According to the bill, the Health Benefits Advisory Committee will be made up of “a panel of medical experts and other experts…to recommend covered benefits and essential, enhanced and premium plans.” The bill requires some diversity of background from members, specifying that the committee be made up of people from the insurance industry, employers, labor and experts in health care financing. That might be reassuring but for the fact that panel members are all appointees of the President and the Comptroller General, so it is reasonable to assume that individuals’ political persuasions will drive these appointments.

Further, here’s where there is real cause for concern for all of us who have been fearful of this type of government overreach into our health care decisions, Section 123 (b). This section establishes the objective of the panel, which is to recommend benefit standards to the Committee for execution. Benefit standards are defined as:

(5) BENEFIT STANDARDS DEFINED- In this subtitle, the term `benefit standards’ means standards respecting-

(A) the essential benefits package described in section 122, including categories of covered treatments, items and services within benefit classes, and cost-sharing; and

(B) the cost-sharing levels for enhanced plans and premium plans (as provided under section 203(c)) consistent with paragraph (5).”

Further, any private plans in existence will have to meet these same benefit standards in order to continue to exist as qualified health care plans under the new system (under Subtitle C, Section 121.) Therefore, this panel of so-called experts appointed by politicians will literally set the bar for what is and isn’t covered. The only ray of hope here that I can see is that the panel will essentially set the floor, while private insurance companies can go beyond the standards of coverage dictated by the panel — at least for as long as they’re in existence and able to comply with all the regulatory requirements set out by ObamaCare — which is a topic I’ll leave for another post.

If Section 123 doesn’t give the government the power to decide what will be allowed and paid for in terms of treatment and for what groups of people, then I don’t know what it does. So for President Obama to get back on the stump yesterday in Iowa and make light of people’s concerns, is simply appalling. With 55% of Americans and 59% of Seniors in favor repealing the bill, and 64% of Americans believing the bill will be bad for the country, the President mocked his critics rather than address legitimate concerns about the bill.

“There’s been plenty of fear-mongering, plenty of overheated rhetoric. You turn on the news, you’ll see the same folks are still shouting about there’s going to be an end of the world because this bill passed. (Laughter.) I’m not exaggerating. Leaders of the Republican Party, they called the passage of this bill “Armageddon.” (Laughter.) Armageddon. “End of freedom as we know it.”

So after I signed the bill, I looked around to see if there any — (laughter) — asteroids falling or — (applause) — some cracks opening up in the Earth. (Laughter.) It turned out it was a nice day. (Laughter.) Birds were chirping. Folks were strolling down the Mall. People still have their doctors.”

Getting back to these panels of experts, the creation of this group shows how flawed Democrats’ vision for health care is. They believe that this select few, chosen by the President, can better gauge what people need from their health care plans than the people themselves who are using the plans. This refining of standards of what is and isn’t covered could have been accomplished more quickly and efficiently if people were allowed to buy into insurance contracts with any provider of their choosing. Now, government regulation as to how consumers could purchase health insurance (which didn’t allow insurance from being bought across state lines) has lead to more government regulation to solve the problem government created in the first place. And thus government begets more government. This nearly 3,000 page bill is just the beginning.

But there I was on Sunday evening, watching the votes come in in disbelief. Since then, like so many Americans, I’ve been trying to figure out exactly what is in this bill. By now, we’re all familiar with the debate over the true cost of the bill, the double-counting, the Madoff-type accounting, as Karl Rove labelled it during his debate with David Plouffe on This Week this past Sunday. But, new facts seem to coming out about this bill daily. A good example is the surfacing of the fact that our new health care reform doesn’t cover children with preexisting conditions, despite President Obama’s assertion to the contrary yesterday. Also, if you’re worried about how states will fund a surge in the number of people dependent on Medicaid, when they already face huge deficits with decreased revenues and no relief in sight, you probably can already guess what Dems’ answer to this problem will be — more bailouts, more money, more dependence on the all-powerful federal government and a continuing erosion of states’ rights.

I’ve heard some references to conservatives’ overly inflamed rhetoric when it comes to this issue. I don’t think one can emphasize enough how far-reaching the consequences of this kind of irresponsible accounting and spending will be — and that doesn’t even begin to touch on how our health care system as we know it will be affected.

And at the end of the day, the level of power this bill allows the federal government to have over all of us is unprecedented and dangerous. This quote from a law professor sums it up better than I can.

“If Congress can require you to buy health insurance because of the ways in which your uncovered existence (affects) interstate commerce or because it can tax you in an effort to force you to do (any) old thing it wants you to, it is hard to see what — save some other constitutional restriction — it cannot require you to do — or prohibit you from doing.“

It is this sentiment that has left me with a bad feeling in the pit of my stomach all week long. More reactions to specifics in the bill to come…

But, despite his vow and the media and public disapproval of the current process, this will not be the first time that the President has broken this particular promise. Back in February of 2009, the same issue was brought up as it related to the negotiations of the stimulus package. Note in the following line of questioning, Gibbs’ answer that the President was pleased with the product and with the process.

Q I just wanted to try again on the issue of the open conference committee question. We just didn’t really resolve it the other day. I mean, on the transition website it said explicitly that the President wanted the conference committee process to be open to the public. In light of that, how does he feel about the conference committee process this week on the stimulus which was, even to apparently some members of the conference committee, not open? And going forward, does he intend to fulfill that promise?

MR. GIBBS: Well, I haven’t seen the particular comments. Obviously the President hopes for greater openness and transparency in government. Whether it’s the transparency that’s part of this bill or transparency that’s part of conference committees, whether that transparency — obviously there’s a lot of things that he believes can be improved. And I think that’s something that we’d like to continue to see.

We talked about — and something that we’re struggling to implement that we talked about during the campaign, which was putting legislation on the web — non-emergency legislation on the web for five days before it’s signed. The White House is struggling with trying to figure out how to do that in a way — when do you do it, how do you do it, what do you put up.

So I think all this is a work in progress. And as I said, it will take probably longer than a few weeks to change how this place works.

Q Was he satisfied with the process this week?

MR. GIBBS: Ask me that when the Senate finishes and we have something.

Q I mean the conference –

MR. GIBBS: Yes, I think the President is happy with the product that Democrats and Republicans put together.

Q The process, not the product.

MR. GIBBS: The process and the product.

Q Robert, some White House aides participated in that conference committee process, meeting, negotiating behind closed doors, in some sense, I guess, validating that process. I mean, could they not have been insisting upon a more open process where C-SPAN cameras come in and record that, as the President promised to do on health care negotiations?

MR. GIBBS: Unclear if Rahm could satisfy some FCC requirements. (Laughter.) But I think the President is, as I said, pleased with the –

Q Cable. (Laughter.)

MR. GIBBS: Yes, the FX channel, unfortunately, is what we’re going to do. (Laughter.)

He’s pleased with the process and the product that has come out. And I think when the process is done, I think the American people will be proud of the product that we believe and we hope will begin to stimulate the economy, get people hired, back to work, and moving things forward, and putting people — putting money back in their pockets.

You don’t have to know much about politics to note how Gibbs dodges this line of questioning from the get-go. First, he states he’s unfamiliar with any complaints about the process. Then, he emphatically states that the President was proud of the process. Then, when directly confronted with the President’s promise to allow C-Span cameras to record and broadcast negotiations, after making a few quips, he repeats the President’s satisfaction with the process and posits that despite the lack of sunshine along the way, Americans will be happy with the end results. In other words, the means justify the ends.

After all, what’s one pesky broken promise? Except that this was one of the cornerstones of the President’s campaign, ushering in a new era of openness and transparency. But now that he’s at the helm, he didn’t just break his word, he urged Democrats to push the bill through and quickly behind closed doors. In the era of Obama, speediness trumps open dialogue about legislation. When public support isn’t on your side, the need for speed to get a bill on the President’s desk becomes priority number one, taking a backseat to bothersome details like cost and a piece of legislation’s effect on personal liberty, taxes, the deficit and our health care system in general. It’s get the bill through at all costs and preferably before the State of the Union. And some of us thought things couldn’t get any worse…

Given our President’s tendency to distort facts, I looked into the story of this Illinois man, who I found out was Mr. Otto Raddatz. And, it turned out the President’s version of what happened to Mr. Raddatz was untrue. Since then, I’ve been wondering if anyone in the media would pick up on this story, and finally, Scott Harrington did so today in the WSJ.

Below is a reposting of my original piece on the American Issues Project Blog on August 23, 2009.
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Debunking willful misrepresentations in the health care debate: the story of Otto Raddatz.

President Obama used his weekly address yesterday to “debunk[] some of the more outrageous myths circulating on the internet, on cable TV, and repeated at some town halls across this country.” If we’re clearing the air of falsehoods related to health care, then there is one story in particular that the President himself has referred to on a number of occasions that he should have corrected. That is the story of an Illinois businessman named Otto Raddatz.

At a town hall forum in New Hampshire on August 11, referring to Mr. Raddatz, President Obama said:

“Another [man] lost his coverage in the middle of chemotherapy because the insurance company discovered he had gall stones that he hadn’t known about when he applied for insurance. Now, that is wrong, and that will change when we pass health care reform. That is going to be a priority.”

A few days later at a town hall in Montana, the President repeated this story.

“One man from Illinois lost his coverage in the middle of chemotherapy because his insurer discovered he hadn’t reported gall stones he didn’t know about. True story. Because his treatment was delayed, he died. “

And on August 15, Obama penned an op-ed in the New York Times titled, “Why We Need Health Care Reform” where he repeated the story for a third time.

“A man lost his health coverage in the middle of chemotherapy because the insurance company discovered that he had gallstones, which he hadn’t known about when he applied for his policy. Because his treatment was delayed, he died.”

The story the President relates of this innocent person who played by the rules and maintained insurance only to have it fail him in his time of a need is indeed a powerful, persuasive story … except that it’s not entirely true.

Here’s the true story, based on testimony from Mr. Raddatz’s sister at a hearing before the House of Representatives’ on June 16, 2009.

Mr. Raddatz was a restaurant owner in Illinois who purchased an individual insurance policy for himself and his wife in 2003. On the original insurance application, he indicated that he had a history of kidney stones and was a smoker. A year into the policy, at the age of 59, Mr. Raddatz found himself losing weight rapidly and sought medical attention. It was then that he was diagnosed with stage four non-Hodgkins type lymphoma, a cancer of the immune system. After undergoing a series of chemotherapy and drug treatments, he was referred to a specialist for high-dose chemotherapy and a stem cell transplant.

At that time, he was informed by his insurer that his insurance was being cancelled due to his failure to disclose material information about his medical history – namely that he had a history of gall stones and an aneurysm. As it turns out, Mr. Raddatz was unaware of this diagnosis, having never been given the test results this information came from.

This happened just as Mr. Raddatz was told that he only had a 3-4 week window in which to get the stem cell transplant he needed. With his insurance rescinded, he could not afford to pay for the procedure out-of-pocket. His sister, Peggy Raddatz, reached out to the Illinois Attorney General’s office who reviewed the situation and sent two letters to the insurance company arguing that Mr. Raddatz had not lied to the insurance company since he had been unaware of the test results and had in fact, never received any treatment for either of those issues.

The insurance company reinstated his insurance policy. He went on to receive the stem cell transplant, “which was extremely successfully” and enabled him to live for three and a half more years. He passed away when, while being scheduled to have a second transplant, his donor suddenly died.

Now in President Obama’s version of the story, Mr. Raddatz died because his treatment was delayed. That is a lie. Mr. Raddatz’s story is powerful in terms of illustrating problems with the insurance industry. It is particularly relevant that he was self-insured, given the problems with the individual insurance market, the low numbers and high turnover of participants and the lack of tax benefits which make it less attractive to individuals. All of this makes the pool of participants amongst which claims can be distributed even smaller, resulting in higher costs to individuals and the insurance companies themselves.

But, that wasn’t the President’s point. He didn’t tell this story to promote reforms in the individual insurance market, to make it equitable with employer-based insurance by giving it the same tax benefits or allowing people to purchase insurance from any state they’d like. Instead, this was a story, much like the cases of tonsil-removing, foot-amputating doctors, that was meant to vilify the insurance industry and exploit people’s emotions given the tragic ending Mr. Raddatz faced at the hands of his evil insurance company under President Obama’s made-up version of the story. If, as he said this weekend, President Obama really wants to open a new chapter, “not one dominated by willful misrepresentations and outright distortions”, then perhaps he should start leading by example.

Not only was Durbin clueless when it came to individual mandates in the House bill (which really, by this time, you don’t even have to have read the bill to know it includes individual mandates), but he continued to spread misinformation about our current system as a way of justifying his government-centric health care goals – namely, that most bankruptcies are caused by medical problems. My stomach hurts at the idea of listening to him closely enough to transcribe where he addresses this, but here goes anyway.

“I’m glad for your experience and that you came out of it without debt, but you are an exception. When you look at the filings for personal bankruptcy in America today, 31% were for medical bills just a few years ago, that’s doubled. And, it turns out that of the 62% who are filing for personal and family bankruptcy because of medical bills, 78% have health insurance. It’s just not good health insurance, and it doesn’t cover them…a lot of people are facing bankruptcy today because they’re not in that good position. And, I’d like to take you back to one sentence you said, the government is going to force us to take an option. Listen to what you said. It’s an option. If you don’t want to choose the government plan, you don’t have to. It’s an option. You can choose private health insurance.”

I’m no math whiz, but Durbin thinks that 62% of individual bankruptcies are because of medical bills that pile up. First of all, even under his own theory, he says that close to 80% of those people have health insurance, but it just doesn’t work for them. That’s false; the controversial study he’s referencing states that nearly 2/3 of personal bankruptcies are due to uninsured medical treatment and loss of coverage. Brett Skinner of AEI’s The American analyzed the study and also compared American and Canadian rates of bankruptcy due to medical reasons, since Canada already has the type of system we’re heading toward.

“Th[is] medical bankruptcy study has been soundly refuted by several researchers. This includes critiques published by David Dranove and Michael Millenson in Health Affairs and a working paper by the American Enterprise Institute’s Aparna Mathur.

The idea that large numbers of Americans are declaring bankruptcy due to medical expenses is a myth. Dranove and Millenson critically analyzed the data from the 2005 edition of the medical bankruptcy study. They found that medical spending was a contributing factor in only 17 percent of U.S. bankruptcies. They also reviewed other research, including studies by the Department of Justice, finding that medical debts accounted for only 12 percent to 13 percent of the total debts among American bankruptcy filers who cited medical debt as one of their reasons for bankruptcy.

As for the notion that greater government involvement in health insurance will reduce bankruptcy, it is helpful to compare personal bankruptcy rates in the United States and Canada. Unlike the United States, Canada has a universal, government-run health insurance system. Following the logic of Himmelstein and colleagues, we should therefore expect to observe a lower rate of personal bankruptcy in Canada compared to the United States.

Yet the evidence shows that in the only comparable years, personal bankruptcy rates were actually higher in Canada. Personal bankruptcy filings as a percentage of the population were 0.20 percent in the United States during 2006 and 0.27 percent in 2007. In Canada, the numbers are 0.30 percent in both 2006 and 2007. The data are from government sources and defined in similar ways for both countries and cover the time period after the legal reforms to U.S. bankruptcy laws in 2005 and before the onset of the 2008 economic recession.The truth is that the majority of debt among bankrupt consumers in both Canada and the United States is comprised of non-medical expenditures and therefore has little to do with health insurance coverage.

On the rare occasion that medical debts do partially contribute to bankruptcy, they likely accumulate from patients’ demands for the kinds of expensive, cutting-edge or end-of-life treatments that would never be covered by government insurance anyway. It is a fact that many of these same types of expensive treatments are increasingly not insured by government healthcare in Canada. Survey research commissioned by the Canadian government found that despite having a government-run health system, medical reasons (including uninsured expenses), were cited as the primary cause of bankruptcy by approximately 15 percent of bankrupt Canadian seniors (55 years of age and older).

There is no objective evidence to indicate that a government-run health care system in the United States will reduce personal bankruptcies. The U.S.-Canada comparative analysis strongly suggests that bankruptcy statistics are being exaggerated and distorted for political reasons.”

The Dranove and Millenson study Skinner cites found that among the 17% whose bankruptcies appear to be linked to an inability to pay their medical bills, most have income within the poverty level. They certainly don’t have private insurance that doesn’t work for them as Durbin suggested.

And it’s no wonder Durbin didn’t want to hold any town hall forums this summer when his strongest argument was, look at the phrase you used, public option. What should he have called it? The public-no-other-option? The step 1 to single-payer public option? I mean, come on, that’s all you’ve got Senator? Your only answer is to play semantics with a man who got up and told you his personal health story of overcoming Hodgkins lymphoma, and you remind him of the label Democrats chose to place on this monstrous transformation of our health care system? Perhaps you raise a good point; perhaps those of us that are anti-ObamaCare ought to stop calling it an ‘option’ altogether since it’s been shown over and over that that term is clearly not based in reality.

Or, here’s another thought Senator. Before you start getting all clever on us with your word games, and before you have another panel discussion about health care, how about you sit down and at the very least, even if you don’t read the House bill since I guess that would be beneath you as a Senator (and you wouldn’t have time for that given all that you’ve been…hey, what exactly have you been working on all summer? This constituent would like to know, but I digress…), why don’t you at least do some research and inform yourself as to what the issues are before you start accusing others of ‘misrepresenting the issues’, ‘sucker-punching their opponents’ and ‘engaging in political theater’?

So, if a federal or state health czar requests any information from your tax returns, the IRS is required to hand it over. There is no requirement for the IRS to contact you or even notify you that this is taking place. And, of course, it would just be too simple and not at all sneaky enough if, in these kinds of situations, the bill laid out a procedure by which any individual who applies for government health benefits could, on their own, follow steps to prove their eligibility – including disclosing their financial information themselves. Basically, why would the government ask you for your information when they can set up a system under which they have access to information that paints them a nice picture of your life – your tax returns, your medical records, etc.

What is extremely distressing, is that in the age of Obama and the bloated government policies that have come along with it, this probably doesn’t phase most people. But, it doesn’t stop there. Under the Senate version of the bill, the health czar can sneak a peak into your bank accounts at their leisure, all justified under the same logic, that the government may need this information to check your eligibility. Wait a minute, those evil insurance companies are criticized left and right for asking questions about your medical history when you apply for insurance. Can you imagine the outcries if they also asked for cart blanche access to your tax returns, bank account information and your health records? For those that find no fault with this policy, may I ask, has the government proven itself so capable, so competent, that you are willing to hand over total control of this information to them? If so, when??? Or, to quote Barney Frank, something I do very rarely, ‘on what planet do YOU spend most of your time?’ Where are all those people that were up in arms over the Patriotic Act? Isn’t this far worse?

Not to mention that as Joe the Plumber found out during the 2008 election cycle, when government bureaucrats have access to your personal information, you don’t want to find yourself on their wrong side.

And, the icing on the cake, the legislation does not allow for a court or administrative review of the provisions in that section. Of course. We wouldn’t want the government to have to answer to the people they represent – better to grant them complete immunity, and if your information winds up in the wrong hands, no redress for you.

But, don’t worry. As Giovanetti points out, we’ve got a politician with conviction, a man of the people, who isn’t swayed by day-to-day politics on our side.

Senator Arlen Specter promised the other day at a town hall meeting that “we’ll do everything we can to stop people from breaking into the files.”

I feel so much better.

Imagine calling on your insurance when you need a new coat of paint. You wouldn’t get very far would you? Take this one step further, and imagine trying to purchase an insurance policy to cover an event that has already happened. Your house burns down. Can you call and get an insurance police to cover your home and your belongings after the fact? Certainly not. If that were how the system worked, who would pay into the system before the catastrophe occurred? And, where would the money come from to pay for claims? And, imagine those premium rates for any suckers who actually maintained insurance prior to making a claims? (Assuming, of course, that there’s anyone would who do this which is highly unlikely.)

You might be thinking, but those are items or goods you’re talking about insuring and that they’re different than insuring people’s health. But, the point is that while the item (or person) that is insured may vary, the nature of insurance is all the same. Despite what Congressman Weiner might think, insurance is a good, just like other goods, that are sold in a marketplace. It is a essentially a contract, whose terms consumers should be able to shop around for and negotiate just like with other types of insurance. And, your insurance should be priced according to the coverage that you choose. For example, if you want a policy with more limited protection, then you will pay less for your insurance. Makes sense. If, on the other hand, you want an insurance policy that covers everything – including riskier treatments or holistic medicine for example, then you should pay more.

Or at least that’s how the insurance industry should work. The option to customize insurance like we customize or negotiate every other contract we enter into does not exist because of the government placing itself in between the provider and the consumer in what should be a completely private, contractual relationship. As Mr. Malanga points out:

“There are significant [] ways that government mandates treat health insurance differently, at great cost to all of us. Consider this scenario: You don’t have home insurance and a big storm comes through and knocks over a tree into your roof. You can’t just phone up an insurer, buy coverage and then submit a claim, even if you face financial ruin by not having the coverage. But that’s more or less what you can do in health insurance under so-called guaranteed issue rules, in which someone who hasn’t purchased insurance and gets sick can’t be turned down for coverage. Needless to say, states that have guaranteed issued, like New Jersey and New York, have the highest health insurance premiums in the country because healthy people know they can run the risk of not buying insurance until they get sick. Insanely, the health reform package now on the table in Washington would create a federal version of guaranteed issue.

In auto insurance, some states have given us our own private version of tort reform to keep premium prices low. In these states, a driver can opt out of the litigation lottery when he purchases auto insurance by promising not to sue for pain and suffering if he’s hit and injured by another driver. By doing this a policy holder can save hundreds of dollars a year on premiums. And yet for some reason the same option, that is, allowing us to buy a health insurance policy where we agree not to sue a health provider for pain and suffering if a treatment goes wrong, is not available, even though I imagine the cost savings would be enormous.”

Government regulators also require us to buy so much more health insurance. In auto coverage, for instance, states will generally mandate that we have certain minimum coverage to compensate anyone we may crash into, but otherwise regulators will leave us alone to decide which options (towing, collision) we want to buy. By contrast, states will require buyers of individual and small group health policies to load up on mandatory coverage, including options that many people don’t want to pay for, like fertility treatments. Politicians will often claim that they demand these coverages because they are looking out for our own good, but that’s a difficult case to make persuasively when mandates help make insurance unaffordable for many people.”

Justifying these regulations by saying the government is looking out for our own good is paternalistic and offensive. People enter into the marketplace and make decisions for themselves day in and day out without any help from the government. Health insurance should not be the exception. I understand that President Obama and many liberals find fault with insurance companies because they believe that operating based on a motive to make profits and fulfill your bottom line is evil. And so it follows that they believe that those evil companies must be reigned in and controlled in order to make the system more ‘fair’.

But, this comes at a cost to all of us. If you want to make something more available to a larger group of people and to bring down cost, you don’t impose more regulations or restrictions on that item. It is competition among private individuals and companies that brings costs down, increases supply and makes markets more transparent. The federal government has never and is incapable of producing these kinds of effects in a market.

The only way to improve an inefficient and costly market is to put the bargaining power back in the hands of the people and eliminate restrictions – on everything from where the good (in this case, insurance) can be bought from to what is or isn’t included for the price. Until then, as Mr. Malanga points out, “insurance costs will continue to spiral.”

*Originally published August 20, 2009 on American Issues Project Blog, here.

“People must be allowed to learn the facts. … Reform will also mean higher-quality care by promoting preventive care so health problems can be addressed before they become crises. This, too, will save money.”

For being so concerned with getting facts out, it seems surprising that they either missed or ignored CBO Director Douglas Elmendorf’s statement last week that refuted this position.
Elemendorf wrote:

“Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

That result may seem counterintuitive.To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. … Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness.”

This is not to say that preventive care shouldn’t continue to be a priority. It should. Preventive care is indeed a priority, as Ed Morrissey points out at AIP, this is why almost all health care plans cover annual preventive visits at 100% (even those high deductible insurance accounts in my experience). This also includes blood work and diagnostic testing, aimed at catching problems early if you do visit the doctor annually so that problems can be, that’s right prevented.

What is also interesting about this video is the dialogue between the health care opponents and supporters in the audience. The first man to stand up after Rep. Tsongas’ inadequate response, calls out the dissenters as disruptive. This is despite the fact that during Tsongas’ answer and while this man began asking his question, he was uninterrupted — until he called other people out, criticizing them for doing just as he was, attending a town hall to make their feelings known and to engage on the issue.

Later in the video, around the 6:30 mark, a young woman gets emotional while speaking on the subject. On another topic, this could be seen as being too much, but this debate deals with the most personal, difficult decisions we face in our lives, and her emotions are not over the top or out of place in any way. As part of the audience cheers her on, when she says “we should have the choice in this…this is not speaking for the people”, one man screams, “don’t believe her, she’s acting.” She finally does get to her question, which is twofold: why won’t she have a choice for herself and for her parents, and why is Congress (and this Rep. in particular) dodging out of the plan that they are imposing on her? Despite how respectful and reasonable her question is, she couldn’t get through it without being heckled and talked over during her exchange with Tsongas.

Compare this to the final comment coming from the audience. A young woman from the other side of the aisle, supporting Democrats’ health care plans, refers to her personal situation. She has a grandmother that passed away from breast cancer after being denied care based on a preexisting condition. Listen closely in the video. Do you hear heckling? Do you hear anyone accusing her of acting, of lying? Do you hear any boos when people applaud after her question? None. Both the supporters and opponents of health care allowed her to say her part – peacefully. <

Why is there such a difference between the reaction people on the left and right side of this issue got? There’s no good way to answer that question, but it is important to take note of. And, when politicians like Pelosi, Hoyer and White House officials decide to castigate opponents rather than set the tone for a civil debate, scenes like this one could become even more heated – as we saw in St. Louis last week.

So, organizing on the left is a bottom-up approach. And, there is absolutely nothing wrong with encouraging citizens to become engaged and politically active on issues. Right? Wooops – there lies the rub. Apparently, the White House, Nancy Pelosi and Steny Hoyer are not equal opportunity encouragers of engagement. As their op-ed in today’s USA makes clear – if you are against health care, if you are trying to engage with your representative and happen to be on the other side of the aisle on this issue, if you have tried to make your way through the bill and decipher what it will really mean for our future — you are an unpatriotic, member of the dissenting mob and should be shut-up. Pelosi and Hoyer say no less in their shocking, speech-suppressing, un-American piece today.

If Pelosi thinks that she stands for what it means to be American, as the Speaker of the House pointing fingers at concerned Americans who are doing exactly what this country’s founders hoped Americans would do – get involved, become engaged, hold government accountable – then she has no understanding at all of what it means to be American.