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Obama's call ignites local health care debates

January 5, 2009
When President-elect Barack Obama called for community discussions of health care reform, about 250 people in Indianapolis answered.

Their answer rang loud with individual complaints, with a surprising number of calls for national health insurance, and with some doubt that their comments would actually shape Obama's policymaking.

"My concern is it is placating people," said Lisa Weber, a nurse at St. Vincent Hospital, who attended a meeting on Dec. 29 in the basement of North United Methodist Church. "They [the Obama team] want us to feel like we're part of it, but are we really part of it?"

Two groups organized discussions in Indianapolis, which were part of at least seven statewide, including one in Dublin, Ind., that drew a visit by Tom Daschle, Obama's nominee as secretary of health and human services. In Indianapolis, events were held at North United and at Community Hospital East.

Obama's team called for the community forums when Daschle was officially named as the health nominee. Indiana's discussions were among hundreds organized nationally between Dec. 15 and Dec. 31, all of which will feed comments to Obama's transition Web site, change.gov.

"The idea is really to put the best list of proposals together," Daschle said in a video posted on change.gov.

The invitation dovetailed perfectly with the vision of one nascent not-for-profit in Indianapolis. Better Healthcare for Indiana, which was founded in part by St. Francis Hospital CEO Bob Brody, has been trying to organize community forums about health care around Indiana.

The group's goal is to build consensus on a vision of the best health care system and on the long-term means to realize it. The group hopes to stage expanded versions of the Obama events in cities around Indiana in the next 18 months.

"We believe that it's necessary for something to happen in Washington, but that's just the beginning," said Les Zwirn, executive director of Better Healthcare for Indiana.

The event at North United drew 115 people. Participants included health care leaders, such as Dr. Judy Monroe, Indiana's commissioner of health, as well as interested citizens, such as Guy Russell, a semi-retired design consultant.

At one point, people at one table called for a "single-payer system," or a system of national, taxpayer financed health insurance—which produced applause from two-thirds of the participants.

That was OK with Russell, 67, who said, "I kind of lean that way, but I think we need to examine every option before we choose which one."

But it's an idea that "scared" Weber, the nurse at St. Vincent.

"Somebody has to pay for that. And when they say Medicare for all, it's going to be just like Canada," she said, referring to that country's reported lengthy waiting times for care.

Talk of national health insurance was more muted at a Dec. 30 event staged by Community Health Network. Community CEO Bill Corley and other hospital administrators spent the first of two hours giving statements and answering questions from members of an east-side neighborhood group.

In addition to those in attendance, more than 100 people viewed video of the event on Community's Web site, ecommunity.com, and held a running online conversation.

"Do we have the courage to have only one nation-wide insurance entity?" asked one online participant. "One entity typically stagnates things," another user responded. But a second said, "It certainly would make billing easier."

Dr. Rob Stone was not surprised by the number of people calling for national health insurance. Various national polls have shown majority support for a "single payer system," including one with 52 percent approval for a "Canadian-style system."

Stone, an emergency room physician, and his wife, Karen, helped organize a health care discussion in Bloomington. Out of 70 attendees in the left-leaning city, 64 said they wanted Congress to adopt a "single-payer system."

"There was lots—lots—of vitriol at the insurance companies," Rob Stone said.

But former state legislator Mike Ripley said the event he was part of at North United in Indianapolis did not draw a crowd that fully represented all views among Hoosiers. Ripley noted that only a half-dozen attendees identified themselves as representing an employer.

That's the group Ripley now represents as a health care lobbyist for the Indiana Chamber of Commerce.

Ripley is concerned that the community discussions will give the Obama team a disproportionately large signal of support for national health insurance. At these forums, he said, "there's a lot of support for a single-payer system. And that, quite honestly, scares me." 
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