Monday, August 17, 2009

Charting America's Health Care Future--a joint town hall with Pete Sessions and Eddie Bernice Johnson

This morning, Eddie Bernice Johnson (TX-30) and Pete Sessions held what was probably the country's most civil--and most tightly controlled--town hall forum on health care. Access was limited, with just over 300 tickets available on a first-come-first-served basis, with notices sent out via email and local media. Originally planned for a meeting room at SMU, the event was moved to Cityplace to accommodate a larger crowd; still, there were only about 325 people in attendance, with a promise of video streaming for those who did not get tickets.

Sessions Watch received some of the rare tickets for the event, which was co-sponsored by Curran Tomko Tarski LLP. We were invited to submit questions ahead of time to the co-sponsor's website, and our questions were compiled and presented to Mr. Sessions and Ms. Johnson in turn by Cal Jillson, professor of political science at SMU, who moderated the panel.

Our Sessions Watch group sat together in nervous anticipation, wondering, "Will this be the day Pete Sessions surprises us with rational thought, coherence, and statesman-like brilliance?" We all secretly hope that one day, Pete Sessions will dazzle us with some really great ideas, that one day we'll finally see what the slim majority of people in the district see in him when they faithfully cast their votes for him every two years.

But today wasn't that day. Pete Sessions was his usual self, delivering a few catch phrases--most notably "free market"--without any new ideas, and without acknowledging what most people feel across all party affiliations, that the free market has done a poor job of delivering access to health care to all Americans.

Cal Jillson began the panel discussion by giving a brief bio of each Representative; in his introductory remarks about Pete Sessions, he mentioned the Family Opportunity Act, but that never came up again in the Q&A portion (Sessions Watch submitted a question that came up in our comments section, asking if Pete Sessions would support allowing the uninsured to buy into Medicare, since he sponsored a bill allowing those with Down's Syndrome children to buy into Medicaid; our question was not one of the ones picked).

Following Cal Jillson's introduction, both Representatives gave a brief statement about health care reform.

Eddie Bernice Johnson went first, talking about the rising cost of insurance premiums, which, she said, are rising three times faster than inflation, and how we have a moral obligation to provide access to everybody and keep people from "falling through the cracks of a broken health care system." She gave a brief overview of the three sections of the bill currently in the House, and assured the audience that she has read everything in all three sections.

Pete Sessions used his time to talk about what the GOP has accomplished over the past 12 years, including expanded funding for the National Institutes of Health, the Medicare Part D drug plan for seniors, and Health Savings Accounts, which allow people to save for their own health care in a tax free savings account.

(Sessions mentioned the Health Savings Account in glowing terms, several times during the course of the panel discussion. He sees it as a way for people to "own" their health care and keep it from job to job, but doesn't seem to realize is that even if a person who pays into it regularly might not have saved up enough money for "surprises"--an emergency heart bypass, for instance, which runs into the hundreds of thousands of dollars.)

He went on to outline what he sees as problems with the proposed House bill, but soon became bogged down into his own tangled logic; on the one hand, he worries that the bill focuses too much on what's working--employer-based health coverage--instead of the real problem, covering more people. But in the next breath, he started talking about how there aren't enough physicians to cover everybody who's not currently insured, and got sidetracked talking about how specialists would have to leave their practices to become primary care physicians in order to accommodate all of the formerly uninsured. (A lot of health care advocates think that would be a good thing, to have more primary care physicians diagnosing and treating illness early, instead of waiting until a specialist is the patient's only option). Pete Sessions also expressed concern about people not being able to choose their own doctor under a Public Option plan, without addressing the problem of PPOs, where your favorite doctor may not be on the list provided by the insurance company.

The first question presented by Cal Jillson was about portability; both agreed that people should be able to keep the same coverage when they change jobs, with Eddie Bernice Johnson talking about the benefits of the proposed House bill, which would offer a range of plans in an "insurance exchange marketplace," which would offer low group rates to participants. Pete Sessions countered with his plan for everybody to be able to buy into "bigger pools," where every association, church group, business, etc., could buy into a group insurance plan. "The free market should have a chance," he said, without acknowledging that the free market has been delivering health care for decades without coming up with a streamlined, cost-effective system where everybody has coverage.

The second question focused on what to do about people who are denied insurance because of pre-existing conditions. Cal Jillson addressed the question first to Pete Sessions, asking him if the market would provide health care to those with pre-existing conditions.

"The market should," he said assertively, "move towards covering pre-existing conditions." He suggested that people with pre-existing conditions could be covered by "coming in to fill out some paperwork" and "paying a little bit more." (That comment elicited the first groan from an otherwise silent audience). He went on to repeat what he had said before, about getting more people to buy insurance by creating "bigger pools" (which, incidentally, sounds a lot like the House plan for an "insurance marketplace").

Eddie Bernice Johnson spent her time talking about how a good health care plan should cover wellness, saying that current insurance plans only cover catastrophic expenses instead of the cost of managing chronic illnesses. She highlighted the success of community clinics, which educate people on managing such chronic illnesses as diabetes. People using the community clinics see a doctor regularly, which, she said, is more cost effective than waiting until a chronic condition gets out of control.

The next question covered Public Option and/or Co-ops to compete with private insurance.

Congresswoman Johnson talked about people unable to get coverage, due to pre-existing conditions, as well as those who have been "priced out of the market" for health insurance; she stressed the need to get them into a group plan where they can't be turned down.

Congressman Sessions loudly proclaimed such a plan "Socialized medicine," and seemed startled when the audience erupted in laughter!

At this point, the two members of Congress actually had an exchange, without the help of the moderator. Ms. Johnson reminded Mr. Sessions that when people go to emergency rooms, we all pay. "We taxpayers pick that up," she said.

Pete Sessions agreed that quality health care is important, saying "People don't get healthcare through insurance like they should. We want more and more people to have insurance!"

Just when it was getting good, the moderator stopped them in order to finish the questions attendees had submitted. The audience responded with calls for them to continue their exchange, but Cal Jillson asked for everyone to settle down and proceed with his list of questions.

Sessions said of Eddie Bernice Johnson, "We have a great relationship."

"Sure we do," said Eddie Bernice Johnson, which got another huge laugh from the audience.

Back to the question of co-ops, Sessions said no to that idea, saying, "We don't need to create anything new." Then, he went off on one of his famous circuitous tangents, on the topic of personal responsibility. He went off on a wild hypothetical situation in which someone would enter the emergency room after getting drunk or doing drugs on a Friday night, "Then," he said, "Somebody has to call an ambulance." He concluded his missive by saying that people need to exercise "personal responsibility," a statement which got weak applause from about 10 people.

Eddie Bernice Johnson looked at him and said, "I don't know how to respond to that." Just about everybody in that room erupted in laughter and applause! Then, she went on to explain that ambulances don't just come on Friday night, they come every day, reiterating her point about people avoiding wellness care because it's not covered by their insurance plan. "If insurance would cover people at a reasonable cost, we wouldn't be here," she said. Congresswoman Johnson went on to tell of the history of Medicare, and how it took twenty years to get it passed, saying "anything for people is hard to come by."

On the question of cost, Eddie Bernice Johnson talked about tax incentives to businesses who provide insurance, and stated one problem with the current system is that insurance companies don't want to take any risk, preferring to insure only healthy young people who don't get sick.

Pete Sessions told us about Health Savings Accounts again, saying "The free market works and works well."

The final question was about physician-owned hospitals; both Representatives agreed that in Texas, at least, physician-owned facilities are working well. (In other parts of the country, there have been problems with physicians ordering too many unnecessary tests to get more money from insurance companies, but both assured us that the Texas delegation is satisfied with the physician-owned facilities in our state).

"I'm all for creative financing," Eddie Bernice Johnson said, "because the last administration really made us broke."

The panel discussion with the members of Congress ended at 10:00 a.m., and was followed by a community panel discussions, with people representing hospitals and insurance companies talking about the need for reform. Sessions Watch didn't stay for that portion of the event, but if any of our commenters stayed, please feel free to share your thoughts about it in the comment box.

Before the event, Cal Jillson told us that this town hall is the only one in the country where a Democrat and a Republican have held a joint town hall; despite what appeared at first to be an overly-controlled ticketing system, it went very smoothly and there's no reason why this town hall couldn't be a model for others across the country.

The need for health care reform affects everyone, regardless of party affiliation. When your insurance company drops you because you got sick, they're not going to ask you if you're a Democrat or a Republican. To them, covering your illness is a "loss" that they have to cut. So isn't it time we stopped the screaming and started working together?


Joe Kelly said...

My view from the outside:

I arrived early to the "Town Hall" meeting(where no one could ask questions of their congressional representatives) without an I-D enforced ticket so I joined the protesters outside of City Place around 7:00 am.

We were told to stay silent and walk in a circle around the outside plaza, so I took a sign and joined the approximately 150 pro-health care reform people as we proceeded quietly around the plaza.

The teabaggers had lined up along the Haskell side of the plaza (about 50 strong) and were not making trouble. As the hour wore on, some teabaggers became vocal and started voicing their opinions of our signs (never mind that some of their signs included the wacko positions of: "death panel," "Obama is a Nazi," "Government health care = Communism.")

My favorite was "Obamacare is a death panel," which is such an easily exposed lie from the fear-mongering right. As our numbers grew, a few of the teabaggers tried to intimidate us as we marched quietly in our circle. One fat-stomached redneck in a red shirt stood directly in my way as I marched silently with my sign, and I brushed passed him silently as he stuck his fat stomach in my path to try to intimidate me.

News flash to idiot teabaggers: I've gotten past 9th grade physical intimidation tactics for about 40 years. If you have an argument, let's hear it! If you think your fat stomach is going to intimidate me, you are sadly mistaken!

An older Latino woman was walking in front of me, and a teabagger shouted a comment as she walked by: "Are you legal?" he asked as she carried her sign.

She angrily dropped protocol and confronted the bigot with "Are YOU legal?" before two women came up to her to convince her that it wasn't worth talking back to these ignorant, racist bigots.

The saddest display I saw on the teabagger's signs was pictures depicting President Obama made up as a clown (a reference to black face) and President Obama with a Hitler moustache, as though he were a Hitler figure.

The opposition apparently has no solution to spiraling health care costs and greedy health insurance companies; all they can say is "no." I saw plenty of older teabaggers with signs saying, "Keep the government out of our health care." And I wondered how likely they are to give up their government sponsored Medicare.

As people went inside for the town hall, our numbers stayed around 120 and the teabaggers stayed at around 50. I'm guessing that as many of our supporters went inside, we had a 200-50 head count. I stayed until 10:00, and as I walked along a sidewalk a block away from the protest, I heard several teabaggers calling out to another, "We tried to chase 'em away."

If their whole strategy is to yell and physically intimidate the opposition, they are nothing but bullies and mindless thugs who don't deserve a seat at the table, as we debate the true issues of health care reform.

Ed Cognoski said...

I wasn't in attendance, but I did attend Pete Sessions' town hall meeting in Richardson. He's consistent on one point. Here is an excerpt from my notes:

"Sessions says government should work on the 20% that's the problem, not the 80% that's working right. Then, inexplicably, he says we don't have enough doctors for that 20%. [Huh? Again, my notes must have missed the logic that ties these statements together.]"

Sessions Watch said...

Thanks for your reports, Joe and Ed.

The main problem with the tea party crowd is that they've been given wrong information about the bill from a company called DCI Group (; DCI specializes in framing issues in a negative light (inventing phrases like "death panel," for instance). Big corporations--like the insurance industry or oil & gas industry--hire DCI Group to cast any opposition in a negative light; they advance the message through talk radio outlets to incite an otherwise honest, patriotic public who really wants to do what's right. The message is based on real fear of change; problems arise when these ordinary people face opposition in person, and don't have real facts with which to engage in a logical debate. All they can do at that point is rant, which is sad, really.

Unfortunately, the media has encouraged this incivility instead of using its power to educate people; if the media would expose the source of the talking points, we could engage in an actual debate, based on facts, and based upon our actual differences of opinion about government's role in our lives. It's a debate we need to have at times like this, but unfortunately, the media is treating this like a circus.

Ed, thanks for your report from Richardson; I'll update my report from the Richardson Town Hall to include a link to your blog.

Your notes are right, and SW had to take a second look, too. If Pete Sessions believes that we only have to look after 20% who are uninsured, why does he start talking fast, like he's in a panic, about why we can't do anything about those 20%? Besides a lack of ideas, his mannerism and speech patterns are hardly reassuring that he's capable of serving the constituency; it's hard to imagine what it would be like to work with him on a complicated problem requiring any measure of creative thought.

Nancy said...

Apparently,t o be a Republican these days means just repeating whatever talking point is the loudest. At the risk of being booed and branded a "liberal" though, I wanted to share some information I picked up by doing some of my own research. If you've seen this mailer that Pete Sessions is sending out notice that he gets his health care statistics from something called Lewin Group. Look it up. this company is part of Ingenix which is part of United Health! It's not an independent group but is owned by the insurance industry. So whne he's saying everythings fine with the free market, it's because it's them telling him everything's fine. Just about everybody's had trouble filing claims with insurance and Pete sessions should hear about it, but we can't speak at these town halls without getting shouted down by some idiot yelling "get a job." He doesn't care, anyway, so why should we bother.

John Peterson said...

I'm definitely on the Republican side of the debate, but come from a more Libertarian perspective. Good points regarding those who are on Medicare. I agree they are already on government run healthcare.

Let's say we get universal healthcare with a public option. Are there any provisions in the bill that ensure that the government competes fairly with private insurers? Especially when the government writes the rules, doesn't have to generate a profit, and has virtually endless amounts of money.


Sessions Watch said...

Actually, John, from what we've been able to discern about the House bill (and accompanying committee versions), it's the other way around--the goal is to make sure private insurers deliver what they're supposed to deliver, health care, regardless of pre-existing condition; public option is on the table to keep them from going back to what they've done all along, boosting profits by denying care to sick people.

According to Eddie Bernice Johnson's statements yesterday, public option is also primarily for people who've been previously turned down for insurance because of a pre-existing condition. She indicated that it will only be available to those in the most need, which brings us back to a question that keeps coming up--we have Medicare already, why not allow those who qualify for the public option to buy into Medicare at a nominal rate?

People who own businesses, or who are currently buying their own insurance will have access to the "marketplace" members of Congress have access to, with the same companies available today (such as Blue Cross and Aetna) but at a better group rate. It's really the "large pool" that Pete Sessions says he wants, so it's unclear why he doesn't at least support the "marketplace" portion of the proposed bill.

Also, Republicans who are concerned about decreased competition should keep in mind that most of the 1000s of insurance companies we see today are actually affiliates of just a few conglomerates, like Well Point and United Health.

Another thing that's confusing for some people is the term "non profit," which doesn't mean there's not a profit to compensate employees, just that the profit goes back into the business. One thing the private insurance companies will have to do to compete with a government plan is to funnel most of their profits back into the business, cutting back on CEO compensation. In 2005, people started getting outraged at insurance company CEO compensation when United Health CEO William McGuire made $124 million ( as ordinary people continued to be dropped because of illness. Any reasonable person has to ask how many people could have been covered if he'd cut his own compensation to just $1 million and put the rest back into what the company promised to do all along--cover sick people.

There's another good article on CEO compensation at Fortune:

The question for Libertarians and Republicans should be, "What is the proper role of government, if any, in making sure private industry delivers the product they promise to deliver?"

Don't know if that answered your question--or even if you question can be answered at this time--but hope it gave some food for thought, anyway.

Sessions Watch said...

Thanks, Nancy, for the information on The Lewin Group. From their website:

"The Lewin Group is an Ingenix company. Ingenix, a wholly-owned subsidiary of UnitedHealth Group, was founded in 1996...The Lewin Group operates with editorial independence and provides its clients with the very best expert and impartial health care and human services policy research and consulting services."

Hmmm...maybe they can be editorially independent on matters of surgical procedures, but on the subject of health care delivery, they're compromised by their relationship with United Health.

Good catch, Nancy. Thanks for bringing that to our attention.

John Peterson said...

Sessions Watch said... "The question for Libertarians and Republicans should be, 'What is the proper role of government, if any, in making sure private industry delivers the product they promise to deliver?'"

The government in my opinion has only a few core functions. One of those is to insure justice, to insure that one person or entity does not trample on the rights of others. Another core function is to insure that contracts are enforced. In that regard, I see several options for the government insuring that healthcare companies live up to their contractual obligations.

The judicial system, review boards, fines, rating agencies, transparency websites (like, etc... There are lots of options out there to insure justice is served. None of them involve creating a government competitor to private industry.

Also, thanks for the added detail on the public option. As benign as the government option sounds now, I think that if the public option is added it's power will slowly increase and with it our private sector will slowly decrease.

In my opinion, that's usually how these things start out. It's like a game of chess or risk, you don't throw down the power play in the beginning. If you did your opponent(s) would gang up on you and defeat you. You set the stage, move your players into strategic positions. Then one day... checkmate. Politicians are great at this stuff. The best ones don't think in years. They think in decades and generations. That way the frog doesn't realize he's boiling.

An example would be, the income tax system we got with the 16th amendment. It originally started out as a tool to tax the super wealthy at around 7% ($10,000,000+ in 2007 dollars) and 1% for others. We're way off from that original goal now, and unfortunately we still can't pay the bills :(



Sessions Watch said...

Interesting comments, John, thanks. Last night, Pete Sessions dodged responsibility for people's health care concerns, saying that it's the job of states to regulate insurance. But on the other hand, he's in favor of people being able to buy insurance across state lines, which would make regulation a federal issue.

As for the judicial system, there are already a number of lawsuits against insurance companies for things like lowering reimbursement rates ( and refusing to pay claims ( But in the subcommittee that Joe Barton was part of, they asked insurance company execs if they would stop the practice of rescission and the execs said, "no." So, apparently, lawsuits aren't scaring these people! :) Joe Barton was quoted as saying, "If they don't do something to stop it, Congress will." So it looks like Public Option is the one thing that might make them tow the line.

As far as having both a private and public plan, I'm not too worried, since most other countries have that, with private insurance co-existing with a publicly funded plan. Germany, for instance, has a public plan for those under a certain wage level, and private insurance for people above that level. France does, too, though their costs are out of control. But that's France's problem--we need to look at all the systems with an open mind, pick what works, discard what doesn't, and see if we can get access to good health care for everybody.

Sessions Watch said...

P.S. John, I was hoping someone would ask about H.R. 1207; we put it on our list of suggested questions. But it was pretty much of a zoo out there, with no room for anything but bashing or praising H.R. 3200. Maybe next time!

John Peterson said...

Yeah, I know there are alot of people from all parts of the political spectrum in favor of HR 1207. I know of folks that have been trying to ask / praise Pete about that topic, but like you said healthcare has been dominating.