Post Politics: Death Panels, Town Halls, More

Alec MacGillis
Washington Post Staff Writer
Monday, August 10, 2009 11:00 AM

Discuss the latest news about the White House and Congress with Post national politics writer Alec MacGillis.


Alec MacGillis: Good morning, everyone, and thanks for joining us here today. It's quiet in Washington with Congress now in recess but there's plenty going on around the country -- health care town hall craziness, Sarah Palin warning about 'death panels,' the economy (possibly) on the rebound. I'm also glad to take any questions about the piece I wrote for our Outlook section yesterday, arguing that the strikingly unrepresentative nature of the U.S. Senate has made itself quite a bit in recent months, most recently in the "Gang of Six," the senators on the Finance Committee who are drafting the health care bill that may end up being the blueprint for the final bill, who together represent states that contain less than three percent of the U.S. population.

Fire away!


Concord, N.H.: Hi Alec,

I'm from NH so will admit my equal representation for small states bias upfront. I don't think the country would be any better served by having the House create & finalize legislation. The feeling big states get when thinking about Wyoming telling them how to live is exactly how I feel about say, California or Texas, making rules for NH. I have to tell you, that thought sends shivers down my spine.

The US is a widely disparate country in terms of demographics state to state. It is very difficult, if not impossible, to enact boilerplate legislation that will fit California as well as it fits NH. Any move the government makes towards enacting federal laws strips from the individual states their power to decide what works for their unique constituency.

A bigger problem in Congress to me is the lack of term limits. No individual should be able to create a stranglehold on chairing a powerful committee for decades. How old was Dingell when his gold-plated Energy & Committee gavel was wrested from his hands - 90? Waxman will now hold it for another couple of decades.

Term limitations would allow for a passing of power. Until Grassley is out of office, there will be no movement on anything that could impact ethanol or farm subsidies. That's more problematic than having legislation decided by equal representation for each state. I doubt the founders imagined that their framework would have to cover what amounts to several countries with remarkably different lifestyles & interests within a giant umbrella.

Alec MacGillis: Concord, I hear where you're coming from on this -- I've got plenty of small-state sympathies of my own, in fact partly because I myself lived in Concord for a few years, working for the Monitor. I find your argument the most persuasive defense of the Senate's composition, more persuasive than those who argue for the Senate as a guard against the 'tyranny of the majority' -- the fact is, it was Madison who warned against the tyranny of the majority but he was also the one who argued for allocating the Senate's seats based on state population. One could have a Senate that was a step removed from direct democracy but also have it allocated more fairly according to state size. So I see the need for the protection of state interests in a federalist system. But we have plenty of other checks in the system to provide that -- strong state governments that control vast swaths of public life, a Supreme Court that is meant to guard against unnecessary federal intrusion. But does the Senate err too much in one direction, perhaps more than the Founders intended? When a state is 70 times as big as another, yet has the same votes in the Senate, has something gone a bit awry? When a country that is so heavily metropolitan as America now is still riddled with, say, farm subsidies, does that not suggest an imbalance of sorts? I could go on about this for a while, but still stop here for now...


Houston: Sarah Palin's comments on her Facebook site have kept me up all weekend. It bothers me that anyone would give these comments credence, and I feel that the Democrats should drop their "turn the other cheek" attitude towards such comments and attempt to stop the never ending parade of falsehoods coming from the opposition. Do you think that this would be a wise thing to do?

Alec MacGillis: There are signs that the Democrats have started, belatedly, to mobilize on this front -- the White House has an aggressive new fact-checking push-back Web site up, similar to what it had up during the campaign to defuse false rumors. But there is also of course a risk in wading too much into this battle, that it might pull the White House down from the elevated level it has tried to maintain on this issue. If you're sending your own troops into the town halls to fight back, is there a risk that what was supposed to be a big national overhaul on a hugely important issue, a test of our civic purpose, becomes a nitty gritty food fight? I think that's the balance they're trying to strike.


Falls Church, VA: Why do "journalists" think they have to do the "he said, she said" thing, in the name of some quest for "balance"? For example, with the health care "debate", the Republicans are putting out utter lies (e.g. Sarah Palin's lie that Obama's plan would have terminated her pregnancy with Trig). Don't you serve Republican National Committee aims by instituting an equivalency between the claims that is utterly FALSE!?

Alec MacGillis: I agree wholeheartedly that reporters too often rely on the 'he said/she said' model and shy from stating what they know to be the truth on an issue. I'm not sure how this particular one has been reported elsewhere, but I do know, though, that my colleague Ceci Connolly made clear in her story on this over the weekend that there are no 'death panels' whatsoever in Obama's proposals.


Valley Station, Ky.: I heard at church yesterday that Obama plans to start death panels where all of my fellow seniors over age 67 would have to go for annual checkups and counseling about how and when we should die. I am outraged that this USA has been taken over. This sounds like something from Orwell's "1984."

Alec MacGillis: Well, here we are. If this posting is in good faith, here's proof that Palin's comments are having an effect. Valley Station, what you heard at church is wrong. Here are the facts: one of the bills that has been submitted calls for primary care doctors to be better compensated for the time they spend offering advice to seniors who have questions about the thorny issues involved in end of life care. Right now, doctors are not compensated by Medicare for the time they spend on such counseling. So it's quite straightforward: do you, or some of your fellow retirees, believe that people should be able to get advice from their doctors about how to prepare for some of the tough questions that arise late in life? (Living wills, etc.) And if your doctor gives you advice on these questions, do you think he should be compensated for it? And as for the 'death panels' -- there are no such things. There may be a new federal board that advises Medicare on how to reform the compensation system to achieve cost savings without degrading care. But no death panel.


Washington, DC: What are these "Senators" of which you speak?

As a D.C. resident, I wholly advocate limiting small-states' representation in the Senate. See how they like it.

Alec MacGillis: Yes, as I noted in my piece yesterday, Wyoming has fewer residents than Washington D.C. yet has three votes in Congress to D.C.'s zero, and has as many votes in the Senate as does California, which is 70 times as large.


Irvine, Calif.: What is the extent of influence of Dr. Zeke Emanuel in the Obama health care reform?

Yesterday on "This Week with George Stephanopoulos", Former Speaker Gingrich referred to Dr. Zeke Emanuel as a health care advisor to President Obama?

What is his position on Obama's staff?

His written articles suggest that care for the elderly and disabled will be "different" for elderly and disabled. And that those with better health and futures will instead get better treatment.

Alec MacGillis: Zeke Emanuel has a job in the Office of Management and Budget, which is run by Peter Orszag and has a very large hand in crafting the White House's health care policy. Just how big Emanuel's influence is within the office I'm not entirely sure - his word carries weight, I'm sure, based on his background as a respected doc and health policy thinker and being brother of the chief of staff can't hurt. But some of his ideas are actually a bit outside of the health care reform mainstream and have not shown up in bills so far.


Alexandria, Va.: Just how tone deaf are some Democrats in Congress? While you may save a few million dollars by buying extra luxury jets right now, is that really worth the pain they are going through when people hear about this story?

Alec MacGillis: The purchase of the jets, which has been well-covered by the Wall Street Journal, is certainly eye-opening. Some of these "codels," as the trips are called, are easier to justify than others. Trips to Afghanistan are one thing. Trips to Europe, on the other hand...


Chicago: Could you give the current odds for the passage of 1) public option in health care and 2)health care reform legislation in general?

Alec MacGillis: Despite all the rough sledding the Dems have encoutered, I would still hazard that a big health care bill has a decent chance of passing. The economy's inching back into form and there's just too much riding on this for the Dems for the effort to collapse a la 1993-94. The odds of a public option, though, are distinctly less. This is the big question of the day, how hard Obama and congressional leaders are going to fight for the public option. I wrote a long piece in Friday's paper looking at this question -- what a public option would accomplish, whether it's really necessary for health reform to work. Obama's been hard to read on this--he's said he wants the public option but has recently signaled he might settle for nonprofit 'co-ops.'


Montgomery Village, Md.: Alec

Do you think Congressional Democrats may now have some regret for not meeting the Aug. 7 deadline to have a health care bill for the President to sign? Or having failed to meet that goal, are they now going to actually be more galvanized in their support for action because of the "crazies" essentially stifling any honest debate back home ?

Alec MacGillis: This is a very good question. The assumption was that not getting it done by the deadline was a mistake, because it would give opponents a chance to scuttle things over the break. But I woudln't be surprised if the dynamic does not in fact turn out to be closer to what you describe here, a kind of backlash against the more extreme forms of opposition. Also, one needs to keep in mind that for all the talk of Obama flailing on this, each of the past two years found him facing similar talk in the dog days of summer (against Hillary in '07, and McCain in '08) only to come back strong in the fall. It's becoming a pattern with him. So we shall see.


Baton Rouge, La.: Why am I, as somebody who supports a single-payer single but willing to live with a public option, suppost to scared of it getting derailed by nonsense yelling and pushing matches at town halls and Sarah Palin's Facebook account. So what Valley Station think he's going off on a ice flow? This isn't going to a public referendum (that was actually the 2008 election). It's a representative democracy. Instead of worrying about the misinformed, why not just pass a good bill and then when nobody ever see a "death panel," then the problem is solved?

Alec MacGillis: You make an important point here that I hear a lot from the reformers -- they argue that the most important thing for the Dems is to pass a good bill that will function effectively and thereby put the issue to rest over the long run. That from a political standpoint it's more important to pass the things necessary for the bill to work than to make concessions that might gain a vote or two in Congress but might substantively weaken the actual success of reform, and therefore hurt the Dems over the long run.


Austin, TX: In 2004 and after, we heard a lot about the red state - blue state divide.

More recently, not so much.

But isn't the division of the country (I would put it more in urban/rural terms) still a huge, troubling issue?

Just one example: I, like many city dwellers, can easily hear half a dozen languages spoken by people of four different religions in a single day. I see gay couples. I know atheists. It's all just a normal part of life.

And all of this is completely outside the experience of many, many people in rural areas.

Are we splitting into two countries?

Alec MacGillis: This is something I've thought about a lot, especially after all the traveling I did around the country during the campaign. It is hard to overstate how strikingly disparate our states and regions really are. Obama held himself out as the guy who could bridge all these divides, but the fact remains, for instance, that way, way more people in the South than elsewhere in the country believe that he was not born in the United States. We may all eat at the same fast food joints and watch the same TV but we need not fear that we're becoming a big homogenous blob. Far from it...


Princeton, NJ: What's wrong with Concord's argument is the facile assumption that all people in a state have a common interest. I submit that a farmer in downstate Illinois has more in common with a farmer in Missouri or Indiana than he has with a poor guy in the slums of Chicago or a prof at Northwestern. The design of states is an historical accident that has nothing to do with the 21st century. If you want a better Senate, break up the big states into WY sized districts that do have more commen interests. That way we would also approach "one man, one vote" that we preach to the rest of the world.

Alec MacGillis: I'll put this one up just to keep this debate going, and say that I agree on the 'historical accident' point. People talk about these states as if they were all hallowed creations carved in wood by James Madison himself, but the fact is that the statehood process for many of our Western states in the late 19th century was riddled with politics and as arbitrary as can be. There were 67,000 people living in Wyoming when it became a state! That's barely bigger than my hometown in western Massachusetts...

_______________________ Democrats Weigh the Calculus of Public Insurance


Washington: Alec,

Great piece yesterday.

My question is about the uproar over health-care reform.

With all of these "coordinated efforts" to disrupt and shout down congressman and others in favor of doing something, I have to ask: where the hell are the 45 Million Americans that are totally lacking in health insurance?

Why aren't they out there defending the drive to ensure that they have access to quality care that goes beyond hefty bills for non-emergency emergency room visits? As unbelievable as I find the behavior of the naysayers, the fact that this massive block of uninsured Americans seem to not really give a damn really bothers me even more.

Alec MacGillis: This is a good question and one that many of the reform advocates are now asking themselves. The simple answer: people without insurance tend to be poor, and the poor don't vote. There are exit poll numbers out there showing that the vast, vast majority of people who vote have health insurance. And of course, it is true that at least some of the people without insurance are people who don't give too too much thought to that, the young immortals who don't think it's worth it to buy coverage, but who might be persuaded to do so if buying coverage is cheaper and if theyr'e facing a fine if they don't.


Philadelphia: For Valley Station, Ky.: I'm sorry to learn that someone in your church has chosen to bear false witness in our national health care discussion. That's a sin against God, of course. But more critically, we should ask ourselves if our current health system is one that conforms to scripture. We live in a pretty wealthy society where more than 40M people are not insured and could see their lives unnecessarily ruined if they had an accident or developed a disease. There are people today who don't get necessary treatment because they can't afford it. There are people with insurance who are kicked off the rolls as soon as they contract a disease or condition that actually requires them to USE the insurance they've been PAYING for.

Our current system does not reflect the ethic of the Good Samaritan. Our current system does not reflect the ethic behind the miracle of the loaves and fishes. Our current system does not reflect the invocation to "love our neighbor as we love ourselves."

And people who walk into church ready to spread dispicable falsehoods about an important issue such as this are not walking the walk of a committed Christian. Plain and simple.

I would thank you for bringing your question to this forum, where the lie can be laid to rest and the truth may set you free...

Alec MacGillis: Going to put this one up as is. Speaks for itself.


Silver Spring, Md.: Please explain to me how a church can maintain it's tax exempt status while "preaching" out right lies to the congregation, as the Kentucky commenter just related.

Alec MacGillis: Another one on the death panels. I'll just add here that it's possible that the Kentucky congregant was referring to something he/she heard from a fellow parishioner, and not from the altar.


Alexandria: "When a country that is so heavily metropolitan as America now is still riddled with, say, farm subsidies, does that not suggest an imbalance of sorts?"

Are you so politically naive as to think farm subsidies are for anything other than keeping food cheep and abundant for metropolitan areas?

Alec MacGillis: Subsidies obviously have multiple beneficiaries. But no, I would argue that they also pretty obviously benefit the big ag interests as well. When Kent Conrad of North Dakota flat out rejects Obama's plan to reduce subsidies for the wealthiest farmers, I don't think Conrad's doing that on behalf of you and your neighbors in suburban Alexandria.


Dover, Del.: Doesn't a bill have to pass both the House and Senate for approval? There is a reason one body has two per state and the other is based on population. Is there not a requirement for government or history classes anymore?

Alec MacGillis: Well, Dover, I took a fair amount of history in school. And I think a case can still be made that there's something a bit screwy when, in one house, Wyoming has one vote to New York's 29 and California's 53, and in the other house, each state has got two. It has a huge, huge impact on a whole array of issues, starting with, for instance, energy legislation. Wyoming's one of the biggest coal producing states in the country, and it has as many votes on energy legislation in the Senate as Illinois or Florida or Ohio.


Minnesota : According to the Columbia Journalism Review here are the facts about those "wasteful jets"

But wait a second. These planes are for an Air Force fleet that's barely used by Congress-at least compared to the others who also use it. Over the last five years, 86 percent of the use of the private-plane fleet has been by the White House and the military. Just 14.5 percent has been congressional use.

The headline and subheadline are clearly misleading, implying as they do that these are congressional planes and that it is adding eight new planes to its fleet. But here's what you find after reading nearly three-hundred words (emphasis mine):

The House Appropriations Committee says the new purchases are designed to replace seven aging and more expensive business jets. The net impact is one additional plane owned by the federal government and a substantial increase in its passenger capacity.

Wow planes mostly used by the AIR FORCE to replace aged unsafe planes. Not quite the clear cut wasteful spending portrayed in the earlier post.

Its a shame that the crazy liberal website Daily Kos references the Columbia Journalism Review but the Washington Post just propogates misleading partisan rhetoric.

Alec MacGillis: This is good context on this issue. I would still argue, though, that there are fair questions to be asked about congressional spending on these trips, whether they are with the old planes or new ones. My colleague Al Kamen keeps close track of them in his Loop column and some of them are truly eyebrow-raising.


Death Panels: "If this posting is in good faith, here's proof that Palin's comments are having an effect."

And doesn't this prove also how ineffective the media has become that this would even be possible. At what point does the media start looking inward.

I saw an article in a Tennessee Newspaper that literally said "Palin stated the plan would have death panels-a charge strongly denied by supporters-..."

Literally. Should a journalist be able to simply say "a false charge" without the equivication?

It is like saying "the world is flat, a charge strongly denied by scientists."

Alec MacGillis: Yes, this is a good example of bad 'he said/she said' journalism. I agree, it really is a problem.


Baltimore: Re the town halls: Let me preface my comment by saying I am 61 and therefore only a few years from Medicare myself, so I am utterly baffled by the fact that many of the screamingly rude town hall protesters seem to be of an age where they are already receiving health care from the federal government, yet they will be damned if they will let the federal government get involved with health care. Are these people too clueless or uninformed to know what Medicare is and where it comes from? Thanks.

Alec MacGillis: There are many, many examples from recent weeks of people getting up at these meetings and declaring that they don't want the government to mess with their Medicare. One Democratic congressman started off his meeting by asking people whether they were opposed to government-run health care, and many hands went up. He then asked how many were on Medicare. Many hands stayed up. Not sure whether the message got across...


Washington DC: Re "splitting into two countries": Twenty years ago, I am sure Livingston MT, an old railroad town on the Yellowstone River, was reliably Republican and extremely conservative. Yet when I went to the Friday Farmer's Market there on my last day of vacation a year ago, there were eager volunteers staffing an Obama for President table and no Republicans ginning up support for McCain. It's not just south/north or urban/rural any more. There are profound changes going on in the Mountain west, driven I think by the fact that people who live out there are basically tolerant and live and let live and the Republican Party no longer is.

Alec MacGillis: A very good point. The differences are often within states, as I saw myself in places like Missoula. And the fact is that Obama may not have won the nomination were it not for racking up so many caucus victories in big sky country. So one has to be careful not to generalize. One of the best books on this whole subject is Bill Bishop's "The Big Sort," how we are more and more grouping ourselves into little cultural islands.


Alexandria: "Just one example: I, like many city dwellers, can easily hear half a dozen languages spoken by people of four different religions in a single day. I see gay couples. I know atheists. It's all just a normal part of life."

This is a good thing?

OK, I'm mostly joking. But I find that "city dwellers" have no idea how the country works and need to get out more. By that I mean how food gets to their table, electricity and water gets to their apartment, how all that stuff gets to the wonderful (non-Wal-Mart) stores that they shop in.

I often think we'd be better off if more people had my experience. I grew up very rural, went to school in a small college town, have lived and worked in New York, and now work in Alexandria and live in the suburbs.

I think having small states have equal representation and powers in the Senate is a good thing. Puts the brakes on "city dwellers" voting for more "bread and circuses".

Alec MacGillis: To be sure, a broad perspective is helpful. But what 'bread and circuses' would city dwellers be voting for? Fact is, the small states are voting a lot for 'bread' in the form of huge ad subsidies. Not sure about the circuses.


Tampa, Fla.: Speaking of "unrepresentative" representatives, what's the outlook for Congressional redistricting? The census is next year. Will Dems draw more district lines than last time? If so, how will that affect the Blue Dogs? Will their conservative-leaning districts lean less to the right and more to the left? I would think that could make a huge difference in the House.

Alec MacGillis: A good point. The redistricting is indeed on the horizon. In most states it is done by the state legislature and so it will matter greatly which party is in control at the state level.


Is history repeating itself ?: What accounts for the change in the way the U.S. is fighting in Afghanistan ? Because this new turn into a war on druglords seems dicey at best. Do you think the Commander in Chief is getting bad advice or is so preoccupied with his domestic U.S. agenda that he's unaware how slippery the slope is that he's going down ? Has anyone defined what constitutes victory in Afghanistan ?

Alec MacGillis: A good question on a subject we haven't touched on today. You're right, there is a whole new approach there with a lot riding on it. The big thing to watch now is whether the generals come back to Obama asking for yet more troops there.


Kansas City: I've heard various jokes about what the Democrats need at these town halls is the Cambridge Police Department. But in all seriousness, isn't it a little odd that a lot of the public thought Prof. Gates was wrong for being disrespectful to the police in his house yet citizens can be disrespectful (mobbish?) in a public forum and not get in trouble...

Alec MacGillis: Congratulations for finding a link between the two big stories of the summer dog days! A shrewd observations. That said, some of the rowdier folks are being cuffed here and there.


Alec MacGillis: Alright, with that I think I'm going to have to call it a day. Thanks very much for all the questions and sorry I couldn't get to even more. Seems pretty clear from all the questions and sharp-tempered comments that this is not the sleepy summer political season of yore. Join us next time!


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