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Stark talks health care at town hall

Submitted by on 1, September 14, 2009 – 6:00 am21 Comments

141131California Congressman Pete Stark faced an overflow crowd at his monthly town hall meeting Saturday at Alameda City Hall, with a litany of questions about the health care reform plan President Barack Obama is touting and the reform bill he and others are attempting to push through Congress.

Most of the 200 people who packed council chambers Saturday said they want Stark to back a “public option,” which essentially would be a government-sponsored plan for Americans who can’t get their care from a private insurer and don’t qualify for Medicare or Medicaid. The “public option” plan would be part of be new “exchange” in which it would compete with private insurers for customers.

“The reform needs to be serious. It must have a public option,” said Tasha Keeble, a public school teacher. She said she can’t afford the health care plan her school district offers so she pays for her own PPO plan, but that her coverage is minimal and that she’s afraid she won’t be covered if she gets sick.

Stark said that while he hopes to “get through with the bill we wrote,” he may be willing to compromise – particularly with conservative Democrats – in order to get something passed. Some of the options under consideration include a “trigger” that would put a public plan in place if private insurers don’t lower their rates or if costs savings aren’t realized in five years and allowing private insurers to bid for the chance to run the plan.

“As long as I can assure you that more than 95 percent of Americans have a health plan in five years, I can’t say I would vote against (a bill without a public option),” he said.

71Stark, who is the head of the House Ways and Means health care subcommittee and a co-author of the H.R. 3200 health care reform bill, said he hopes to have a bill pass the House of Representatives in October. He said that 26,000 people in his district lack health insurance.

But that assurance wasn’t enough for some participants in the town hall meeting, who shouted at Stark for engaging in what they called “political horse trading” over health care. One man yelled that today’s efforts to fix the system are “a once-in-a-lifetime opportunity.”

A group of doctors from Asian Health Services in Oakland presented Stark with petitions bearing 3,000 signatures from constituents who want a public option included in the final health care bill. They said the system as it exists now costs people more money than health care in other industrialized nations, and that we have much less to show for it.

112Some town hall participants offered their horror stories about getting sick and dealing with insurers. Alyssa Eisenberg of Emeryville, who was diagnosed with multiple sclerosis in 2000, said that she struggles with keeping a full-time job, in part because she has been forced to take many days off to haggle with her insurance company over its denials of her claims. She said she has never lost an appeal.

“This mean tone some people have (on this issue) has become acceptable. I think people like you need to say that’s wrong,” Eisenberg said. “Don’t make me feel like I have to apologize because I’m sick.”

Opponents of the reform plan, who were a distinct minority at the meeting – and with whom Stark had a few testy exchanges – raised fears that have dominated much of the debate over the plan – that it will drive up the federal deficit and slash quality. And some asked if the plan would pay for care for undocumented immigrants or abortions.

One woman said her son-in-law’s father, who lives in Canada, was unable to get the care he needed for cancer when he needed it. She said she doesn’t want the government to run health care.

Canada’s health care system is a single-payer system run by the government.

Stark said the plan would not include money to cover illegal immigrants or pay for abortions, though he said that under current law, anyone can purchase health insurance and that hospitals are obliged to help anyone who walks into their emergency rooms. He said that federal law prohibits the use of federal funds for abortions except in cases of rape, incest or to protect the health of the mother, and that his bill doesn’t change this.

“Don’t go home thinking you’re going to be paying taxes to subsidize illegal people. That’s not going to happen,” Stark said.

Another opponent, Richard Clark, questioned Stark’s assertion that the reform plan would pay for itself. He cited statistics from the Congressional Budget Office that said the plan could cost more than $1 trillion over 10 years.

The non-partisan budget office offered preliminary estimates in July saying the plan would cost $1.042 trillion over 10 years and that it would result in a deficit of $239 billion through 2019. But it said the estimates were not based on specific bill language.

The Congressional Budget Office said Thursday that they don’t expect the cost of a “public option” health plan to increase the government’s health care spending, though they said the government could see costs if the premiums it charges under the plan don’t fully cover the cost of its subscribers’ care.

They said provisions the Senate is considering adding to the House bill that would expand eligibility for Medicaid, the public health care program for the poor, could cost more than $1 trillion over 10 years.

Stark said the cost of the overall reform package – which President Obama pegged at $900 billion over 10 years in his speech to Congress last Wednesday – would be covered by shrinking annual Medicare rate increases, eliminating waste and abuse in the current Medicare and Medicaid systems and increasing taxes for the wealthy.

In addition to creating a new insurance marketplace for America’s 45 million uninsured, President Obama says his plan would prohibit insurance companies from denying coverage to people with pre-existing medical conditions and from dropping people’s coverage when they are sick, and cap out-of-pocket costs for medical care. It would require many employers to cover their employees and also would require people who can afford it to buy coverage.

After the hearing, Stark spoke to the 50 people who weren’t able to get into the town hall, who waited on the steps of City Hall to chat with him.


  • Art A says:

    How could anyone believe that the government has been waiting til now to cut $450 billion or so in waste and fraud from Medicare and all it needed was something good to spend it on? If it could have been cut, it would have been cut. Also, how can anyone believe that cutting all that from Medicare in order to insure the un-insured will result in more or better healthcare in total? Since Democrats in committee have gutted provisions that would insure benefits only go to citizens and legal residents, it's classic Pete Stark to say that he's not for expanded free healthcare for illegal aliens (they already have free healthcare in most cases). It's a classic something-for-nothing sales pitch. Oh, and Michele, that's $900 BILLION not $900 million of projected deficit. Speaking of projected deficit, Medicare costs 16 times as much as originally projected in inflation-adjusted dollars this year. So much for government spending projections.

  • Jan says:

    Art brings up legitimate concerns about the cost of the bill. If only opponents would focus on these kinds of real arguments rather than scare tactics.

    As for his concerns about the cost of the health system changes, it's really anyone's guess how they would affect federal spending and the premiums and coverage of people who now have insurance. You have to look at this globally…the current "system" is getting more and more expensive because it's so fragmented and inconsistent. People without insurance cost the system money because they use medical services inefficiently. The cost is increasingly being borne by insured people whose benefits are being cut so they spend more out of pocket. So it's a matter of reintroducing the concept of insurance to this system — sharing the risk among a large group of people, that's what the exchange would do. It will cost some money to get it up and running and to get more people into the game. But after a few years, once we are spending more on primary care doctors and nurses and less on high-profit procedures by orthopedic surgeons and MRIs, things will even out and we'll have a system that provides more people with basic care and that is less focused on rewarding whoever has found a clever way to suck money out of medicine (surgeons, for-profit insurers, etc). Will it be perfect? Never. But it will be better than this random, unfair and often tragic system we've got now. The free market is fine for bond trading, but it isn't very responsive to sick people.

  • S. Munson says:

    Jan is right that no one has a crystal ball to predict the future. At the same time, we're talking about the federal government here. I think given it's abysmal track record on everything from it's wars, Medicare, education, the postal system, it's ridiculously complicated tax code, welfare, cost of public improvements, you name it… there is no reason whatever to think that this will be well-managed or even acceptably managed. If it is, in my opinion, it would be a first. It would be like giving a completely incompetent employee, who has blown almost every task given in the past, a new important job of massive scope and expecting that to go well simply because you want it go well. It's the difference between good intentions and good results. I respect Jan's hopes, but don't believe there is the slightest chance of that working out well. Nor do I think the middle of big recession is a good time to re-work the whole thing. Especially when there are a lot of good reforms that don't require such a massive change and gamble with 1/5th of the economy.

  • RK says:

    Great coverage of this issue, thank you.

  • rc says:

    Many of us opposed to HR 3200 are supportive of health insurance reform and many of the goals stated by Pete Stark. The comments made above are right on track.

    There are legitimate concerns about 1) increasing government control and 2) the impact on the deficit and long-term impact on the economy. The fiscal deficit just hit $1.38T.


    While Medicare and social security are much needed programs, the government is spending every dime raised now to fund future program obligations. There is a large deficit looming for these programs that will dramatically affect the level of the benefit and or create a huge tax burden on our children. How the government is economically running these programs, makes Bernie Madoff look like a man of high integrity.


    Move forward in a thoughtful manner to address tort reform, increase competitiveness across state lines, address portability issues, provide support for those falling through the cracks, implement a national standard benefit design…etc.

    We need a thoughtful bipartisan approach to implementing health care reform; not a path toward government run single payer system.

  • Richard Bangert says:

    Today's KQED Forum program featured T.R. Reid, author of "The Healing of America." Listened to it by going to KQED's archive.

    His book compares healthcare systems in other countries. He offers fresh insight on the healthcare reform debate.

  • Art A says:

    I think that one of the things that is often overlooked in comparing to other countries is the difference in political systems. In America we have what I believe is legalized political bribery. You can't just do some pragmatic thing, because there's always a politician who has received money from a special interest to keep the gravy train going. So, you can't just transplant some other country's system and think you're going to get great results. You're going to get what you have with this proposed reform: tort reform isn't part of it, because of trial lawyer political contributions. Drug companies are for it, because they see the Medicare donut hole closing and a whole new vista of subsidized drugs. As S. Munson put it above, "It’s the difference between good intentions and good results. I don’t believe there is the slightest chance of that working out well."

    • You know, the thing that I find interesting about this discussion is that people aren't saying that they think the health care and insurance systems we have now are great, only that they don't have faith that the government can fix things, or that the things that the politicians behind it say they'd like to see – which include medical malpractice reform and cutting Medicare/Medicaid costs – and what they say they're not doing (single-payer system).

      Anyone want to weigh in on this?

  • Jack B. says:

    Another thing being completely left out of the discussion is how our gov't subsidizes unhealthy food production (think of all the food made from corn) which causes the bulk of our nation's health problems.

  • S. Munson says:

    To Michele's point, I am quite happy with the quality of healthcare my family receives and am not interested in anything that risks that. I don't see why the system used by 85% of the population has to be risked in order to accomodate the 15% that already receive free healthcare or at least a lot more healthcare than they themselves pay for.

    The argument is that somehow there will be more healthcare with the same or fewer (after compensation controls) doctors. I would think cutting or controlling a doctor's pay would result in fewer doctors. And, that it will be paid for Medicare savings is like saying you have more money if you move it from your right pocket to your left pocket.

    • Hi S,

      Thanks for your comment. So let me make sure I understand what you're saying. Are you saying that the President's plan will make health care accessible to more people, so the system will be stretched further and you're concerned that it can't handle more people? Or are you anticipating other risks?

  • Barbara M says:

    This country just tried an experiment in forcing a country to be "free". It cost billions of dollars and how many lives? If we are going to "waste" money on an experiment, can't it be one of offering the human right of health care? I bet this would be much more successful and cost less than the war.

    I hear very little on the success of Kaiser and using it as a model. Kaiser gives great care, they don't have "death panels" in fact they work so hard at giving someone the best care to extend life as long as possible and quality of life is considered at every turn. Our family is 3 generations deep with Kaiser and I couldn't be happer. Yes it is expensive but it is actually less than other health insurance plans.

  • Art A says:

    Barbara M.,

    I agree with you that Kaiser is a good and affordable option. Pointing out how little of a “crisis” for lack of options this is.

    If subsidizing and expanding Kaiser were the limit of some of the various possibilities under consideration, that would be relatively minor. You could probably do that for the low tens of billions and have bi-partisan support.

    Personally and in general, I don’t see big government as fair, efficient, non-corrupt, cost-effective, quality-driven, smart, fast, understandable, well-intentioned, effective, accountable, pragmatic, compassionate or reasonable. So, when I think of the quality private healthcare I work hard to afford for my family, I believe Big Government’s new controls and changes will only screw that up.

    If you feel big government has a great track record, and therefor deserves a promotion and greater responsibility, please cite some examples of cabinet level agencies contrary to the above. What big government agency do you think is most of the above positive adjectives?

    On your point about healthcare being a right, not according to the U.S. constitution. Is food, clothing and shelter also a right? What about dental? If so, I guess it is then no one’s responsibility.

    Also, people often like to talk about rights they are owed, but rarely responsibilities they must shoulder. Isn’t one’s first responsibility to take care of one’s own family? Does providing the funds for other’s healthcare trump providing good healthcare for one’s own dependents? I ask because all family expenditures are in competition with eachother. Like, “do I pay for a vacation or my taxes or health insurance?”

    What about others who haven’t taken care of themselves or haven’t been prudent in providing for their own health insurance when they could have? Is that their right and now my responsibility too?

    BTW, I saw a funny bumper sticker the other day, “Honk if I’m paying for your healthcare!”

    When I think of some of the crazy, Crazy, CRAZY proposals that have been floated this year, it doesn’t fill me with hope about that change. Things like:

    – crushing small business with new health insurance mandates during a recession;
    – stripping safeguards so that the U.S. becomes the free healthcare insurance provider magnet to every single person in a poorer country;
    – limiting doctor pay and therefor doctor quantity and quality;
    – subsiding more big pharma (why do you think they’re for it?);
    – taking a hands-off approach to tort reform because the trial lawyers are democrat supporters;
    – excluding legislators and unionized public employees from the new healthcare scheme;
    – creating new massive deficits that are by definition unsustainable;

    …and doing all of it with a new bureaucracy with all the style and panache of the DMV is, in my opinion, just criminal. It wil end up killing people.

    That from the U.S. government that has stolen from and owes tens of trillions to the so-called Medicare Trust Fund for promises already made. Other than one’s HOPE for something better, I can’t believe any reasonable person would imagine all this could turn out really well. I do understand that the intention feels good.

    Again, if I’m missing concrete examples of how cost-effective, intelligent, compassionate, smart, fast (etc) Big Government agencies usually are, please provide some. Then, I might consider expanding it’s responsibilities. Either way and against my opposition, I believe the decline and fall of western civilization is proceeding on-time and under-budget.

  • Folks, here’s the latest on this if you haven’t seen it already, a story on the proposal released by Sen Max Baucus:


    And here’s the CBO’s preliminary analysis. They’re saying the plan would save the federal government $49 billion over 10 years.


    Oh, and a quick note for Art: You said health care is not a right according to the U.S. Constitution. But it is for one group. Can you guess who?


  • Art A says:

    Dear Michele,

    Yes, sad but true…. prisoners. I was actually saying “according to the U.S. Constitution,” as different from one federal judge.

    On government projections, sounds like it’ll all work out great. What a relief.

    Just kidding!

    You’ll notice that so far that no one has taken up the challenge of naming a government agency that inspires such massive confidence because of it’s incredible track record.

    Also, the CBO doesn’t forecast how future political choices will change the reality. They pretty literal and limited that way.

    • So maybe we should do nothing … ever? Is that what you’re saying, Art? I mean, I think taking a hard look at the costs of any government program and the potential unintended consequences – I’d use the In-Home Supportive Services program as an example for the former point and electricity deregulation for the latter – is important. But I am challenged for examples on what abject cynicism has accomplished for us. Maybe you can name some?

  • Art A says:

    I think this country is founded on a well-justified cynicism. The U.S. constitution is all about limiting government because of a wise cynicism towards it’s intentions and possible damage.

    I think it’s a pretty thin argument, Michele, to paint the other guy’s position as black and white so you can more easily disagree. You might want to re-think that approach.

    I am not advocating doing nothing. I’m all for:

    – Taking time to find good solutions.
    – Giving tax deductions for buying your own health insurance.
    – Expanding medical savings accounts.
    – Allowing insurance companies to compete across state lines.
    – Having a non-government-run health insurance marketplace where insurers compete for clients.
    – Some reasonable subsidy for those who truly cannot afford or qualify for insurance.
    – Not fining people for not having insurance.
    – Expanding good systems, like Kaiser.
    – Greater incentives for doctors and patients to remain healthy in a preventative way
    – Making sure recipients of aid are U.S. citizens or legal residents. Otherwise, the U.S. taxpayer will be crushed by tens of millions of illegal aliens. Not just paying this issue lip service, yet defeating the tools that would ensure it works this way ala Pete Stark.

    I can name still more initiatives that would be good changes… just not the big government gamble.

  • Art A says:

    Michele, then why not just ask, “Art, what are you in favor of?” Instead of: “So maybe we should do nothing … ever? Is that what you’re saying, Art?” and “…I am challenged for examples on what abject cynicism has accomplished for us.”

    “Doing nothing… ever” and “abject cynicism” are your exaggerated characterizations.

    BTW, I did answer you completely.

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