Eighteen people, all but one of us seniors, attended our home meeting on December 28th to discuss the US health care system and provide a report to the Obama Transition Team. Everyone was passionate about the topic; so much so that it was difficult for my wife Marguerite to get them to confine their self-introductions to their name an their major concern. She gently moved ahead, following the moderator guidelines provided by the change.gov website.
If you are interested in the specifics of the discussion, a copy of the group’s report is available in PDF format here. This article focuses on the process, rather than the specific responses sent to the Obama team. However, as you might expect, no one there was defending the status-quo. They all want to see a single-payer system that eliminates the waste and frustrations of dealing with health insurers, and the many problems that arise for those who must find insurance as individuals. Most of the personal stories people told harkened back to days before they qualified for Medicare. Those who expressed a degree of satisfaction were covered by a plan provided by a major employer. Individuals and small business people were the least satisfied. It’s fair to say that most of the people at this meeting were more concerned for others than for themselves in terms of coverage. But all were concerned about the tax implications of a national health insurance program.
The agenda worked quite well. Everyone got a copy of the questions and topics to be discussed at the beginning of the meeting, and though discussion ranged widely not always remaining confined to the immediate topic, Marguerite was able to record key ideas and points on a large flip-chart so that everyone could see that their points were recorded.
The discussion obviously had benefits for the participants beyond communicating their ideas to the transition team. Many of us came with a fairly narrow focus based on personal experiences. But as we participated in the discussion, we were prompted to enlarge our awareness of the scope of the problem. While some wanted more and better benefits, others were concerned about how the program would be financed. Marguerite burned the midnight oil to condense the notes, sent a draft to all who were there and incorporated corrections and afterthoughts before submitting the report on 12/31.
I originally went into the meeting wanting to see the costs of medical care reduced, and the frustrations of dealing with private insurance fixed. I was primed to spout-off about my personal dissatisfaction with the system. But as I listened I heard other points of view, and I began to appreciate the complexity of the problems. There are many interconnected issues involving various public policy areas. I discovered that I did not know as much as I thought.
As a group, the 18 of us became listeners as well as speakers—we became stakeholders and not just angry opinionated observers. In the end, everyone wanted more information. Each of us will listen to the arguments with a broader view and a more inquiring attitude.
This may be a big part of what Obama was hoping to achieve: a large number of people who are really engaged in the issue, people who won’t be satisfied or easily swayed by the propaganda and sound-bites that are served up by insurance providers, drug companies, litigators, and others who have a financial stake in keeping things as they are. If that was the “hidden agenda” it succeeded.
In my previous article I invited people to email me about their experiences, and I hope to get more such reports (click on my by-line and then click the send message button). From the reports I have seen so far here are some notes:
· One person commented that his group of 65 “strongly rejected using the questions and instead voted unanimously to tell Obama that we want single-payer system…”
· Another had not attended a meeting yet, but intended to “do the same” as the person quoted above.
· Other comments express skepticism that Obama can be persuaded to make significant changes in the face of the powerful pharmaceutical and insurance lobbies. (These people did not mention any intention to participate in the meetings.)
· A Florida resident reported positively on her meeting: “I'm reporting in on the meeting I feared would be partisan. It turned out to be a good meeting. The Doctor who hosted it is an ER Doc and is fed up with what he describes as a system that is not working. He's a Republican who turned off on McCain because McCain said uninsured people can always go to the ER. He's been communicating with the Obama team for a year now on healthcare. The Republican moderated said healthcare is nonpartisan and did a good job. The Doctor had a nice PowerPoint presentation and it turns out he wants a single-payer system. He said he doesn't care who runs it. He likes Blue Cross/Blue Shield. There were some dogma types there who spouted we didn't want socialized medicine or that tort reform would fix the whole thing but everybody blew past them pretty fast. Most people complained of not being able to purchase insurance due to pre-existing conditions. The report is going into the Obama-Biden transition team tomorrow.”
I am very optimistic about the process that is going on here. If a politician is trying to push his agenda rather than be open to debate and compromise, it meetings of this sort would not be desirable. They create motivated, informed people. The promote and help organize activism in directions that can’t be anticipated or easily manipulated.
But if one wants people to be thinking and standing up for their concerns, this is the way to go. With the reports pouring in to the transition team, some of them complete with video and photographs, it is Obama’s turn to respond. Stay tuned.