Defeating the Health Care Forum Bullies (getting something done)

(Thanks to iowademocrat for bringing this discussion to Bleeding Heartland. - promoted by desmoinesdem)

(crossposted from Daily Kos and iowademocrat)
Last Wednesday, I attended a health care forum in Iowa hosted by Senator Tom Harkin. Following it, I wrote a diary, “Now I understand why war happens (a health care forum story).” In it, I asked the question, how can you defeat the bullies who are overrunning most of these meetings?
The problem in dealing with the teabaggers, deathers, birthers, racists, anarchists and radical libertarians who are overrunning health care forums nationwide is simple to describe.
They. Don't. Listen. Ever.
So, you can't really talk to them. When they have stacked the room, the intimidation is palpable. That's how they win.
I couldn't for the life of me think of how to beat these people, short of overpowering them somehow – hence the title of the diary. But, even as I wrote it, I knew that overpowering them just feeds into their fear and paranoia, and realistically, it's impossible anyway.
Today, after a little sleep and some reflection, I realized that the effect of the teabaggers' aggressive intimidation made me stupid for about eight hours. Anger is an amnesic agent. It makes you forget what you know. I was angry, depressed, agitated, and clueless all at once.
Now, I have calmed down, and guess what! I already knew the answer – and it has been sitting right in front of me all the time.
The answer is us.
The solution requires both:
1. Imagination, and
2. A lot of hard work.
It also requires a reality-based approach to reform. The hard work part is already being done. We are doing it here and elsewhewre everyday. The imagination part needs some more development.
First, a little psychology:
Facts are irrelevant to the disruptors. Their actions are borne out of fear and hatred. Their ideas are arrived at by how they feel, not by what they know. In psychology this is known as emotional thinking. The problem is that emotionally needy folks who discover they have the ability to frighten people WILL frighten people to feed that desire.
They become bullies.
When they get into groups, they discover they are more powerful. They crave power, so they create more of it by frightening more people. They attract other people who feel powerless to their group, and that's how the danger builds. Bullies are dangerous to their victims both emotionally and physically.
Make no mistake about it. These people are not trivial. History is full of examples of fearful people banding together to tamp down their anxieties by intimidating the “others.” Left alone in the petri dish of economic disaster these groups grow and become violent.
Can that happen here? Well, it can happen when the political environment is just right and the dominant culture is in a perilous condition. We don't like to think about it, but the country is still in a wobbly economic state.  So many jobs have vanished, and enough symbols of American power have crumbled (GM, the banks, etc.) that it's a very uncertain time, even for the most sane people in the country.
The current health forum bullies are lashing out based on their fears that American dominance in the world is permanently disappearing (we can't seem to beat the bad guys in Iraq or Afghanistan), foreigners are overrunning the country (white people will soon be the minority), and our most virulent political-cultural defect has been exposed once again. Barack Obama, for these people, is the nightmare trifecta at the dirt track of American xenophobia. He's black, liberal, and (in their minds) foreign – all at once. The level of fear, rage and hatred this has “ginned-up” is the source of the disruptive behavior at these forums.
So, now what?
The only way to stop bullies is to confront them. In the movies, the weakling hero gets his nerve up, learns karate and beats the bully at his own game. In the real world, this isn't very effective. Bullies wield real power, and they know how to leverage it better than their victims. They're in a different weight class!
The only way to beat them is to isolate them, and then outnumber them.
Since we can't argue with the deranged, we have to surround them with people who understand that it is not in their interest to let these nuts think they can actually achieve anything with their fear-based political power play. Getting outnumbered is their Achilles heel, because they are cowards. All bullies are cowards at heart.
We can turn this to our advantage, because some of the people we are fighting against for a good bill, are people we need to help us get the bullies to shut up and go home.
The challenge to this strategy is we need more brave people on our side than we actually have. Progressives are outnumbered on the health care issue (according to the suspect conventional wisdom). That doesn't mean we should give up – far from it – but, we need allies where we aren't thinking to look for them.
I want single payer. We're not gonna get it. There will be private, for-profit insurance after this specific battle is over. Realistically, what we will get is incremental insurance reform, temporary because the systemic financial imbalances will be punted down the road yet again.  Still, if we get everyone covered somehow, and if we create insurance security for everyone, the inevitable structural problems an imperfect plan turns out to have can be addressed as they become crises. That's the American way, unfortunately.
There is one thing that works in our favor, though, both long and short term.  Doctors and insurance people don't like anarchist non-thinking maniacs. Republican doctors and insurance agents can become our allies against the bullies if we choose to recruit them.
I have had good luck talking to doctors about universal health coverage. I tell them it means they will get paid for every single patient, which doesn't happen now. Many of them don't want to work 70 hour weeks. Covering everybody makes the workload bigger short term, but much more predictable. Once everyone is covered, the trends in care will be far easier to discern, and systems for dealing with it will be easier to design. Doctors like this idea a lot. Most of them want simply to get paid for their work, and to be freed to make decisions based on medical assessment, not insurance options.
Insurance people are trickier, but their business model is crumbling in the same way the banking model has crumbled already, and in the same way American manufacturing has crumbled. But, they don't get it, yet, because they are still making money. But, insurance's practice of turning health policies into a game of three card monty with policy-holders has been recognized as what it is, a very expensive fraud. That business model is politically nearly obsolete.
The insurance industry is beginning to face the fact that their industry is at risk, too. I tell the insurance people I talk to that universal coverage is not their enemy. Medicare proves that.  The public option is not their enemy, either. Fed-Ex and UPS are doing fine, even though they compete with a wholly government owned competitor. Public-private hybrids are successful all over the world, even in the insurance industry!
If we talk to people like doctors and insurance agents and convince them that it is in their best interest to sign on to the admittedly crummy watered down plan we are going to get, we will win a lot more than many of us currently believe. Doctors must be convinced that they will get to treat patients instead of being forced to practice insurance-driven medicine.  Insurance agents need to be reminded that there was life after Medicare, and there will be life after universal coverage, too.  Patients will like their insurance companies a lot better when they aren't getting blindsided by them. Agents won't mind that a bit.
Health care will be a bit better, and the roots of a better system will already be in the ground.
Ah! you say!  DHinIA is a closet Blue Dog. Them's fightin' words!!
Au contraire! I have been working for single payer for a long time. My favorite argument is that we can no longer allow our health care dollars to be spent building lake homes for insurance agents. Too many doctors where I live are far more interested in their status as socialites than they are in the patients that come to see them. A big part of it is that they see an awful lot of people whose care adds nothing to their income.
Doctors put the numbers on paper, and the numbers won't add up to a decent income for them if Medicare is simply expanded. I work in the health care industry, and I can tell you that Medicare works a whole lot better for patients than it does for providers. Medicaid is even worse. The kicker is, it's not government mismanagement that causes this! It's misdirected politics.
Here's where the imagination part comes in. We need to be able to imagine a better health care system than we currently have that doesn't include our best ideas, and doesn't permanently solve the obvious problems we all see so clearly. We need to realize that there is life after Max Baucus.
Once we understand that our part of the work is to push as hard as possible for what is right, but then to absorb our losses without giving up our long term beliefs, then we can work within the limitations of todays politics to prepare for the next round of the fight. We must ALWAYS fight for a better deal for people. Thats what Democrats do, and that is specifically what w try toe do here. But, if we lose an argument, we need to make sure we consolidate gains that we do achieve.
So, I say we CAN cut a deal with our political opponents (but, only after we go down fighting), and the benefits with that deal will be a better health system, PLUS we can marginalize these Limbaugh, Beck, teabagging no-nothings who are being victimized by the astroturfers that organize them.  
Why do I think this cockeyed optimistic version of a plan could work?  Because I am slowly learning to trust the President.  He has asked all the groups with a stake in health care (and that's everyone) to come to the table and stay there until it's done. That's why he drives us nuts by praising people like Chuck Grassley when he clearly doesn't deserve it, and it's why Tom Harkin, a very progressive Democrat at heart, is proud of the 160 Republican amendments that made it into his committee's bill, despite the fact he disagrees with many of them.
If progressives can help drive the legislation into a position where patients are taken care of reliably, we will have won something worth winning.  Should we give up talking about single-payer or a pure public option. Absolutely not! We are right when we say the only way to make care less costly and better at the same time is to remove excess profits and needless insurance chicanery from the system. Of course we are! We need a strong public option to keep private insurers in line. A single payer system is clearly the best way to deal with this problem.
But first things first, let's get on board with the President's vision of everyone learning to trust each other a little bit more than we do now, and let's keep ourselves engaged with people we may not feel very comfortable around for the purpose of preventing the people who really know nothing, and who contribute nothing but fear to the debate, out of luck and out of power.
We're not going anywhere, and there's always the next election. The Netroots have learned how to drive elections in this country, and we're getting nothing but better at it. As Obama is fond of saying, quoting the greatest reformer in my lifetime, the arc of history is long, but it bends toward justice.
Let's win this sucker, even if it's not the fulfillment of our dreams.

About the Author(s)


  • I question your premise

    I’m enough of a pragmatist to believe in cutting deals, but certain deals the White House has been cutting will not give us a better health system (in terms of cost, social justice, or patient outcomes) than the status quo. I don’t want Obama signing the Max Baucus/AHIP plan and pretending that we’ve accomplished anything. I would rather not allow a bill to reach Obama’s desk (although I acknowledge the very slim chances of the House Progressive Caucus not getting rolled into voting for a Baucus bill).

    • I know you disagree with this.

      That’s fine. But, if you read the top AP story today, you’ll find a really discouraging story. “public option not a dealbreaker for Obama.”

      It’s a dealbreaker for me, but what do I d?. Do I want to hand a victory to Glenn Beck, or to Blue Dogs? Left to my own devices, I’d turn the whole thing down. Realizing that we ought to still get everybody covered, pretty much, I’m inclined to lick my wounds and work on.

      Two things to remember: Obama has made strange concessions before, and he is maddening in campaign mode, but I still trust him to size up the possible, and to make his stand in a place he can win the fight and get the credit.

      So, I’m disheartened by today’s report, but I stand by my original assertion in the diary. Let’s get something done.

  • Here's an example of how to run a forum!

    • I was not happy to read

      this part of the Cedar Rapids Gazette report:

      Along the way, he defended Republican Sen. Chuck Grassley, who one questioner accused of lying about “death panels” that would make end-of-life decisions. Grassley never mentioned “death panels,” Loebsack said, but may have been wrong in his characterization of the bill when he told an Iowa audience “(We) should not have a government-run plan to decide to pull the plug on grandma.”

      Why is Dave Loebsack defending Grassley? Grassley is not operating in good faith here.

  • Hello? Anarchists?

    Those ARE fighting words, Iowademocrat.  I am a devout anarchist, and I didn’t see a damn soul pick up on my suggestion we put down our keyboards, get off our collective asses, rent a bus, and schedule face time with Congressional reps on Sept. 12th with n response to the Tea Party folks scheduling their “thing” in DC on Sept. 12th.

    I spend a LOT of time fighting for policy issues in Washington. I am on a first name basis with Sen. Harkin’s, Sen. Grassley’s, and Rep. Boswell’s legislative aides.

    I’m not willing to simply give my proxy to elected officials.  Anarchy is taking personal responsibility for the world as you would like to see it, NOT simply disrupting events.

    Ready to travel to DC with me now?  I can guide you through the maze of the Hart and Cannon office buildings with ease.