LEMMINGMANIA

The dog days of August are usually a slow news period. Leading politicians go on vacation, while Congressional representatives return home to touch base with their constituents. Town halls are often a good venue for representatives to state their positions and receive feedback. Concerned constituents have an opportunity to express their views on issues that matter to them or comment on Congressional action or inaction. Rarely, do town halls get much press coverage. Not this year!

No, for the past several weeks we have witnessed irate constituents berating Democratic representatives in the House and the Senate for betraying the Constitution, taking aim at Grandma and attempting to turn the United States into a 21st century USSR. A few of the participants seemed to be in search of answers. Too often, representatives were treated to boorish individuals rude enough to shout and shove to cut off debate before it began. Many of these were egged on by media bloviators such as Rush Limbaugh. Others, perhaps, read the blogs of former Alaskan governor Sarah Palin or sought inspiration in the musing of Sen. Charles Grassley of Wisconsin who claimed that Americans had every right to be fearful of Obama style health reform. The spectre of "death panels" dooming decrepit granny to a premature death were just the tip of Republican demagogy. At the more extreme wing of the opposition, there was a display of one representative dangling from a noose.

Whew! For the mostly older participants of these angry demonstrations of know-nothingism, it is tempting to give them exactly want they want: no government run health care. Take away Medicare, the primary care vehicle for most retired persons, and let these people insure themselves in the private market. Take that you ignorant old farts!

Where would the many elderly constituents who most prominently savaged Senator Specter of Pennsylvania during not one, but two town halls be without Medicare, the last major contested innovation in the American health delivery system? Destitute. Indeed, even with Medicare, many elderly have had problems coping with infirmity in old age. Prescriptions are expensive and many have fallen through the donut hole created in the Bush era modification of Medicare to include partial government aid for prescription drugs. Medicare, at least, ensures that the elderly will receive health care that would not and could not receive through private insurance.

Lost in all the hyperbole about health care is a very simple fact. The United States is the last advanced economy to expand health coverage to all of its citizens. Every major economic competitor has some form of universal health coverage. Indeed, the last two countries to revise their health care delivery systems - Taiwan and Switzerland - did so without much of the political bile that has been spilled this past August. Taiwan took the time to study other health care systems and crafted a program best suited Taiwanese expectations. It even included health care auditors who visit those patients excessively accessing health care. Imagine that coming to an American hospital near you!

As Paul Krugman noted in today's New York Times op-ed, at best it can be argued that Obama and the Congressional democrats are steering the United States towards a Swiss style health care system where coverage is provided by private insurers. Whether there is a public option to get coverage for those individuals whom private insurers least desire to cover - those with pre-existing conditions or those facing catastrophic medical procedures - now hangs in the balance as the result of constant demagoguery. And, in the absence of a public option, what would pressure private insurers to act more reasonably and accept a Swiss style health care system?

With whom should one have a rational health care debate? Newt Gingrich? His op ed in Sunday's Los Angeles Times might have conveyed the impression that he could reasonably debate the various Democratic positions. Senator Chuck Grassley? At his outdoor address to his Wisconsin constituents, he admitted that his presence on one of the Senate committees reporting out health care legislation was essentially a stalling operation. That he confessed this while stating that American citizens were justified in fearing Obamacare ought to remove him from any bi-partisan considerations. Sarah Palin? She is a one-woman wrecking crew would shouldn't be allowed to blog, let alone get her bizarre views broadcast on a national basis.

Indeed, some of the most reasonable voices have been heard at Mr. Obama's town hall fora. It certainly is a legitimate question to ask how a public entity would impact private insurance providers, especially when the playing field might not be level. Would a public entity be allowed to lose money providing coverage for those least able to afford it or those whose medical bills would threaten private insurers? Would a public entity be subject to political tampering every time it went to Congress to make up for deficits that it could conceivably run?

There may be answers to these questions, but you won't hear them from voices within the Republican party. The Republican party - what's left of it - seems hell-bent on marching toward the sea. Lemmings everywhere unite and head toward the cliffs, and let the rest of us reform a health care delivery system on the verge of collapse.