Democratic Rep Adam Smith Holds Town Hall in Lakewood

US Representative Adam Smith (D) held a town hall meeting in Lakewood, WA Tuesday night, with upwards of 2500 attendees.

US Representative Adam Smith (D) held a town hall meeting in Lakewood, WA Tuesday night, with upwards of 2500 attendees. Judging from pro-single payer and pro-public option signs and t-shirts, progressives seemed to have a slim majority in the crowd, though most people selected to speak voiced skepticism or opposition to House bill 3200, which includes a "public option" for health insurance. Smith, facing a fractious and occasionally belligerent audience, remained calm, collected, and frank in his responses and explanations, delivering disarmingly honest answers to most questions.

"I don't know," he replied to a woman who asked if the bill would pay for abortions deemed "medically necessary." To a man who asked if the bill would eventually eliminate his ability to set up a preferentially taxed "health savings account," Smith said his account would, in fact, be eliminated, and then went on to explain the rationale behind the bill's restriction on such accounts. He clearly stated his opposition to a single payer plan, indicating his belief that a "balance" between public and private sectors was preferable and attainable.

On the question of a so-called "public option," Smith voiced support in principle, but said he would vote against the bill as currently formulated. Citing the inefficiencies of the current "fee for service" model of health care payments, in which doctors are paid for each service they offer, he insisted that moving to a different payments model would drive cost savings more than other measures currently proposed. Under both private insurance and Medicare, the existing single payer plan for seniors in the US, the fee for service model encourages unnecessary tests and the layering of prescription drugs, since doctors earn more money for prescribing more tests, treatments and medications. Smith, calling this a "quantity over quality" approach, pointed to the fee for service model as a key factor in ballooning US health care costs.

Mention of tort reform brought applause from the anti-public option members of the crowd, though it is unclear how government restrictions on lawsuits would jibe with the general anti-government sentiment of these citizens. The representative did not offer any specific suggestions on tort reform, but did say it should be part of any overall reform package.

Smith, whose district includes Fort Lewis and McChord Airforce Base, responded to the concerns of active duty and retired military personnel, saying that it would be unwise to withdraw from Afghanistan immediately, but that it might be possible within the next five years. He also disavowed any knowledge of the so-called "death book," a VA publication that offers information for veterans on end-of-life care. One veteran in the audience vehemently denounced the publication, while another veteran praised it, saying "Thank God... now I don't have to hire a lawyer to write my living will."

J. Baldridge
Olympia, WA

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