August 12 -- On a humid evening, in a non-air-conditioned church sanctuary, beneath mobiles of origami birds on which prayers are written, Representative Joe Sestak (D-PA) held a town meeting, answering questions on health care reform with few interruptions. More than 500 people gathered in the sanctuary and overflow room of the Broad Street Ministry, in the heart of Philadelphia's cultural district, to pose questions and listen to the congressman. Participants formed a long line in front of the church and around the corner and waited without incident before the event began, many of them carrying red, white and blue signs that said, "Health Care Reform Now."
In preparation for the town meeting, MoveOn and various local groups that support health care reform contacted their network of members and encouraged them to turn-out for the event and outnumber tea-baggers and others who might try to prevent citizens from asking questions. The result was so successful it could serve as a model for town meetings across the country.
Sestak, who is challenging Senator Arlen Specter (D-PA) in Pennsylvania's Democratic Primary, has been holding health care "summits" across the state for more than a year and demonstrated both his understanding of the public's concerns and his mastery of the details in the House health care proposal. He responded to numerous questions from supporters and opponents of health care reform calmly and with command of the facts. Those who even attempted to disrupt the town meeting were met with Sestak's unflappable patience and knowledge, and the audience's disapproval.
In the audience, were people like Norman Fehr, 63, of West Chester, PA who said, "I am positively, definitely for the public option," and explained that because he has a pre-existing condition, he is one year away from losing his current health insurance. "When you have pre-existing conditions, you have more claims and insurance costs keep going up," he said, "We need to temper that." A public option would offer an affordable alternative to for-profit insurance.
A 34-year-old woman who identified herself only as Paige was also in the audience and told me she is skeptical of reform. Paige works as a speech therapist at Temple University Health Sciences Center in North Philadelphia, the inner city, where many people in the surrounding neighborhood are poor and rely on Temple's ER for their care. "I work hard," she said, "And I'm tired of all these people who don't work and I'm getting squeezed to pay for them."
Elizabeth Parziale, 67, of Montgomery County, one of the suburbs that turned from red to blue in the presidential election was in the audience to support health care reform. She told me, "I am on the wonderful government program called Medicare."
Before Parziale was eligible for Medicare, she said, her monthly bill under Cobra rapidly went from 350 to 750 dollars a month. Because health care insurance in Pennsylvania is really a monopoly, she had no other option except to pay. "Medicare has saved my life," she said, "and my husband's life."
One participant asked a question about "purging" which happens when insurers "purge" policyholders from their rolls because they have had costly treatments; and purge small business by raising their rates after an employee has had an expensive hospitalization -- even though policyholders and small businesses have been paying premiums to the insurers for years.
Sestak pointed out that under the proposed legislation, "No one can be denied coverage and insurers must take people with pre-existing conditions." He explained, "We have created a new insurance exchange from which people can choose. Also, we will cover fifty percent of small businesses' coverage."
Jean Bishop, a primary care physician from Philadelphia who stopped practicing in order to fight for health care reform asked, "How can we get insurance companies to stop rationing care?" Sestak's answer included the fact that under reform, physicians and hospitals will not be paid for quantity of procedures but rather for the quality of care they provide.
One man asked how he would be able to keep his current insurance if his employer decided to take the Public Option. To this Sestak explained, "The bill mandates that employers must continue their current plan, except for small business that can choose the public option."
When the subject of the public option came up, many in the audience applauded and cheered their approval. In outlining the importance of the Public Option and how it would work, Sestak first explained that in Pennsylvania private health insurance plans are controlled by only two companies, a virtual monopoly. "Therefore," he said, "Hospitals have no bargaining power."
A public option, offered by the government, would be subsidized by co-pay and premiums of those who join, offer an affordable choice, won't pay millions to CEOs, and would save 150 billion dollars over ten years.
Sestak explained, "We [Americans] are good at competition -- and competition will make it fair. With the public option, we will beget the kind of competition that we've lost."
Sestak pointed out that the public option is that -- an option, a choice -- among other choices. No one will be forced to take it.
When a participant asked, "Why not single-payer," the congressman explained that the House bill covers ninety-seven percent of all Americans, and the three percent who are not covered are those who choose not to be covered.
The questions continued for more than two hours and Sestak answered each one thoughtfully. There were a few people who sought to stir up a ruckus, but they found little if any support and were soon silent. Although one well-dressed woman held a sign outside that depicted President Obama in a derogatory way (which I prefer not to describe) this time, the would-be belligerents were outnumbered and democracy prevailed.