A Town Hall Meeting 3000 Miles from Washington, DC


Seaside, Oregon, is about as far away from Washington, DC, as you can get in the continental U.S.  Not quite 3000 miles, but almost (2860 to be exact).  And it seemed very far away from the sound and fury of the health care debate in the nation’s capital when I attended a Town Hall meeting last Friday.  Sen. Ron Wyden was the speaker at the event, which was attended by over 400 people crowded into the Seaside High School cafeteria.

As we waited, the crowd was calm and polite, but there was a murmur of anticipation and an undercurrent of tension.  We had all seen the stories about disruptions and threatened violence at similar Town Hall meetings across the country.  Would it happen here?  We could see people standing at the back with signs opposing health reform.  Would they interrupt the proceedings and cause problems?  We all respect freedom of speech, but somehow it wouldn’t seem like “freedom” if someone else was shouting us down and disrupting our attempts to learn about the health reform proposals.

To my pleasant surprise, everyone behaved well; the process was orderly, and the tone was respectful.   People asked Sen. Wyden some tough questions: Why not simply expand Medicare for all?  Will there be enough doctors to take care of everyone?  What will happen to the federal deficit?  How can we reduce the administrative hassle for doctors?  Why do you take campaign contributions from insurance and drug companies?  Sen. Wyden is very knowledgeable about health care and answered the questions thoroughly, but – more importantly – he didn’t speak down to anyone.  He explained the issues clearly and tried to help people to understand the complexities of the challenges we face.  I overheard him talking afterwards with a member of the U.S. Army color guard who said, “I learned a lot from what you said and what the people were asking today.”  Isn’t that the basic idea of a Town Hall meeting?

The scene reminded me of the well-known Freedom of Speech painting (one of the Four Freedoms series) by Norman Rockwell.  A man in a flannel shirt and leather jacket is standing up to speak at a Town Hall meeting, and the people around him are looking up with interest and curiosity.  Many people think Rockwell was just a talented illustrator who painted sentimental themes.  They may be right from an artistic perspective, but I think he tapped into something important about us – something we often forget.  Big issues like health care are too important to leave to the special interest lobbyists, the experts and the cable television commentators.  We need to have conversations in every one of our communities around the U.S.  We need to listen, share our ideas, learn from each other, move toward consensus, and trust the wisdom of the people.

During the past few weeks we’ve heard about the disruptive and abusive tactics used by opponents of health reform at some Town Hall meetings.  We haven’t heard, however, what happened at the hundreds of other Town Hall meetings across the country.  I suspect that most of them are like the one I attended in Seaside, where people are struggling to find common ground to address one of the biggest problems we face – providing access to affordable, high quality health care for everyone.  Seaside may be far from Washington, DC, but it’s close in spirit to Stockbridge, MA – the home of Norman Rockwell – and thousands of other communities in the U.S.  My faith in the American people is being strengthened, one Town Meeting at a time.

Bill Kramer is an independent health care consultant, focusing on
health care management, finance and public policy. Bill served as a
senior executive with Kaiser Permanente for over 20 years. Most
recently, he served as Chief Financial Officer for Kaiser Permanente’s
Northwest Region. More information about Bill may be found at

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3 replies »

  1. Is it true once someone was to opt into the public or government run health care they can not opt back out? I hear this is the way this Bill has been wrtten!anyone know?

  2. I just came from a doctor appointment. I spent 10 minutes with the doctor and they did not do anything except talk to me. Now while I have no idea what that visit cost, no one in their office could tell me, I know it was probably $150 – $250.
    What is wrong with this picture?

  3. The problem that we have is “health care costs” spiraling out of control. This is hospital charges, doctor charges, drug charges etc. As these charges go up so does the cost of insurance. As the cost goes up fewer people can afford insurance so the insurance companies must find ways to bring down the cost of insurance, this they have done by reducing the coverage offered by their plans. So this has created a situation where cost for insurance goes up, but benefits decrease. For some reason many people do not see much beyond this point and blame the insurance companies for all of the problems in the industry.
    However, you do not need to look very hard to find the reasons for the rising healthcare costs.
    They are:
    · The GOVERNMENT reports that it losses 30% to Medicare fraud…The government collects taxes to cover Medicare and 30% of the total collected to cover Medicare is lost to fraud. This is staggering! In 2010 that will amount to about $200 BILLION.
    · Hospitals over bill millions of patients every year. It is almost accepted as a normal practice nowadays. But this practice over billing is costing us all billions of dollars per year. Hospitals make it very difficult to price comparison shop their services. I have called many hospitals and asked the price they charge for various services or medications and more often than not they will not give their price information.
    · Defensive medicine. Medical providers in fear of been sued make sure they cover all bases by ordering every test and procedure imaginable.
    · Waste in medical practices. As an example at my local hospital when nurses are dispensing insulin, they draw one dose out of the vile for the patient then throw the vile away. But they charge the patient for the whole vile. What they should be doing is sterilizing the needle before inserting it into the vile, taking what they need and putting the vile back on the shelf. A vile of insulin costs thousands of dollars!
    · Obesity. It is now official, 40% of Americans are obese. And this 40% of the population costs 40% more in medical treatments than the rest of the population. We have to take responsibility for our own health.
    · Hospitals are required by law to accept all patients whether they have insurance coverage or not. Many people who do not have insurance coverage visit the emergency room for simple things that could be handled in a doctor’s office. A very large percentage to these charges go unpaid, so the hospitals passes these costs on to those with medical insurance coverage. With nearly 50 million uninsured this is a major cause of escalating hospital charges.
    These among others are some of the reasons we have a broken healthcare system. PricewaterhouseCoopers recently estimated that our current system wastes about $1.2 TRILLION per year, that is 50% of the total cost of our healthcare system.
    This is why it makes no sense when the current administration talks of health INSURANCE reform. Do not get me wrong, insurance companies are not blameless, but they are not a major contributor to the problem.
    This is why if the government continues on its current path of health insurance reform it will not fix the problems in our system. All it will do is the further bury the problem, we will all then be tax more to cover the unseen problems.