Tuesday, August 25, 2009

Health Reform: The Efficiency of the Post Office with the Compassion of the IRS?

Prelude: Ideally town hall forums ought to be a place where ordinary citizens, the silent majority, the voices of reasons, can be heard. What follows is an example of such a voice, as reported in in the August 24 New York Times "Calm, but Moved to Be Heard on Health Care."

Published: August 24, 2009

MONTEZUMA, Ga. — Until Thursday evening, nothing in Bob Collier’s 62 years had stirred in him the slightest desire to take a stand — about anything — in public.

He skipped the antiwar protests of his college years, took a job as a regional salesman of paper and chemical products, and built for himself a quiet life of family and church (and hunting and fishing) in his rural hometown in southwest Georgia.

But on Thursday, Mr. Collier drove more than an hour down Route 19 to attend a health care forum in Albany, Ga., being held by his congressman, Representative Sanford D. Bishop Jr., a Democrat serving his ninth term.

To his wife’s astonishment, as the session drew into its third hour, Mr. Collier rose to take the microphone and firmly, but courteously, urged Mr. Bishop to oppose the health care legislation being written in Washington.

He told Mr. Bishop that his wife of 36 years had survived breast cancer through early detection and treatment, and that he feared that her care would be rationed if the disease returned.

“She’d be on a waiting list,” he said.

“This is about the future of our country as we know it,” Mr. Collier warned, “and may mean the end of our country as we know it.”

The town-hall-style meetings that have so defined the national health care debate during this month’s Congressional recess have produced an endless video loop of high-decibel rants. In many instances, the din has overwhelmed the calmer, more reasoned voices of people like Bob and Susan Collier, who came to Mr. Bishop’s meeting not because they had received an electronic call to action but because they had read about it in The Macon Telegraph.

There are plenty such people among the thousands packing county courthouses and college auditoriums, including some in the raucous crowd of 500 that confronted Mr. Bishop at Albany State University. The cameras may linger on those at the extremes, but it is the parade of respectful questioners, those expressing discomfiting fears and legitimate concerns, that may ultimately have more impact.

What prompted the Colliers to attend a Congressional district meeting for the first time was an almost solemn sense of the magnitude of the health care issue, and its place in determining the scope of American government.

“We both think this is the most important thing we’ve ever seen in our lifetimes,” Mr. Collier said the next day in an interview at his family’s four-bedroom house, overlooking a fishing pond. “I mean, the Vietnam War, which was a big deal in my early formative years, pales in comparison to the way this thing could turn our country.”

“I know we need some reform,” he said, in a deliberative drawl. “I’ve just got questions about how we’re going to do it.”

Ms. Collier, 60, an interior designer, said she had wanted Mr. Bishop, a soft-spoken centrist Democrat who has yet to take a formal position on the legislation, to understand that there were deep concerns.

“I wanted to make sure we were represented,” she said.

The Colliers are committed conservatives who have voted Republican in presidential elections since 1980. They receive much of their information from Fox News, Rush Limbaugh’s radio program and Matt Drudge’s Web site. But they said their direct experience with the health care system had persuaded them of the need for change.
When Ms. Collier’s breast cancer was diagnosed three years ago, Mr. Collier’s employer-provided insurance paid for her office visits, a biopsy and three surgeries. But the insurer covered only a small fraction of her radiation treatments, which it considered experimental, leaving the Colliers with a $63,000 bill. To their great relief, the charge was later written off by Emory Healthcare, whose doctors had recommended the regimen.

Mr. Collier’s employer, Buccaneer Inc., which is based in Atlanta, pays 100 percent of his health premiums but requires $509 a month to cover his wife. That cost has been escalating by at least 15 percent a year, and the couple’s deductibles have quadrupled.

Furthermore, Mr. Collier recognizes that were he to lose the job he has held for 39 years, his wife’s pre-existing condition might well make her uninsurable.
“We’ve got to do something about those people who can’t get insurance,” he said. “There has to be a safety net there. But I don’t want that safety net to catch too many people.”

That is the crux of the issue to the Colliers, who describe themselves as middle class. Since President Obama’s inauguration, their frustration has compounded as the administration expanded the federal government’s reach, seemingly every week. The final straw, they said, was the Democratic proposal to create a new public health plan, which they are convinced will evolve into a nationalized insurance system.
“I’ve never seen the government as intrusive as it is today,” Mr. Collier said, harkening back to President Bill Clinton’s declaration that the era of big government was over.

“Here comes this new guy in town,” he said, “and he wants to centralize everything.
He wants to take over the car companies. He wants to take over the banks. Now he wants to take over health care. It’s a power grab, and if he gets this, there’s no turning it around.”

If everyone is covered, Mr. Collier said, supply and demand will dictate that some must wait for their care. He does not believe the president’s promises that the elderly will not stand in line behind those with longer life expectancies.

“I don’t trust him on that,” he said, and then echoed a phrase used regularly by opponents of government in health care: “I think you’re going to have all the efficiency of the post office with the compassion of the I.R.S.”

The Colliers worry about the financial burden the health care plan may place on their two grown children and young grandson. While Mr. Collier said he did not object to paying more to support coverage for the truly needy, he predicted that a universal coverage system would dole out tax dollars to “lazy and irresponsible people who play the system.”

Doing something, he said, is not necessarily better than doing nothing.
Mr. Collier, who has voted for Mr. Bishop in the past, said he felt proud, in a patriotic way, to have been able to make his case.

“You don’t know what you’re getting when you send an e-mail to those guys,” he said. “You don’t know what you’re getting when you call one of their people. But when you can talk to him face to face like that, it’s a great opportunity.”


Matthew said...

Voice of reason? Really Dick? That was a profile of one of the dumbest people I've EVER heard of. In any other country his wife would have had the treatment she needed and it would have cost him nothing. Instead it only didn't bankrupt him because Emory decided not to push him.

And he opposes reform that would (go at least some way to) solving the problem? That's the definition of stupid. And you can't pretend that it's a rational position.

Matthew Holt

Richard L. Reece, MD said...

Matthew: I am always bemused that you consider ordinary Americans opposing reform as "stupid" and only you, and other elitist reformers, who in favor of govenment-directed reform, are "rational."

I am not confident in any other country " hiw wfie would have had the treatment she needed." I would point out that cancer survival rates in the U.S. are much higher than in Britain and Canada, partly because of the "responsiveness" of the U>S. health system, rated #1 in the world by WHO.

To me your attitude is more about intellectual arrogance than intelligence. Of course, I may be wrong and even stupid.

You have a fabulously successful website, and I congratulate you. You may, however, be on the losing side in this debate. Brace yourself.

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