Congresswoman Gabrielle Giffords brought a secret weapon to her health-care town hall in Sierra Vista on Monday night (Aug. 31): Richard Carmona, the Tucson doctor who served as surgeon general in the Bush administration.
It was Carmona who made the case for reform at the start of the meeting, telling the capacity crowd of 1,300 concerned citizens that health-care costs were rising out of control, and that an estimated 50 million Americans lacked health insurance.
"Most of them are working poor," Carmona said, "not as they've been characterized as deadbeats. Most of them are working poor who are struggling every day just to put bread on the table and keep their houses and keep their kids in school."
Carmona concluded with a call for civility at the town-hall meeting.
"I've been around the country with other elected officials and watched the debates," Carmona said, "and I'm hurt by how often they degrade into shouting matches."
The crowd responded with a loud chorus of boos, with one man yelling: "You're the only one talking!"
Some rowdy behavior continued through the meeting—a pair of girls in a back corner booed and screamed "liar!" nearly every time Giffords had anything to say—but the crowd appeared split between those who supported reform and those who were opposed.
Giffords said at the start of the meeting that she had not sponsored health-care legislation and didn't sit on any of the committees that were hearing the bills, but that she was there to listen to what her constituents had to say.
Speakers, who were chosen by a random drawing, alternatively argued for reform of a failing system and against government expansion.
Many of those opposed to the Democratic proposals for health-care reform expressed skepticism about the ability of government to handle anything.
Jake Kimball, a registered independent who said he had mixed feelings about Giffords' voting record, said he'd rather see costs brought down through tort reform and the deregulation of insurance companies so they could do business across state lines.
"It has been my experience that the federal government is unbelievably inadequate in taking care of business," said Kimball, who sat through about 90 minutes of the two-hour town hall before getting up to leave. The meeting did little to change his mind about health-care reform.
"It needs a hell of a lot of work before it ever comes out of committee," he said.
Roberta Atlas, 70, said she understood that some kind of reform was necessary.
"Definitely some tweaking needs to be done," Atlas said. "But why throw the baby out with the bathwater?"
Atlas, who said she was happy with her Medicare coverage, added that she was concerned that giving more people health-insurance coverage would lead to cuts in what she receives. She was particularly opposed to a single-payer system that would insure all Americans through the government.
Giffords herself opposes a single-payer system. She supports a "public option," which would create a government-run insurance program that would compete with private insurers.
As envisioned in HR 3200, the major health-care reform legislation moving through Congress, the government would create a new Health Insurance Exchange where insurance companies would offer to sell coverage to people who can't get insurance through their employers and who aren't already covered by Medicare or Medicaid. In competition with private insurers, the government would offer health-care coverage policies that people could buy, according to OpenCongress (www.opencongress.org), a Web-based resource that tracks legislation.
As polling pundit Nate Silver pointed out last week at fivethirtyeight.com, support for the public option has ranged from a low of 35 percent to a high of 83 in various polls, with the result often dependent on how the public option was described.
Silver concludes that much of the public is confused by what a public option actually entails, although he notes that supporters of the public option "should have little to fret about; the most neutrally and accurately worded polls on the public option ... suggest that their position is in the majority, with 56-62 percent of the public supporting the public option, and 33-36 percent opposed."
Giffords says she "strongly supports" such a public option, as does Congressman Raul Grijalva. (Grijalva has gone so far as to say he would oppose any reform that doesn't include a public option; he considers this a compromise from his preferred policy of a single-payer system.)
Critics of the public option say that it will put private insurers out of business, because a government program will undercut private businesses, which will lead to a single-payer system that will provide substandard health care.
Carmona, however, argued at the start of the meeting that the United States needed to reform the current system to get costs under control.
"The legacy we will leave our children and our grandchildren is unsustainable unless, at this critical juncture in our history, we take some bold steps to make the system more responsive to your needs," he said.