.

9:36 a.m.

The event proper has begun, with the AARP moderator Kathleen S. Connell, Senior State Director, AARP-Rhode Island. Each speaker will make a presentation, and then questions will be accepted, at first in written form from the tables.

9:49 a.m.

Kennedy's staff should expend some effort to teaching him to adjust his speaking tone depending on setting. He's shouting at us like it's a potentially hostile audience, although I suppose it's fitting, inasmuch as he's throwing the world of politics at the issue: "This bill is not just about healthcare. It's about..." everything from peace of mind to homeland security.

"YOU'RE ALREADY PAYING FOR THE UNINSURED!"

The high price of healthcare is apparently the fault of uninsured asthmatics who use the emergency room for care.

9:53 a.m.

America needs the government to step in and get primary care doctors to coordinate all of the patient's care. See, without federal mandate, doctors just don't do that sort of thing.

"ONE-THIRD OF YOUR HEALTHCARE DOLLAR DOES NOT EVEN GO TO HEALTHCARE DELIVERY!" "That's a crime and we shouldn't allow it to continue."

Although, he just said that four-fifths of "your healthcare dollar" goes to 20% of healthcare consumers.

9:56 a.m.

And yet, doctors support the Democrats' reform 3 to 1 because... they're tired of paperwork.

10:00 a.m.

"Do you want the public, through the members of congress to be the ones who regulate healtcare, or do you trust the private insurance companies? They are accountable to stock holders and boards of directors. The public option is accountable to the public."

Hey, he's got a point. If the public is paying the bill, and the healthcare system is accountable to a representative democracy, the payer won't have to worry about customer backlash if it's got political cover for such things as, say, rationing.

10:01 a.m.

Kennedy: It's all paid for through efficiencies and other obvious savings. Defensive medicine, etc .

Why not save all that money first and then move to expand the government involvement?

10:04 a.m.

We need a public option because the current system doesn't treat people as anything other than a monetary unit, and the government would see them as people. (Or, you know, voting units and campaign donation units, but we'll put that aside.)

Kennedy just complained that his friends call him up from emergency rooms all the time so he'll come down and get them special handling. On the fact that powerful folks get special treatment: "That's morally outrageous, and that's the country we live in right now."

Bad, materialistic America.

10:09 a.m.

By the way, to put a face to the journalism, this is Steve Peoples:

10:13 a.m.

Kennedy's done. Ann Gardella is speaking. Congressman Langevin just arrived.

10:15 a.m.

Tivertonian Dr. Nick Tsiongas is up.

10:17 a.m.

Mr. Tsiongas related the story that his parents recently visited and suggested that he ought to take down the healthcare reform political sign he's put on his Main St. property. Everybody who receives healthcare should be "afraid" if this reform doesn't pass; reference to Churchill's line about Americans always doing the right thing... after they've tried everything else.

Bad, backward-looking America.

10:22 a.m.

Donna Policastro is up. She's pleased that this issue has brought the R.I. State Nurses Association together with the SEIU and Ocean State Action.

Nurses are tired of working so hard to make the healthcare system work for their patients. I wonder if Congressman Kennedy would position that in contrast to those primary care doctors who don't help their patients coordinate their various specialists.

10:29 a.m.

Langevin is wired with a mic, and he's going to get a turn to speak.

10:31 a.m.

10:34 a.m.

Q&A time (read off cards).

By the way, Langevin mentioned the unsustainable trends in premium costs. The argument brings to mind a graphic that reader Roland Benjamin emailed me the other day:

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The big dip in 2003 follows the introduction of healthcare savings accounts.

10:47 a.m.

Interesting collision of issues: Ms. Policastro is talking about the coming shortage of nurses, and she cited the problem that many potential nurses get a year or two into their education and realize that there's more hard science than they'd expected, her conclusion being that high school and lower education has to improve.

Amen to that, for a multitude of reasons. Of course, the solution of the sorts of people populating this room is to flow more money to the problems, which happily benefits their friends in labor unions and other public-sector-related organizations. I suspect I'm not alone on the other side in believing that that solution is the problem.

10:53 a.m.

Kennedy's redirected to his push for more money and requirements for care, which will benefit those who provide care ("NO COPAY!" for screening procedures). Eventually, it comes down to taking money from some Americans to give it to others. Everything in between is quibbling about the "who" and in what form.

10:59 a.m.

Tsiongas just put the difference in practical philosophical approaches to the issue of healthcare: He wants to take "all of the money" currently constituting the healthcare system — consumers, unions, providers, insurers — and put it all together in one pile "so we can make better decisions."

How can such folks not see the clear consequence of that sort of consolidation? Defining the "we" who will make the decisions becomes a huge battlefield. Let's assume the pure motives of Mr. Tsiongas and everybody else who currently advocates his position. By what mechanism do the Tsiongasians intend to keep control of the decision making process? And to the extent that they create those mechanisms, why should we trust them to have that expanding power?

11:04 a.m.

Kennedy: "If the insurance companies and everybody is so good at lowering prices and finding efficiencies, why aren't they doing it?" Umm. Government mandates, requirements, and regulations.

11:11 a.m.

Moderator Kathleen Connell called for a round of applause for the press for coming out on a Saturday. Curious.

11:15 a.m.

Steve Peoples started to ask me my thoughts on the event but had to run after Kennedy for a comment. For the benefit of all media types who may want the right-wing opinion (as filtered through my potpourri of philosophical and personal inputs) should feel free to call or email or, you know, just read the above...

ADDENDUM:

I've posted the video from the event here.