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On August 7, I attended a Town Hall sponsored by Rep. Scott Murphy of the 20th NY held at Granville, NY.  On August 8, I attended a Town Hall held at Valatie, NY by Rep. Murphy.  In each case other issues were discussed but the primary focus was health care reform.  I have the following observations:  

Granville, August 7, 2009

-The crowd was not partisan or polarized.

-The majority of those asking questions opposed the proposed Plan (Rep. Murphy focused on H.R. 3200).

-Those that supported the proposed plan seemed to support it in the context of a move toward a single payor system (a "strong public option").

-Almost everyone agreed that reform is necessary and that insurance is becoming unaffordable.

-Rep. Murphy had a good control of the event, keeping it focused.  He is clearly used to speaking in public and has an ability to disarm restive individuals with a self depreciating style.  His Staff did excellent work setting up the event, despite some difficulties with the PA system.

Valatie, August 8, 2009

-This event was more polarized, but was amiable.

-On arriving, I noticed that there were two groups of protesters with signs arrayed on either side of the parking lot.  There were roughly 1.5 times more protesters against HR 3200 than supporting it.  Those supporting it seemed to support HR 3200 more as a move toward single payor than on its own merits, with many of the signs calling for a single payor system or a "strong public option."

-"Brooks Brothers rioters" among opponents of the Legislation and "bullet-headed union thugs" among supporters were conspicuously absent.  Both sides seemed like average people who wanted to be heard.

-I ran into an older man, perhaps in his 70s, who asked me and a woman who appeared to be in her mid 30s or early 40s, which group we stood with.  Each of us answered, "Neither."  I then said that I thought reform was critical but that I thought the proposed Plan . . . the older gentleman interrupted me by suggesting, " . . . sucks?"  

-He said that while he could support single payor, he was on Medicare which works well, he could not support what he saw as disingenuous conduct on the part of the Administration by trying to sneak in a single payor system.

-Rep. Murphy's presentation was, again, quite assured.  The fact that he had, and referred to, a tabbed and marked up copy of HR 3200 went over well with the crowd.

-The crowd was a bit more strident, however, the more boisterous were quickly told to let the representative speak.

-Again, there seemed to be no support for HR 3200 qua HR 3200.  Many, in fact, asked Rep. Murphy to support Rep. Conyers's Single Payor Bill, HR 676.

Analyst's Comments

Two things appear to be true:

  1. most people think health care reform is needed; and
  1. no one really supports the current proposed plan(s), certainly not HR 3200.

While there are some misconceptions floating around about the Plan, for example it does not end private health insurance, its use of the exchange model, like the similar "Massachusetts Connector," does not allow people to exercise market power by forming self-insured buying co-ops.  

An atomistic buyers market will do little to restrain prices.  While requiring everyone to buy insurance might open the pool up enough to allow payors to ease restrictions on pre-existing conditions without financial hardship to those payors, it does nothing to reduce the cost of such a policy to the buyer.

Rep. Murphy stated that there were states where the insurance market is dominated by one or two payors and that a public option plan, so long as it was not overly subsidized by the government, could actually increase competition.  However, allowing small employers and individuals to form self-insured plans modeled on ERISA welfare benefit plans that can buy insurance across state lines might be a simpler approach.

I cannot see any Democrat representing a traditionally Republican District being willing to risk his or her re-election in 2010 by expending political capital to support this bill which no one really supports.

I was most impressed by Rep. Murphy and his Staff.  His ability to master a somewhat hostile crowd and run a productive meeting suggests he has potential for positions in government of increased responsibility.                    

Originally posted to John Minehan on Mon Aug 10, 2009 at 07:22 AM PDT.

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