By Michael L. Millenson

The Obama-Biden Transition Team has encouraged individuals across the country to gather in small groups with friends and neighbors to discuss their ideas for health care reform. The team provided a background paper, discussion guide and a specific list of questions as a framework within which citizens could provide feedback to health reform czar-designate Tom Daschle. More than a thousand would-be hosts have officially registered on the change.gov website, and my wife and I were recently invited to one such gathering in a small village (yes, that’s the official designation) north of Chicago. My report below is not the official one.

‘Twas three nights before Christmas, and despite cold and stormWe’d gathered together to talk health care reform.Clutching Team Obama’s brief questionnaireWe went over each item with scrupulous care.Middle-class, middle-aged and in the MidwestWith our host’s college kids for reality test.O’er the country many thousands had signed up for the sameDespite fear “special interests” would come rig the game.But as we plain folk gathered by the living room fireWe closely read instructions, then vented our ire.

It was plain to us as the new-fallen snowThat insurers existed just to say “no.”Choosing hospitals and docs? For verificationOur group relied on the best reputation!While I plumped for more data on quality of care“You can’t measure,” they said – so I tread lightly there.(OK, the truth – and please don’t tut-tutI struggled, alas, to keep my mouth shut.But praise to the docs there, all credit should beFor their politeness to the lone plaintiff’s attorney.)

We were asked to tell tales that came from our livesLike self-employed men who hire their wivesIn order to become an insurable group –They still paid big premiums; insurers ain’t dupes.“Healthier lifestyles and policy?” – we gave that a jab.It’s mostly your fault that you’ve got so much flab.(Not being Republicans, we adjured condemnationWe knew of the links ‘tween income and education.)The role of employers? We cried, “Get them out,”But decided, “A transition” — after thinking of clout.Yes, we had fun, we talked “big picture,” too:Single-payer, malpractice, and why Americans doNot think other nations can help us advance –Though our group had lived in Italy, Russia, the UK and France.

But most of our talk, and most of the clatterCentered on cost – there’s the heart of the matter.A woman whose son has a quite rare diseaseSpends endless time fighting for care that he needs.Oftentimes, she must threaten to sueTo get paid for the care she knows is their due.And this is a woman of much sophistication –What happens to the less powerful in this, our great nation?

Care’s a “privilege” or a “right”? – those words carry freight.And so we conducted our own short debate.“Basic care” for all? Yes, but choices are hard.Do you get the same care if you have no green card?Ethics, morality – all very niceBut what Team Obama omitted was any hint of the price.

Will cutting out waste and boosting preventionAllow painless “reform”? That is the question.Someone will pay – there is no free lunch.But “someone,” for now, won’t be our small bunch.We took a group picture (it’s what was suggested).We’ll soon review notes (it’s what is expected).And though Daschle by the “grassroots” has vowed to be led.No false visions of sugar plums danced in our heads.‘Twas three nights before Christmas, but we’ll know Santa was hereWhen reform becomes law – and as a Cubs fan I believe, this is the year.