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Dr. Jon LaPook Headshot

The Health Care Debate the Media Missed

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Last weekend I was in Vermont on vacation when I heard that Senator Bernie Sanders was hosting a town meeting on health care. On Saturday, August 15th, I grabbed my video camera and went to the afternoon meeting of an estimated 450 people in the small town of Arlington. Their voices were passionate and emotional but civil and respectful. Although it was a hot summer day, tempers simmered but never boiled over. That makes for good discussion but bad television. Absent fiery sound bites, the event flew under the radar of most media.

Two microphones were set up, one for people who support health care reform and the other for people who don't. At one mike, a diabetic iron worker who called himself a "proud blue collar guy" described what it felt like to be out of work and have no health insurance. A woman with breast cancer and no insurance told us about having to sell "everything we had worked for" to pay for her treatment. At the other mike, a woman asked "why we need a system for everyone." A man voiced his distrust of the government, saying it can't run Social Security, Medicare or the post office so why should he trust it with health care reform.

Senator Sanders listened carefully, spoke thoughtfully, and welcomed opinions on both sides of the issue. But I do think there was a moment of missed opportunity. At one point a woman, referring to the health care reform bill (H.R. 3200 [PDF]) introduced in the House of Representatives, asked Senator Sanders "Have you read the entire thing?" He admitted, "No, 'cause I'm not in the House." She then went on to read from a piece of paper, saying "Page 430, lines 11 through 15, the government will decide what level of treatment you will have at the end of your life. It IS in that bill." The Senator responded, "That is not in that bill. Sarah Palin notwithstanding, that is not in that bill." The Senator was referring to Sarah Palin's contention that the current health care reform proposals would lead to "Obama's 'death panel'" deciding who is "worthy of health care."

A more specific response from the Senator would have been more instructive to the crowd. I looked up that section and it refers to Medicare covering for the first time doctor-patient consultations about end of life planning such as drawing up a living will or planning hospice treatment. It describes "advance care planning," clearly stating (on page 424, lines 21-23) "the term 'advance care planning' means a consultation between the individual and a practitioner." It is NOT about an interaction between the individual and the government.

The fact that so few people have actually read the bill is a formula for mischief. Imagine if everybody in your English literature class -- including the teacher -- had only read the CliffsNotes of the books being discussed. Granted, the bill is 1017 pages long and is filled with cryptic language. But there are only a few sections that have led to widespread misinterpretation such as the death panel myth. Members of Congress should read the actual language of these passages rather than rely on summaries.

I left the meeting impressed by the tone of the conversation. In his closing remarks, Senator Sanders said he was proud that "we live in a state where people can have different points of view and yet we can listen to each other and we can treat each other with respect." Respectful listening by people with diametrically opposed points of view won't usually end up in the headlines but it does end up on today's episode of CBS Doc Dot Com. I look forward to your comments.

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