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Many Republicans who are holding town hall meetings during their August Recess are getting an earful about their opposition to the A.C.A. At a Marshall Michigan town hall meeting Republican Justin Amash faced angry questions about his opposition to the Affordable Care Act and what Amash wants in its place.

Retired Attorney David Getto:The problem is I've never heard anyone explain who's competing against who. As a patient I'm the end user of the system. I can't shop for quality or price. I can't call up five doctors to find out who's going to give me the cheapest operation on my arm, and then call five hospitals up to find out which ones are going to charge me so much for the anesthesia. So when you talk about competition the typical capitalistic model doesn't seem to apply. Who's going to compete?

Rep. Justin Amash The insurers are - the insurance companies going to compete.

David Getto: Well then we're going to turn everything over to the insurance companies. Why - why would we want to trust insurance companies to run the entire medical system?

(General murmur of agreement from the audience.)

Rep. Justin Amash That's not true. And also you're trusting the government to run the entire medical system which is far more dangerous and far more monopolistic.

David Getto: We don't have doctors - we don't have doctors being employed by the government like they do in some countries. Most Hospitals are private operations, they may not be for profit but they're private operations. If you don't have any regulations at all how would you achieve any quality under the system?

Rep. Justin Amash You achieve quality in all areas of life through competition. That's how you achieve quality.  

David Getto: But where's the competition that's what I'm saying?

Rep. Justin Amash You can have it if there is less regulation and more competition.  The more regulation you have in any industry the less competition you have.

David Getto's pointed questions go right to the very crux of the health care debate. Every year hundreds of thousands of Americans who trusted their health insurance companies had their big claims denied and ended up in Bankruptcy Court. Amash's doctrinaire free market extremism doesn't really provide a satisfactory answer to these questions. And I think everybody in the room could sense it too.

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