In Asheville, Matt Mittan hosted a radio town hall meeting on healthcare reform with Congressman Heath Shuler. It was broadcast on three local Clear Channel Communications stations and podcast elsewhere. Following are short summaries of questions asked, Shuler’s answers, and an occasional Wild West assessment. Everything is paraphrased.

Shuler: (Opening remarks) The country needs a program like the Asheville Project. Insurance needs to be made available to those who can’t afford it, like those with preexisting diagnoses. 50% of bankruptcies are attributable in part to medical expenses. Everybody needs healthcare. The US taxpayers are subsidizing healthcare in Iraq, thanks to President Bush, but they don’t want to subsidize it for their fellow countrymen. Lifestyle changes need to be encouraged, and wellness promoted.

Question: Did you read the entire 1300-page bill?
Shuler: Yes. We read it in committee.
Wild West: You must be a fast reader.

Question: Why aren’t you holding real town hall meetings?
Shuler: One colleague tried and got so much flak, he only answered 25 questions in 3 hours. One can answer 25 questions in 1 hour in a controlled format and reach many more people on radio.

Question: What kind of tort reform do you have in mind?
Shuler: There need to be caps on malpractice awards as well as compensation for gross negligence. Defensive medicine is over-practiced.

Question: What’s the worst part of HR 3200?
Shuler: It doesn’t reform the system. It just adds people to it. The cost curve needs to be bent.

Question: Government has never run anything responsibly. What gives you hope that it can run healthcare?
Shuler: As a businessman, I believe the private sector can usually do a better job than government bureaucracies. Social Security would work if officials didn’t raid the trust fund. Medicare and Medicaid aren’t functioning that badly, either. They just need to be updated.
Wild West: There is a systematic reason why government should perform worse. Bad decisions do not result in loss of business. Taxes still roll in, and competition is difficult, if not illegal, to find. Appointees usually lack the passion and expertise of private businesspeople, too.

Question: Why won’t government let us buy health insurance policies across state lines like we can buy automobile insurance?
Shuler: Obama never said he supported HR 3200. One man wrote it. North Carolina used to have over 52 insurance companies. Now it has four. Competition is necessary to drive down prices. People need to make healthier lifestyle choices.
Wild West: Shuler didn’t answer the question. People can’t buy health insurance policies across state lines because government arbitrarily declared the practice illegal.

Question: Do you support allowing illegal aliens who don’t pay taxes to benefit from government healthcare?
Shuler: I support e-verify to make sure people aren’t coming here illegally; however, it would be immoral and inhumane to allow any person of any persuasion to die when help was available.

Question: Are any parts of Medicare to be eliminated with healthcare reform?
Shuler: Yes. Advantage 1 is one specific program HR 3200 singled out for termination.

Question: Do you know of anybody who didn’t get treatment because they weren’t carrying insurance?
Shuler: Yes.
Wild West: This sounded like one of the faces Obama’s community organizers have been asking people to put on the “crisis.”

Question: The country is running a deficit of $13 trillion and Congress is considering adding to it a healthcare program valued at another $1 trillion. When will Congress say enough is enough? Shouldn’t you eliminate fraud before growing the system?
Shuler: Waste, fraud, and abuse must be eliminated. The federal government adopted a pay-go policy which forbids the creation of new programs without funding. Bush really wrecked the budget.
Wild West: Huh? How is the government authorizing the printing of so much new money in the name of “stimulus”?

Question: Are you willing to go on the healthcare policy you want to force on all Americans?
Shuler: Congress should be made to take whatever they wish to dish out. Some people think Congressmen have special benefits packages, but they get the same perks as all other federal employees.
Wild West: I’ve heard the rumors enough, I would like to check this.

Question: How will the healthcare reforms impact the value of the dollar and the purchasing power of low- and middle-income citizens?
Shuler: First of all, HR 3200 has no chance of passing. Second of all, since the government must remain deficit-neutral, costs cannot be paid by printing or borrowing, but must be made up by consumers and/or taxpayers.
Wild West: After the town hall, somebody remarked the best thing government can do for him for healthcare reform would be to lower his taxes and let him afford the healthcare of his choice.

Question: Most people are not concerned so much with healthcare. They don’t trust the president and the radical leftists he has appointed as advisors. They view the reform as a very scary power play for control. The bill has provisions to put personal financial information in the public domain.
Shuler: This is nothing new. The IRS has had access to personal financial information for years. A prominent Republican said on MSNBC that the bill is scary enough that it is not necessary to make up stuff about it. People need to be careful about where they get their information.
Wild West: It would be a happy world if everybody viewed it as hopefully as Shuler. A friend of mine recently remarked that just because socialism has led to tyranny everywhere else it has been tried does not mean it will happen here. Shuler’s optimism gave me an insight into what is wrong with government. In the press room following the podcast, he was not willing to look at second-order consequences or look at the consequences of putting two ideas he promoted together. That fell into the realm of “speculation.” Government needs checks and balances because it is a magnet for megalomaniacs. The masses never intentionally vote themselves under tyrannical regimes.

Question: Obama ran on a platform of eliminating partisanship, and yet Republicans were excluded from votes on the healthcare bill and the stimulus program.
Shuler: One Congressman and his staff wrote HR 3200. A lot of Democrats weren’t involved in the drafting process. On the other hand, some Republicans refused to negotiate because the bill was a Democrat product. I support stimulus projects to invest funds in rebuilding America’s infrastructure.

Question: Why doesn’t Congress let people pick and choose the particular services for which they want to pay for coverage rather than making everybody pay for abortions and the Cadillac of services?
Shuler: Coverage for abortions isn’t necessarily in or out of the bill.
Wild West: Taxpayers should not have to fund practices that offend their religion. People should be able to pick what they want to insure and be held personally responsible for what they don’t.

What do you think of interstate healthcare coops?
Shuler: They’re a great way to go. Large pools reduce rates. Quality, affordability, and portability are essential ingredients of healthcare reform.

Question: Is healthcare a right?
Shuler: Yes. It is for children and the elderly and vets.
Wild West: It is not a right. A member of the audience later commented that people do not have a right to her tax dollars to pay for their healthcare. Also amazing is the concept that people who fought for freedom would accept socialism as their reward.

Question: Since you don’t currently support the bill, how much are you getting in campaign contributions from pharmaceutical companies and insurance companies?
Shuler: “Nobody purchases my voting power.” I vote as if my constituents and future generations were in the room with me. Wellness programs should be pursued, like the Asheville Project, to keep costs down.
Wild West: I am sure the numbers are available.

Question: Do you support mandatory enrollment?
Shuler: Yes, if healthcare included wellness and disease control management. The more people in the pool, and the healthier they are, the lower the rates will be.
Wild West: This was a shocker. I questioned Shuler about this in the press room afterward, asking if he wouldn’t allow for conscientious objectors; and he charmingly told me I was speculating two or three times. If I thought he had an answer, I would have probed further.

Question: You talk about lifestyle in government healthcare. Are you envisioning lifestyle police or food police? I don’t want my tax dollars to pay for people who eat a dozen donuts when their doctors tell them not to.
Shuler: We don’t live in a communist society. You need to be realistic. The government just incentivized the selling of 700,000 vehicles in two weeks. The government could provide incentives to encourage Americans to eat better.
Wild West: Yet. Who provides the incentives for government to dish out, and is it in their best interest to do without so government can give them their money back if they eat good food?

Question: You talk about being deficit-neutral. What about being quality-neutral?
Shuler: There certainly are issues that need to be fixed with healthcare provision. The Blue Dog Democrats talked the healthcare budget down from $1.6 trillion to $1 trillion.

Question: Government is trying to solve all the nation’s problems in one bill. Medicare and Medicaid will run out of money in 6-8 years, government wants to insure 50 million more people, and fewer people are going to school to enter the medical profession. If I opt out of the government plan and keep my private insurance, will my tax dollars still be taken as if I had the government plan?
Shuler: Incentives should be provided to encourage people to go to medical and nursing school. North Carolina has very low costs for medical school, and so it could become an economic hub for training.
Wild West: I think there was more to the question. Most importantly, will people who don’t want the government plan have to pay for two plans?

Question: The guy who drafted the healthcare bill also drafted the Cap and Trade bill for which you voted. Do you intend to read all facets of any healthcare bill proposals on which you will vote?
Shuler: I supported legislation already to give legislators and the public 48 hours to read any bill on which Congress will vote. Look at Bush’s “knocks and socks” bill to eliminate acid rain and see if Cap & Trade isn’t a good bill by comparison.
Wild West: I commend anybody who can critically analyze 1300 pages plus in 48 hours.

Question: I object to the narrow format of this radio town hall meeting. You should be open to hearing the opinions of your constituents, not just one-minute questions.
Shuler: OK. I’ll let you give your opinion.
Question: No. I’ll respect Matt’s format. 40 million Americans are not insured. Can you give us a breakdown of who these people are?
Shuler: Caucasian, black, Asian, old, young, . . .
Wild West: I didn’t even take notes. It sounded like something from Dr. Seuss. Many in the audience later commented this was lame, too. Said one, one would think Congress would have a clue who the target population was of such a significant piece of legislation.

Question: Emergency room usage has fallen dramatically, contrary to claims of Congress. How can we trust Congress to make good decisions about our healthcare if they’re misinformed on fundamental facts? Are you and Obama using this bill to accomplish goals other than healthcare reform?
Shuler: Congressmen have integrity, because integrity and character are what get people elected.
Wild West: It was a good question. I disagree entirely with Shuler’s statement, which wasn’t a response.

Question: How many new employees will the bill payroll, 100,000? Congress recently voted additional perks for federal employees. How is that supposed to increase voter trust?
Shuler: We have to pay for leave for mothers bearing children. As a country, we’re losing scientists, engineers, and mathematicians; so we have to provide incentives to encourage people to pursue these interests.

Shuler: (Closing remarks) The Asheville Project has saved the self-insured city money by hooking people with high-risk diagnoses up with counselors, pharmacists, and others to make sure they stick to their treatment programs and put up a flag as soon as the treatments are not working. The city pays for the little stuff like the counseling and insulin so they don’t have to pay for bigger stuff like amputations later on. Savings have been impressive. Access, quality, affordability, and portability must be included in any healthcare reform. Insurance companies must be allowed to compete across state lines. Waste, fraud, and abuse must be checked before adding to healthcare programs. It is best to contact Congressmen by email because, since 911, it will take 30-40 days for them to receive snail mail.

In the pressroom, much was repeated. Most stunning of the new comments was that Shuler didn’t believe insurance monopolies nor pharmaceutical companies were benefiting from special legislation. Most positively, he stated fraud, waste, and abuse must be eliminated before growing any programs.