Health Care Town Hall in Georgia

In my years living in Georgia I’ve only lived in the 4th district, and attended town halls thrown by both Cynthia Mckinney and Hank Johnson. These events usually average out to about 30 people – 150 if there’s a panel and other things going on, and they’ve all been mostly African-American. What I saw yesterday was, for me, unprecedented. I’m not good at estimations but the turnout was well in the hundreds.

I arrived about ten minutes late (if I were a conspiracy theorist I would say it was really unusual that the 122 and 125, the buses that go to Georgia Perimeter College, stopped running from 6 to 6:50 – apparently unrelated coincidences, so most of us who take public transit arrived late). I wasn’t able to get there in time to make it into the main auditorium where the town hall was taking place, but hundreds more were ushered into a cafeteria or some sort of large room, where screens had been set up for viewing. The general feeling in the crowd was tense – when I was walking in line amongst a mostly white (which I can assume was mostly conservative at that moment) crowd remarks were being made such as “we’re being taken to the gas chambers”. Pamphlets were being handed out warning us of upcoming socialist tyranny. At one point I received a tap on the shoulder and was scared to even look up but (and I think I literally said Oh Thank God out loud) luckily it was two like-minded friends – although they left early.

Anybody who knows the fourth knows it’s a mostly black, democratic district. This wasn’t reflected in the crowd. The republicans were definitely more mobilized, and the crowd ended up being about half pro- healthcare reform/universal healthcare and half anti-reform conservatives, with people of color being the definite minority in both camps (at least in the viewing room).

This I can positively say – the right wingers were not able to dominate this town hall meeting like they have in other parts of the country. I think Rep. Johnson did a great job of cutting them off at the beginning – reading the e-mail that has been circulated among the right wing asking for disruptions and disputing it with a plea for dialogue, which received enough of an applause from the crowd that any major disruptions (and I know there was a few conservatives in there that were holding back) would have seemed silly and counterproductive. That doesn’t mean, of course, that the republicans didn’t take every opportunity to jeer the congressman and other speakers and cheer every time some rhetoric about personal responsibility and freedom from government came up, but most of it was limited to spectator reaction, that was countered by applause and counter-points from the other side.

After the congressman’s uninspiring remarks, which were hard for me to make out, came the panelists. Not surprisingly, not one single advocate of single payer healthcare was present. The panel had six members that included doctors, a member of the American Medical Association, the CEO of Grady Hospital, and somebody from the right that was really big on tort reform from a group I’m not familiar with. They were diverse in terms of background but ideologically hovered around vague ideas of tweaking the system here and there – small reforms - national, state and local - that would allow for more coverage but keep the sanctity of privatization in place. The most radical voice on the issue came from the CEO of Grady. He spoke of the issues Grady is having just keeping afloat as the main hospital in Georgia and one that serves patients unable to pay in strictly private hospitals. He told of the millions and millions of dollars Grady gave away each year in medications and came out firmly for a national public plan option and government negotiated prescription drug prices. He probably received the largest applause from universal healthcare supporters in the room.

Then came the question and answer session, where I thought universal healthcare definitely had the upper hand. People of color – mostly African-American, were the majority of those asking questions. One of the more charged statements (and one that garnered the most reaction from both camps) was an older black woman that had no insurance, couldn’t be treated at Grady because she wasn’t a resident of Dekalb or Fulton and was generally frustrated. She ended her question with a statement “if you make slaves, at least take care of your slaves”.

Another charged moment (and my favorite) came from a new father who had a baby of maybe 8 months in his arms. He was perhaps in his thirties, white, so not easily profiled ideologically, which gave him the full attention of everybody watching, waiting to see what he’d say. He spoke emotionally, telling how his baby was born at 11pm, resulting in the hospital charging his family for an extra day’s stay. His insurance company disagreed, leaving his family in a financial pickle. At the end of his statement, he lifted the baby in the air and said to applause and more conservative confusion and silence rather than boos “this is a victim of insurance rationing” – directly confronting the talking point of government healthcare leading to rationing. It was a powerful moment. There was no great moment for those that opposed reform, only skeptical questions (many valid) about what was in the bill, which is over 1,000 pages long. Hank Johnson, to their delight, didn’t really seem to know the answer to that question.

While the ideological battle around healthcare did seem to go (slightly) to those that favored universal healthcare or some sort of reform in this town hall, those that came to express that sentiment found little concrete affirmation in the at times incoherent ramblings of Rep. Hank Johnson. While he did feel emboldened enough by the democratic presence to use rhetoric to declare this (rightfully) a moral issue, take partisan shots at George Bush and needlessly praise Barack Obama, behind his statements of support for a public plan and reforms were murky details, which he usually let his legal assistant work out. At times the reform was presented as more regulation of private companies and at times Johnson spoke with authority about needing a public plan for everyone, and making sure it wouldn’t be watered down. Johnson did make sure to couple his summation with the statement “I still believe in profit, capitalism will be preserved”, which might just sum up the major contradictions of the democrats’ plan. If this is coming from one of a small minority of congresspeople who has been vocal about the need for single-payer in the past, it doesn’t give much hope towards what the end result of all this bargaining will be.

Another thing that was quite obvious, although I already knew it theoretically, was that the “O” – Obama – generation and movement has no teeth – at least in the 4th district. The people that took to the streets to register votes, canvass and vote themselves were not present en masse at this event – perhaps by design. Organization and numbers definitely went to the right wing, especially considering the demographics of the area. While there was a presence of groups like ABLE, Health Care for Americans Now and other mostly white, liberal groups, the only vocal and worthy activism seemed to be from Healthcare Now and single payer advocates. A handful of single payer activists held signs outside – one had his mouth covered by tape with “single payer silenced” written on it. They said they were deliberately passed on during the q and a session, and said many people they talked to, even though they agreed, didn’t know what single payer meant.

It was a relief to be able to attend one of the few town hall events around the issue that didn’t devolve into a shouting match or right wing take-over. Even with all the passion and dialogue on both sides, though, I couldn’t help leaving with the feeling that nobody won, except the corporations that will have their hand in our pockets no matter what the outcome ultimately is.

"Medicare for all" now!

On a long drive from Michigan to Louisiana, I received a "robocall" from Republican Senator David Vitter urging me to attend a "town hall" meeting in Metarie, (a suburb of New Orleans) to have been held today. Vitter urged me to attend where i could hear
his "plan" for reducing medical costs, without taxpayer funding.

I immediately thought of the militancy the of anti-health care reform demonstrators in Pennsylvania. I thought, "hmm, wish i was closer than 800 miles away, i think i'd show challenging Vitter on his taxpayer subsidized health care"; maybe i could make a "Medicare for All" sign. With a little notice, it could have been an opportunity to mobilize dozens from New Orleans that have no health insurance and now with Vitter supported closure of Charity Hospital have all but no access to health care.

The rightwing is unafraid to use militant tactics in this debate. Much of the left, with a few notable exceptions, has been hesitant to act allowing centrist Democrats in the pocket of the insurers and pharmaceutical companies to frame the debate, and liberals to bolster the Obama plan. Since this is the 75th anniversary of "three great strikes that led the way" to rebuilding a fighting union movement- the West Coast LongshoreStrike, Toledo Auto-Lite, and Minneapolis Teamsters. I thought about the class-wide demands of those strikes and how the energy spilled over (more about that in a later post).

Then i took a step back. The "healthcare debate" or, the discussion of medical insuarance in the US is not even framed in a way that the grassroots can fight for class-wide demands. Obama's folks have read the tea leaves, and have continually framed it as an individual choice, trying not to ruffle the feathers of the (imaginary, percieved, or focus group) "middle." Medical insurance is cast as an individual choice of private insurers. In doing so they get backing from a section of capital that supports expaning insurance coverage in the US: the insurance industry.

One of the ways that the debate is currently framed pitts "expanding coverage" versus "controlling costs" (see "Health Care fight tricky to wage," USA Today
Monday August 10, 2009). Young people and the uninsured support a position of expand coverage (including Obama's proposals) while those with private insurance or Medicare are more interested in keeping their coverage, but controlling costs. Sadly, only a single-payer system can do both. "Medicare for All" should (continue to be) our rallying cry!

Medicare for All, in the form of House Bill 676, (authored by Democrat John Conyers of Michigan's 14th District) would put the bulk of private
insurers out of business and finally eliminate the staggering levels of medical inflation. It would reduce the huge amount of waste and forms of parallel
recordkeeping, billing and administration under the existing system. Unlike most Congressional bills, HR 676 is responsible to workers in insurance companies, doctors offices, hospitals, and nursing facilities, whose jobs who would be eliminated due to reduced
administration to have first priority in retraining and job placement in the new system and be eligible to receive 2 years of unemployment benefits.

It seems to me that the ideological opening to fight for HR 676 is now. A recent Health Care "town hall" in Portland saw 100 people rally for single payer health care, under the auspices of Jobs with Justice. "Medicare for All" is a demand that makes
sense to the public, and bridges the differences of opinion that exist among the working people in the US. Of course, the insurance companies will fight at least as hard as the right to keep HR 676 from becoming law. But we can learn to fight back- and hopefully build momentum as others learn to fight- if we can work together to mobilize around class-wide demands, and willing to use militant tactics as part of our toolbox.

http://www.pnhp.org/
http://hr676.org/
http://www.johnconyers.com/hr676endorse

nice article

some synergy with this piece by David Duhalde on his visit to his local town hall:

http://theactivist.org/blog/dispatches-from-a-town-hall-where-is-the-left

Obama, the Democrats & "Medicare for All"

I think Obama and the Democrats have blown it! The right is on the attack and the Democrats with their mild vision of reform don't even have a concrete proposal on the table. In his desire not to repeat President Clinton's detailed bill of 15 years ago, President Obama let Congress draft the bill--which they still haven't done.

The only way to control the rising health care cost is through eliminating health care as a profit-driven industry. That's necessary in order to eliminate the waste in advertising, paper work and a medical insurance system built on fee-for-service payment system.

Obama believes he must win over the insurance and pharmaceutical industries in order to win universal coverage. But bringing them on board and getting them to pledge a $2 trillion cost reduction over the next decade doesn't come close to controlling costs. Meanwhile the health care industry is delighted with the possibility of a Massachusetts-type bill mandating coverage for everyone. On the other hand, they want to do everything possible to prevent a "public option" for adults under 65!

In his op-ed article in the NYT on August 16 Obama never mentioned a public option! In fact he talked about a reform of the health insurance industry, not a reform of health care!

While the right is in a frenzy over the possibility of politically defeating Obama on the issue, it seems like Obama and the Democrats in Congress are stuck because they won't/can't take on the health care industry and extend Medicare to all.

The Pathetic Nature of Reformism

Dianne,

So very true.

All throughout this mess, I've kept thinking how well the health-care "debate" demonstrates the sad dialectic of reformist politics.

Reformism holds to the mythical possibility of "third way" politics, and its ideologues seem to never learn enough for them to abandon proposing fantastic, impossible "win-win". Is it a matter of them being stupid, and needing to learn more? Don't think so; it's their pathetic function at dominant center of US politics.

Reformists tell us to conciliate to the right and the ruling class, and get everybody's "buy-in" in order to move reforms forward. In reality, it means abandoning things like actually campaigning for what you want, class struggle, and basic ethical principle. It cedes the ground and terms of debate to the right before things even get started, and cynically calls for "constituencies" (workers, people of color communities, the oppressed) to get on board.

Witness the befuddled President and Congressional Democrats idiotically confront the rights' accusations that health-care reform will mean "death panels" and creeping socialism. Liberals are not capable of saying what simply needs to be said in return - that health care is (should be) a right and the fact that the market and moneychangers determine how we care for the sick, diseased and injured - determine who lives and dies - is an absurd moral crime.

Unable to say this - which would immediately challenge the profit logic of how we care for one another - they are reduced to babbling about surtaxes, "co-op plans" and all kinds of stupid tinkering. The liberals have been so bad at trying to present their "reforms" that I wonder if they not greedily lying to people and hope that what they claim to push for actually fails.

I think this is also a great object lesson to discuss accusations by some on the Left against those of us who call the DP what it is and refuse to betray ourselves and others down the hopeless road of reformism. It is one thing to ride a wave of enthusiasm around Obama's election and believe it will somehow catalyze struggles for reform. It is quite another to build politically independent struggles around what we really want - public health-care - no matter which capitalist party is in office.

This is not about holding onto some sort of "revolutionary purity" - its about waging a fight for reforms that can actually win; and understanding that political independence is our only guarantee of forcing ruling-class power into retreat (and even defeat). I find it sad that some on the Left are busy diatribing against our "purism" and urging support for the EFCA-lite and the health-care non-reform being pushed by Democratic Party liberals, as opposed to jointly organizing the movements it will take to win real reforms and speaking out against the crimes of the Democratic Party hacks who we are tirelessly being told are on our side.

"Public Option" is a Dead-End

To continue on Amauta's comments on the paradoxical logic of reformism. At the moment, more and more of the left-- including single-payer supporters-- are rallying to support the "public option" feature (now being dropped) of Obama's original health-care proposal. Some are trying to present the "public option" as a first step toward a universal, public health insurance program in the US. Others are arguing that it makes the Obama proposal-- filled with subsidies to the private insurance companies-- a tolerable "lesser evil."

The reality is that the "public option" is neither a step toward "Medicare for all" nor a "lesser evil" to the present system. The "public option" is actually more "Medicaid" for the poorest US citizens (remember, none of Obama's proposals cover the millions of undocumented immigrants who live, work and pay taxes). Only those who cannot afford the privately provided, for-profit, insurance would opt for what will be underfunded and inadequate insurance under the "public option." Not only is this not a step toward universal public health insurance, but it will be paid for through special taxes on (mostly) unionized workers who have employer provided health insurance.

Put simply, the "public option" in Obama's health care plan continued the long-tradition of US social welfare programs. With the exceptions of Social Security pensions and Medicare, most US social programs are not universal-- only the poorest US citizens qualify. Given the realities of institutional racism in the US, this means the people of color will be over-represented among its recipients. The programs tend to be massively underfunded and bureaucratically administered. Finally, the programs are paid for by taxes on employed (and disproportionally white) workers.

The result is that these programs become, in the hands of both liberal and conservative politicians, an excuse for attacking social welfare. The programs tend to "not work" (because they are underfunded) and tend to be seen by employed (and white) workers as a "hand out" to unemployed (and non-white) workers. Put simply, the "public option," like most other US social welfare programs, are not only inadequate, but deepen racial divisions among working people.

We will probably not win single-payer health insurance in this round of struggle. But it is crucial that leftists and progressives create and preserve networks of activists who educate and organize for a very different type of social welfare program in this country-- one that is adequately funded with taxes on the corporations and the wealthy and that is universal. In other words, a program that benefits working people and promotes a relatively united working class constituency for its defense!

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