Listen to the people packing town halls on health care, and you'll hear earnest concern or outright rage. Many agree that the system is broken. But is this how to fix it?
The Ridgedale Library auditorium doesn't often draw a standing-room-only crowd.
But with 20 minutes to go before the start of a health care town hall meeting there last week, every one of the 150 seats was taken. Throngs, some still in work boots, others in suits, lined the walls or found a patch of carpet. Some lugged copies of the 1,000-page health care bill, the margins marked with comments or questions.
As the meeting began, some had only technical questions. Others came to vent. The crowd erupted in applause when one man decried health care mandates as "socialistic" and "un-American."
Across the Twin Cities, and the country, voices are rising in anger, fear and confusion over what would be the biggest change to the nation's health care in generations. People are shouting down others; jamming Capitol Hill switchboards to voice support or concern; sending threatening letters to lawmakers, even hanging one in effigy.
The debate also is exacerbating the divide on other problems facing the nation, from the wars in Iraq and Afghanistan, to the banking bailout, the economy and even racial equality. On Friday, outside Rep. Keith Ellison's Minneapolis office, debate over health care suddenly turned into a standoff on race. "The real deal is you don't want black folks to get what you got," yelled the Rev. Jerry McAfee. A crowd of white picketers circled the preacher. "You're the racist," a woman yelled. The fracas only ended when a police car arrived, lights flashing.
Is this mob rule, or democracy in action? A passing frenzy, or evidence of a newly engaged populace that will be a political force when Washington confronts health care this fall?
Is it '1984'?
To hear people discuss or debate the bill is to realize just how dizzyingly complex the legislation is, and how seemingly minor provisions can have far-reaching implications and mean different things to differet people.
President Obama campaigned and won last fall on a promise to address the lack of coverage that is a fact of life for millions of Americans. He and advocates for the bill say time is running out to fix the runaway costs and patchwork care of the current system.
While many agree that costs are out of control, getting from that broad point to agreement on the details of an acceptable replacement is proving difficult, if not impossible.
At the Ridgedale Library forum, for example, the implications of just one section of the proposed bill gave the crowd a chill. Its title: "Surveillance."
What did the government mean by surveillance? Was it appropriate? What would the magnetic strips on the new health care ID cards contain? Could the data land in the hands of private companies?
Twila Brase, a nurse and president of the Citizens' Council on Health Care, a policy group in St. Paul, raised the spectre of Orwell's "1984'' in arguing that the federal government would be free to share personal health information among multiple federal agencies.
A number of older people expressed puzzlement at how the Obama administration could say that quality of care would remain the same under Medicare, while still pledging to cut $500 billion from the program.
"Now, that just doesn't make sense," said Cecil Martin, 74, a scrap-metal trader who arrived at the meeting in his work suspenders. "There's no way in God's green Earth that they can cut that much from Medicare and keep quality the same."
Fears of government rationing were pervasive; so were conspiracy theories. Someone questioned why the members of Congress were excluded from the new, public plan. Brase suggested it was because they already had a better plan and didn't want to risk losing it.
Most seemed hungry for information. Each time someone mentioned a website with information on the bill, hands furiously scribbled the address. When a speaker asked how many people had watched Obama's health care forum in Portsmith, N.H., nearly every hand shot in the air.
At 9:15 p.m., more than two hours after the forum began, security guards were still trying to get people out of the building. Some of the discussions moved to the parking lot. About a dozen people decamped for a nearby Champps restaurant, where they discussed health care policy until nearly 11 p.m., said Toni Backdahl, one of the event's organizers.
"Everyone was talking over everyone," Backdahl said of the Champps outing. "It was a loud scene."
Change, yes, but not this
Jill Schwarz, 40, of St. Michael, a stay-at-home mother of three, said her mind was so overflowing with ideas after the event, and after weeks researching the health care issue, that she decided to try to organize them in a letter. She didn't finish the note until 2 a.m., which she e-mailed to friends and family who are interested in the issue.
"Look, I've got a lot of opinions," she said.
Like many who oppose the legislation, Schwarz is no defender of the status quo. She has nightmare stories of her three children receiving poor service from for-profit hospitals and clinics. Once, Schwarz said, a doctor tried to argue that her 12-year-old daughter's six-week virus was really a bout with depression.
"I'm frustrated with the system and I want reform," she said. "It's just not this reform that I want."
Instead of rushing to create a public insurance option, Schwarz said the government should find a way to separate health care insurance from being tied to your employer -- what she considers "the first and greatest mistake in the evolution of health care America." Consumers, she argued, should be able to shop for coverage like they shop for car insurance or a TV, not forced to accept whatever their employer will provide.
"Everyone is afraid they're just one pink slip away from losing their health care," she said. "If my husband were to lose his job or his life, me and my kids would be left in the lurch."
Many of those raising their voices at public meetings say they have never been politically active before.
Dan and Katie Hovsepian and their daughter, Beth, have long talked politics around the dinner table. But the family, which lives on a leafy cul-de-sac in Bloomington, have never attended a single political event until Wednesday night's event in Minnetonka.
"This is our lives we're talking about here," said Beth Hovsepian, 22. "Of course, we're getting involved."
Even so, they approached the meeting with some trepidation. They had heard reports of activists shouting, screaming and shoving legislators at town hall meetings from Pennsylvania to Texas. Their nerves were heightened when they saw two security guards at the entrance of the library. "I thought, 'Oh boy, this doesn't look good,'" Dan said.
But after listening to Wednesday's talk, they agreed to become more involved. On Friday, Dan and a group of opponents to the Obama plan met with staffers in Republican Rep. Erik Paulsen's office and turned over letters.
"Not everyone who is opposed to this bill is loony, you know," Dan said.
For Beth, who became a nurse this spring, her opposition is largely based on experience working as a nurse intern. In a town outside Duluth, she saw how people receiving Medicare weren't receiving home care -- left instead to struggle alone, in places far removed from hospitals, with serious health problems. On the other hand, she's seen for-profit hospitals take care of people who have serious medical problems but no insurance, free of charge.
"The government will see the statistics and the costs, they won't see the person," she said.
She and her parents expressed concern that people have been lulled into supporting the bill by promises of expanded coverage.
"Wouldn't it be wonderful if everyone was covered?'" she asked. "But if someone is promising the moon, and saying they're going to fly you to Cancun for free, do you say, 'Really, that's great!' Or do you hang up. You really have to wonder if this is real."
'Scared of us'
Liz Decker, 42, a musician from Minneapolis, is still trying to determine what the proposed legislation actually says. Like many, Decker is frustrated by the sheer size of the bill-- it's too big for her home printer -- and its frequent references to other bills that she can't find.
Three weeks ago, Decker downloaded the entire bill -- America's Affordable Health Care Choices Act, or H.R. 3200 -- from the Internet and begun highlighting the key issues that concerned her. Decker then compared her notes with those of her 74-year-old mother, Beverly, and was surprised to discover that they shared many of the same concerns. Both thought the "end-of-life counseling" mentioned in the legislation would open the door to the killing of the elderly, a claim some Republicans have stressed but which has been dismissed by independent analysts.
David Durenberger, a former U.S. senator from Minnesota and senior health policy researcher at the University of St. Thomas, has been impressed with the size and passion of the crowds showing up at the town halls. But he questions whether the participants are well-informed.
"There are so many people out there today relying on punditry and talk radio for information that it's hard to tell if this is real," Durenberger said. "We're better informed, but are we getting good information?"
One sign of the emergent movement's impact, some argue, is that proponents of the Obama plan are beginning to take the opponents seriously.
Last week, for example, the Senate dropped the controversial provision on consultations for end-of-life care.
Efforts to label the protesters as extremists acting on behalf of right-wing groups have only angered many political moderates, such as Carole Christianson, 60, of Robbinsdale, who joined picketers at Ellison's office on Friday.
"It's a putdown," she said. "No one has brought us here except ourselves."
At the forum in Minnetonka, it was clear that many present felt momentum had shifted their way.
"The members of Congress are afraid to hold town halls ... We are winning,'' Brase told the crowd. "They're scared of us."
Chris Serres • 612-673-4308