The Reston, VA, Town Meeting

I have just watched the town meeting at Reston, VA, held by Congressman Jim Moran, with Gov. Howard Dean, MD (Vermont) fielding audience questions. All things considered, it went rather well, although there was a lot of orchestrated shouting in the beginning, until one of the political activists in the crowd was invited to submit his question and speak to it for five minutes only, or leave. He left, rather than speak under the rules of courtesy.
The subject was, of course, House Bill 3200, Health Reform. Mr. Moran spent most of the first hour explaining the bill's provisions and dispelling ten of the most widespread misconceptions making the rounds ("Grandma's going die", "The government will assign you a doctor", etc.), and then Dr. Dean, himself a physician as well as an ex-governor, explained the major points as well as what was left out of the bill and why.
I am pleased that the bill preserves personal choice of each person's choice of insurance carrier and choice of doctor, and is designed to have everyone medically insured. I would be more optimistic about the plan for handling the cost if the bill had not left out two of the biggest ways of lowering health care costs.
Tort reform will not be in this bill. Dr. Dean explained that including it would mean submitting it to the House Judiciary Committee which is strongly opposed to tort reform, and would not have allowed it to come out of committee for a vote on the floor. But by capping the non-medical, non-economic costs some lawyers seek, tort reform would reduce those tests and treatments of little benefit to the patient, done only to prevent a trial lawyer from accusing the doctor of negligence. Dean did predict that continuing progress toward nationally recognized standards of medical care will eventually solve the problem. (Adhering to standard of care is a strong defense against claim of negligence.)
Bidding down the price of medicine for Medicare and Medicaid will not be allowed, in exchange for a 50% reduction in the "donut hole" where seniors pay the full price of medicine out of pocket. This was an agreement between the President and the pharmaceutical companies. I think the President would have found bidding a much bigger way of cutting costs of medical care (Dr. Dean said the VA bidding system cuts the cost of their medicines to between one-fourth and one=half of what the other programs pay.)
But politics is recognizing what will pass Congress and what will not, and doing the possible. The final bill must pass the Senate, too. Mr. Obama may yet give all citizens a way of paying their medical bills without going bankrupt. I hope so.