Pulling the plug on Grandma

For most of August, America's representatives in Congress were back in their home states, meeting with their constituents. Many of these voters were angry because of plans to reform the health-care system.

"This is about the dismantling of this country," one woman shouted at Pennsylvania Senator Arlen Specter. "We don't want this country to turn into Russia!" A woman carrying a poster of Barack Obama with a Hitler mustache asked Massachusetts Representative Barney Frank why he supported Obama's "Nazi policy" of wanting to offer health insurance to everyone. Other representatives received death threats.

To two such meetings run by Obama, a few people even brought loaded weapons — a frightening thought: more assassination attempts have already been made on Obama than on any previous president. The inmates are taking over the asylum, because they don't want it to be government-run. Here's why they're afraid.

The present system

1. Health care in the U.S., though expensive, is very good. Patients generally don't have to wait long in doctors' offices or hospitals. Doctors use modern equipment and take time to talk to patients. Double rooms are the norm in hospitals. Rational fear says don't change a good thing: the cure might be worse than the disease!

2. People are living longer and expecting more and more medical care. Advocates of the current system, run by private companies for profit, say it creates incentives for better doctors, hospitals and medicines.

3. However: insurance is offered to people of working age (and their spouses and children) almost exclusively through employers. You have to take whatever insurance your company offers. If you lose your job, you lose your insurance. Any medical bills after that can be catastrophic.

4. New insurance, or treatment, can be hard to get if you are older or have anything an insurance company can consider to be a "pre-existing condition". Child obesity may be a pre-existing condition to adult diabetes, for example.

The proposal

1. Part of the plan is to forbid private insurance companies from refusing care based on "pre-existing conditions".

2. The so-called "public option" is to create a parallel, government-run, system in which anyone could buy insurance and choose their own doctors, which is often not possible under the current system. The high initial cost would be a bitter pill to swallow, but the plan would pay for itself over time.

Proponents such as Michael Moore believe that the government-run system will be cheaper and people will ditch the insurance companies. Critics believe that insuring the 50 million uninsured / unemployed / poor / sick, as well as those who will inevitably cheat the system, will result only in a net cost.

Fear number 1: the country does not have the money, especially now, to start a new system. Fear number 2: working Americans will have to pay for two systems — one through their insurance, the other through their taxes.

Students of Rove

Behind a lot of the furor is a strategic rejection of all things Obama. George W. Bush's political strategist, Karl Rove, said to attack your opponent on his strengths. Ten months ago, a majority of Americans wanted Obama's health-care reform; now, only about 40 percent do. In July, Republican Senator Jim Demint said, "If we're able to stop Obama on this, it will be his Waterloo. It will break him."

To stop Obama requires unleashing the loonies, and who better to do that than Sarah Palin? The former governor of Alaska invented a persistent, but false, rumor that Obama's plan would create "death panels" to decide which patients live and which die. Iowa Senator Charles Grassley chimed in that the government, if allowed, would "pull the plug on Grandma". Misinformation has been spread about European medical systems, causing a storm of protest in the British press.

Most representatives in Congress recognize that the town-hall hecklers are often the same ones who follow them around. It will, however, be up to Obama to pull the plug on these grandmas — and quickly — if he wants to stop his popularity from sinking any further.