A reassuring but occasionally feisty President Obama took his healthcare reform pitch to Portsmouth, N.H., Tuesday afternoon, in a town hall that featured several tough questions but no hecklers or disruption. Despite hundreds of protesters -- from Birthers to Glenn Beckers to aides to disgraced GOP Rep. Bob Ney, and even one man with a gun strapped to his leg (legal in New Hampshire) -- Obama made his pitch with reason and humor, and got respect even from those who said they differed with him on the issue. Obama's getting better at pitching this -- he was much more effective than in his July press conference -- though he missed some opportunities to rally support and calm fears. Still, it was a relief to see civility and reason prevail.
Not so in Missouri. Cable news shows moved almost immediately to scenes of Sen. Claire McCaskill being heckled and shouted down at her own "town hell," a particular irony because the Missouri Democrat has been defending the disruptive protesters as "real grassroots" in her Twitter feed. Sen. Arlen Specter got the same reaction in Lebanon, Pa., this morning. The calm that prevailed at Obama's event was a welcome break from mob rule, but the mob clearly hasn't gone away.
First, what Obama did well. He spoke directly to the organized scare campaign against his plan, mocking false claims about "death panels" and telling the crowd, "People who want to keep things the way they are will scare the heck out of folks, and they'll create bogeymen that aren't real." He sharpened his message to take aim at the inefficiencies and inequities of private insurance companies, promising "a healthcare system that works for us, not the insurance industry." And he got off his best line early: "I don't think anyone should be in charge of your healthcare decisions but you and your doctor -- I don't think government bureaucrats should be meddling, but I also don't think insurance company bureaucrats should be meddling."
Obama talked even more fiercely than usual about his mother's battle with her insurance company, which denied her coverage because "she should have known she had cancer before she took her new job -- even though she hadn't been diagnosed yet." He took a page from our Mike Madden, running down a list of insured Americans unfairly denied coverage for their illnesses by private insurers, promising his plan would ensure "your health insurance should be there for you when it counts -- not just when you're paying premiums, but when you need it: when you get sick."
Finally: Obama suggested, once again, that he was prepared to push through healthcare without Republican votes. "I hope we can do it in a bipartisan fashion, but the most important thing is getting it done for the American people," he told the crowd.
What he did less well: I continue to be disappointed that the president doesn't say more about how he'd like to pay for these reforms. Once again, he insisted he favors limiting charitable deductions for high earners, but admitted Congress opposes it. If that's true, it's incumbent on Obama and his team to suggest other revenue sources. He rambled a little when answering a Portsmouth teacher's admittedly ill-informed question about panels denying care to seniors; he made his answer all about unnecessary testing rather than zeroing in, again, on "death panel" fears. On a subject this complicated, he just can't ramble.
He almost got in trouble -- à la the Gates flap -- by answering a tough question by starting out, "I don't have all the facts" -- and then venturing an opinion, anyway. A man on Medicaid said state doctors denied him Lipitor in favor of a generic cholesterol-lowering drug, even though Lipitor worked best for him -- a real-life example of a kind of healthcare rationing. Obama suggested taxpayers deserve to make sure doctors prescribe the cheapest effective medication, which generics tend to be. What he didn't point out: Many if not most private health insurance plans (every one I've ever had) do the same thing. And I hope he doesn't have to spend a lot of time explaining a quip he made to relieve worries that the public option would drive private insurers out of business, with a slap to the U.S. Postal Service: "UPS and Fed Ex are doing just fine; it's the post office that's having problems."
But those are small quibbles; overall, Obama did well. Still, it was hard to be reassured that we're moving to a fact-based debate when MSNBC immediately switched over to McCaskill's rowdy and disrespectful town halls, where loudmouthed right-wingers repeatedly filibustered, asking follow-up questions and shouting down her attempts to answer them. It was a little bit ironic, because on Friday, as many Democrats were attacking the GOP "town hell" strategy, McCaskill blithely tweeted:
Real grassroots on both sides of the healthcare issue, both sides organizing. Yay to both, yay for democracy, hope both are civil and polite.
The crowd was civil and polite at the Obama event, leading conservatives and even some media commentators to suggest Obama unfairly pre-screened participants; in fact, NBC's excellent Ron Allen reported the vast majority of participants he talked to said tickets had been distributed online randomly. The contrast in tone no doubt had a lot to do with the Obama's charisma, the power of the presidency and a hell of a lot of Secret Service.
But there hasn't been a lot of civility or politeness at other Democrats' town halls; recent Democrat Specter faced a crowd like McCaskill's in Pennsylvania this morning. I hope Obama's passion and reassurance can turn the tide on the debate; if not, he's got two more town halls this week to try again.