Durenberger renews his hope that health care reform is ahead

On one of the last days of August, David Durenberger sat in his quiet, sunny office at the University of St. Thomas in Minneapolis and talked about how August was the month that changed his mind.

Durenberger, who heads the school's National Institute of Health Policy, had been a moderator for Rep. Tim Walz's town hall forum and watched reports of a forum held by Rep. Michele Bachmann last week. The natives had been restless, but relatively civil. They mostly listened and debated an issue that has been close to Durenberger's heart since he represented Minnesota in the U.S. Senate from 1978 to 1995.

Because some health care forums had gotten a little rambunctious, Walz called in Durenberger to lend a calming presence and gravitas. When it got loud, Durenberger played elder statesman and asked that people "mute it down a little bit so people can talk."

He has heard the people who spread fear and myths. "But for every one of those guys, there have been people who stood up and talked about how they were sick and couldn't get coverage, or who talked about the greedy insurance companies," he said. And veterans have been saying, "I go to the V.A., and I get good care," he said.

"These town hall meetings have been the best thing that ever happened to health care," he said. "They shook the hell out of the tree, and politicians are scared. It shows them that if you don't get this thing out of the way now, you are going to face it for the rest of your career."

In July, Durenberger wrote that Congress should put the health care bill on a respirator until after the 2010 elections. Now, as he looks out onto the silent campus where he has spent most of his time since he left politics, he thinks they can get it done.

What changed his mind?

It was the short, cool summer when America got off its substantial hind end and forced the issue, for better or worse.

Same story, higher stakes

Durenberger remembers town hall meetings on the same topic in the late 1970s. Then, school gyms in Mankato were venues for elderly couples who told of skipping medications because they couldn't afford them, and delaying surgeries. "It went from heart-rending stories to special interest groups, an assortment of local representatives of associations," he said.

The hurdles to improving health care for more Americans never really changed, he said, "but the ante just kept going up. There is just so much money in it, so many people making a heck of a lot of money off the intransigence of the system. It keeps coming back to, unless you change the payment policies and the definition of insurance, you can't change anything."

Durenberger has been a lifelong moderate Republican, but he voted for Barack Obama because he thought Obama had a unique ability to sell an issue that he cares deeply about. He thinks the president has not adequately explained how to cut costs and pay for it.

When Durenberger recently went to his family's birth place in Germany, he looked into the health care system. What about those who say we have the best system in the world?

"No, that's a myth," said Durenberger. "Most [in Europe] are better."

"What's happened in the past 15 years is a change in the ideas of entitlement versus individual responsibility," he said. "Most people believed in help for those who needed it. But they've seen misuse. Now they go through this whole litany of people who need to be taken care of by me. I think they've had it with carrying someone else's load, whether they are carrying their own or not."

But at least the town hall forums have kept the issue alive. "Regardless of what is said, the signs, the ridiculousness of the crap, everybody knows [the issue] is out there," he said.

Durenberger said he hadn't talked to some colleagues in Congress for 15 years, but now they are calling him for advice. The man who was once censured in the U.S. Senate for unethical behavior over outside income has once again become a moderating force in health care. He has done that, he said, by overcoming Catholic guilt, Minnesota nice, tear-down journalism and the "self-deception" of politics.

Maybe that's why, while Obama's popularity polls are dropping and some are saying reform is not possible this year, Durenberger remains the eternal optimist.

"I've got a sense of the positive," he said.