The din of the debate over national healthcare reform reached a fever pitch in Santa Barbara Wednesday night as Congressmember Lois Capps (D-CA) held the first in a series of town hall meetings regarding HR3200 - America’s Affordable Health Choice Act. The controversial healthcare legislation has undergone several significant changes as it has wended its way through Congressional committees, but Capps defended the current version as something that addresses everyone’s needs. “One thing we can all agree upon is that the system cannot continue how it is,” she said, adding that the number one cause for bankruptcy in the United States is uncontrolled medical debt. While many people in the audience were audibly supportive of HR3200, nearly half were opposed to it, and continually voiced their displeasure with shouts, catcalls, and hisses throughout the meeting. “I championed that legislation. I read it, I was engaged in it, I participated in parts of it, and it’s a good bill,” she reassured her detractors.
Held in the social hall of the First United Methodist Church in the heart of downtown Santa Barbara, the City Fire Marshal was strict about the number of people admitted, allowing only 210 of the several hundred people who showed up to enter. The shouts of the angry crowd of people denied entry - which stood at about 100 even an hour into the meeting by several accounts - could be heard from within the hall, forcing police officers to keep all but one of the doors of the sweltering room closed. With attendees vigorously fanning themselves with pieces of paper, the scene took on the character of a Southern revival meeting as Capps went through the details of the legislation.
“If you like the plan you have now, you can keep it, and our plan will help you lower your costs,” Capps reassured her detractors, saying that with the current plan, the government will go broke from the costs of inefficiency and corruption, which the nonpartisan Congressional Budget Office pegged this year at more than $500 billion. Capps promised that by closing loopholes allowing corporations to operate in offshore tax havens, among other tools, HR3200 would be deficit neutral.
Capps said that a reasonably priced public insurance option, which she stressed would never be required for people who wished to maintain private insurance, would stimulate competition between private companies, whose administrative costs would be limited to 15 percent of their entire budgets. “I believe that a robust public insurance option is the only way to ensure true competition,” she said, adding that the bill includes a provision to phase out the current “doughnut hole” that leaves many seniors without adequate prescription medication coverage, as well a guarantee that patients will not be dropped from insurance policies due to preexisting conditions. The main goal, she said, was to change the procedure-driven insurance billing standard currently in place to one that encourages doctors to focus on a patient’s outcome and overall wellness. By eliminating co-pays for preventative healthcare measures, Capps said that costs for more advanced illnesses can be reduced.
Joined by Dr. Ned Bentley, an area gastroenterologist and head of the County Medical Association, and Joyce Lippman, the senior advocate for the Area Agency on Aging, Capps held a lengthy question-and-answer session during the meeting’s second half. Moderated by former Santa Barbara mayor Hal Conklin, there was much criticism regarding the manner in which the questions were submitted, with meeting participants writing their questions on note cards, then read aloud by Conklin. “It was kinda rigged,” said Santa Barbara resident Mike Creegan, who voiced his concern that too much of the bill had been formulated in Congressional backrooms. “In a lot of ways, this was a real sham in that at least 40 to 50 percent of the audience was against the bill. But the questions were all softball pro-bill.”
While the format of the meeting prescribed on huge wall placards was observed for most of the night, one man finally shouted enough to be allowed to ask his question verbally. Clad in a green baseball cap that said “Border Patrol,” he angrily inserted that concern for the uninsured should not affect people who are already covered. He declined to comment further to The Independent, but plenty of commentary was offered by Capps and panelists concerning the 148,000 uninsured residents of Santa Barbara County. “I think it’s shameful. A caring, affluent society such as ours ought to be able to provide healthcare for all of its citizens,” said Bentley.
In addition to questions, many whose cards were read offered suggestions, running the gamut from revamping medical liability all the way to going with the type of single-payer or nationalized system currently seen in Canada and the U.K.“I believe strongly that we are not ready for such a major change from what we have now,” said Capps in response to someone who asked why Congress wasn’t going the single-payer route. “We need a bill that can be passed and signed into law.” She did, however, support the Kucinich amendment to the bill, which would allow each state to determine whether or not to go with a single-payer model.
Much of the presentation portion of the meeting was dedicated to dispelling myths Capps said have been propagated about HR3200. Chief among these explanations were her promises that the so-called death panels are a fallacy - she said that under the bill’s provisions, patients make their own end-of-life care determinations - and that undocumented workers and their families will not be covered. Furthermore, she said, the plan calls for federal employees, including members of Congress, to have the same coverage as everyone else, and offers incentives for medical school graduates to go into primary care roles - an effort to eliminate a system that Bentley said is top heavy with specialists.
Although HR3200 will move tenuously forward through congressional debate over the next several months, it still faces Senate review. Capps said that it is her hope that it will be signed into law sometime before the end of the year. “What’s the hurry?!” someone blurted out toward the end of the meeting. “The cost of inaction is too great,” she replied. “That’s my opinion, but it’s been substantiated by numerous studies.”