Obamacare Before and After

For a long time we didn't get health insurance from our jobs. I purchased health insurance for my family on the individual market. Last spring, I switch to a new employer that does provide health insurance. If we hadn't switched, I expect we would have been one of those families being told that because of Obamacare, we would be losing our health insurance plan. It wouldn't surprise me to learn that our previous insurer is no longer selling individual insurance in New Hampshire.

But that's OK. We didn't like our plan. We didn't care if we could keep it.

I didn't like the sign up process. The price quoted to me online was totally misleading. I couldn't sign up on online at all. I had to contact an independent broker to actually navigate the process. The actual price was much higher than the one quoted on the website.

I didn't like the fact that they wouldn't insure my entire family. They would insure some of us, but they would not sell a policy to cover my son - who is a generally healthy, normal kid. He was born prematurely with a low birth-weight. Preexisting condition. For him we had to buy a separate, more expensive plan. From a different insurer.

They wouldn't cover maternity. That would be too risky given our history. We aren't planning to have more kids. But I didn't like the idea of a for-profit health insurance company making that decision for us. Whether or not to have children is the kind of decision we should be able to make for ourselves.

We didn't really like having a $5,000 per-person deductible. The insurance didn't end up covering much of anything. If we had more than one incident in a year we could be out $10,000+ in addition to the money we were paying in premiums. That didn't happen every year. But it did happen.

We contacted the insurance company when the law changed and they could no longer reject children due to preexisting conditions. They waffled, delayed, and refused to quote us a new price for a policy that covered our entire family. When they finally relented, they jacked up the price so much that we were better off sticking with the separate plans. I didn't like that.

One time my wife had knee surgery at our local hospital. We were informed that the hospital was in-network. But the anesthesiologist in the hospital was not in the network. So, we were supposed to pay for that. We appealed that decision and won. But the insurance took the novel approach of simply never, ever paying the money they agreed to pay. I didn't like being told a dozen times, over many phone conversations, over several years that this would be taken care of. I didn't like collection agents calling us to demand the money that the insurance company had promised, but never paid.

We did not like our insurance plan. But we kept it. We renewed that plan year after year, ever as they kept jacking up the premiums. We kept our plan because there is no way we would take the risk of going without health insurance. We kept our plan because the alternatives were worse. Other options had ever more strict underwriting requirements and wouldn't sell  us policies at all. Or they were ever more expensive. Or provided even worse coverage.

I supported the ACA and was very much looking forward to being able to purchase insurance on the health care exchange. We started getting insurance through my new job before the exchanges were launched. But it's instructive to compare what's available now compared to what we were going through.

The insurance exchange in New Hampshire is far from ideal. We're part of the federal exchange and have had to deal with the complications that came with that. What's worse is that there is no competition, and not much to choose from within our exchange. Currently, there is exactly one insurance company that offers policies through our state exchange.

The good news that the sole insurer is the biggest, most reputable insurer in the state. They can no longer pick and choose among members of our family. They don't get to decide if we're allowed to have more children. And getting an accurate quote from the web site was quick and easy

Under our old plans, we were paying a total of $832 per month for multiple plans, each with a $5,000 per person deductible. On the exchange today, a comparable plan would cost us $730 a month. Even without subsides, we could save over $1,200 a year. Or we could pay what we're paying now for superior coverage, fewer hassles, and a more reputable insurer.

I've been a supporter of health care reform. I didn't support that effort because I wanted everything to stay the same. I recognized that system was terrible. The whole point of the reforms was to change it.

That's not a promise that was broken. It's a promise that was kept.

1st In the Nation Primary

One of the great joys of being political junkie and New Hampshireite is, of course, the cyclical spectacle that is the nation’s first presidential primary. I had expected that much of 2011 would have been spent talking in events and using this space for some eyes-on observations of contenders and characters vying to be our next president.

But. As it turns out... not so much... I didn’t manage attend a single town hall, didn’t hear any stump speeches, didn’t have a  single candidate sighting. This outcome stems in no small part from the fact that my focus and attention have been directed elsewhere. But also reflects the nature of the campaign.

My natural loyalties tend towards the Democrats and I love me some Obama. I’ll happy vote for his renomination and would even if there was competition - which there isn’t. No drama there.

The Republican nomination battle has been a wonderful show. I’ve been following the ebbs and flows of that contest with a mixture of schadenfreude and slack-jawed amazement. But even there the action hasn’t been in New Hampshire. My Granite State perch hasn’t improved the view.

Normally, in a contest this open I would expect something of an ongoing carnival atmosphere. Battling visibility events, a town square occupied with supporters from different camps, phones constantly ringing with campaign calls and pollsters, and lots of candidates coming to town are all part a robust campaign season. Not this year.

There have been a few appearances by candidates and near-candidates. Sarah Palin and Donald Trump both popped into the gourmet goodies shop beneath my office during their flirtation phases. A visiting Parisian relative happened upon Rick Perry offering up his ignorance of evolution during a downtown stop. Yard signs have popped up most everywhere. But the season’s been relatively quiet.

Perhaps this is as it should be. The unfair influence of the New Hampshire is an regular complaint. This time the campaigns have been national affairs from the start. The fortunes of the candidates have been tied the televised debates and, more importantly, the post-debate media-spin, and the blogospheric reaction. The rise of Herman Cain certainly had nothing to do a great ground operation. Gingrich's flame-out was unrelated the efforts of local organizers.

I’m a fan of the traditional first ballots cast by the good citizen’s of Iowa and New Hampshire. More than ever, it appears we’ll just be the first to ratify decisions that have already been made by the parties as a whole.

Soon it'll be all over. It feels like it never really begun.

Live Free, New Hampshire

Today's front page of the Boston Globe has an article on the branding of New Hampshire (featuring photos of Portsmouth, naturally). Since our big stone face fell down, apparently there have been some problems coming up with icons and slogans that capture capture the essence of New Hampshire.

Vermont has its cows, farmers, and hippies. Maine has the coastline and Lobsters. Massachusetts has it's history and dynasties. New Hampshire has a little of all of that, but less that is distinctly its own. When the West Wing was on the air New Hampshire native President Bartlet was always in search of New Hampshire maple syrup. We can relate.

The Floridian firm that has been tasked with the re-branding effort is steering clear of the state slogan: Live Free or Die. "We're not touching that." And that is why they fail.

The one thing that unifies us as a state is our willingness to deploy our motto at every opportunity and for every purpose. It's an echo of our patriotic past and present. We're a state with no sales tax, no income tax, no motorcycle helmets, gay marriage and plenty of firearms and fireworks. We have beautiful mountains, trails, ski slopes, and historical areas. And we have industry and entrepreneurial spirit. There's opportunity here. People have the means to enjoy it all and there's much to enjoy. New Hampshire is also famous for its importance in primary politics. But its citizens are fundamentally skeptical and unpredictable.

Our independence is our unifying theme.

Live free, New Hampshire. There is no alternative.

The Day I Joined the Tea Party

The Tea Party held a tax day rally in Portsmouth. I went to the rally to see what the fuss is about and check it out for myself. I was surprised more by what it was not, than by what it was. For better and worse, the New Hampshire seacoast chapter of the Tea Party doesn't live up to it's reputation.


There were plenty of signs on display. I didn't see signs with egregious spelling and grammar errors and the messages were relatively tame. Nothing racist. No Nazis. Nothing that seemed overly hysterical. No Fox News references.

I expected the general mood to be one of anger and defiance. But it wasn't really. Cranky, yes. But the partiers seemed to be mostly just enjoying the opportunity to curse big government, complain about onerous taxes and root for freedom.

I didn't see any guns. I thought implied violence might be a theme. But it wasn't really. At one point the MC was explaining a mock tea party bit where costumed reenactors were going to dump "the things we don't like" into the river. When someone yelled out "But Obama's not here!" the MC responded with a jokey agreement. He quickly followed up. "You know that's the one line they'll use in the papers." Big laugh.

Another thing the rally wasn't is large. The newspaper estimated the crowd at 250 which seems about right. Prescott Park has certainly seen bigger events. The annual Chowder Fest, for example, draws crowds more than 15 times that size. And they have delicious chowder.

In addition to talking in the scene, I was there for the speeches. I wanted hear what the fine minds of the Tea Party had to say-- to bathe in their vision of human liberty. There was not a lot of thematic diversity. The speakers struck the same notes again and again. I'll outline their arguments. I had some quibbles.

Founding Fathers

The Tea Partiers are big fans of the Founding Fathers. They are under the impression that the feeling would be mutual. Apparently the Founding Fathers would unanimously support every Tea Party utterance. I'm not so sure.

One memorable sequence was called: "Obama or the Founding Fathers". The speaker was going to say a phrase. We, the audience were supposed to call whether it should be attributed to President Obama or the authors of the Constitution. I was looking forward to this. I was genuinely curious what excerpts from the Federalist Papers or out-of-context Obama quotes might be used in service of the Tea Party thesis. I was disappointed.

Rather than draw material from anything the subjects ever said, the speaker just tossed out slogans. "Honest work", "Government handouts", "Freedom from oppression", "Federal control". A few times the speaker said something like "Projecting American power" and the crowd was genuinely confused about who we were supposed to be calling for.

Some notes on the Founding Fathers: They invented the federal government. The reason they invented the federal government is they had already tried the independent states approach and found it to be a disaster. They knew a strong nation would require a strong central government. So they created one.

The authors of the US Constitution held a diverse set of political views. They didn't agree with each other. No matter what your beliefs are, they would not all agree with you. They did ok despite their differences. So do we. Imagine if, by some miracle, we could resurrect James Madison today. Suppose we could invite him to see what has come from their little experiment in Republic-building. He would be impressed. America today is much more than anything they envisioned. We've build a great nation upon the foundation they established. We've kept their principals intact and inspired the world with our example.

The Founding Fathers would not be joining the calls to tear it all down.

Taxes and Deficits

If I hadn't already known that we had a trillion dollar deficit and that 47% of Americans don't pay federal income tax, I could have learned these facts from the speeches and signs at the rally. They neglected to mention that Obama has lowered our taxes or that income tax rates are now the lowest they have been in 60 years. Many of the people there complaining about the oppressive federal tax burden are among that 47% that pay no income tax at all.

It is no coincidence that we have historically low taxes and historically high deficits. One naturally leads to the other. The TPers claim they want to reduce spending. But their lack of specifics is damning. I want to "eliminate wasteful government spending". Everyone wants to eliminate wasteful government spending.  The problem is there is no consensus on what counts as waste. And you can't build consensus without offering specifics.

An energetic call for tax cuts paired with vague hand-waving in the direction of spending cuts is a clarion call for increased budget deficits.

God

God got number of shout-outs (Jesus Christ, not so much). My favorite: "God was the first entrepreneur. He created the universe with His own toil and His own imagination. He derived the pleasure from His work and reaped the rewards. He would have us live by His example."

No. The first artist? Maybe. But God was not an entrepreneur. He may move in mysterious ways, but we can safely assume that God isn't in it for the money. The universe was not created as one big franchise opportunity (The Almighty Dollar Store?). If that is the altar at which you worship then your faith rests on a very shaky foundation.

Liberals 

Speaking of shaky foundations, much of Tea Party rhetorical edifice is built upon an simplistic house of straw. Each of the speakers was building a bulwark against some imagined, imminent assault on our civil liberties. Apparently, Obama and "the liberals" have some big plans.

I don't claim to speak for all liberals. Like all vaguely-defined labels, liberalism is a many-splendored thing. I am an Obama supporter.

So, to all you Tea Partiers:

I'll happily defend your right to speak your mind. I don't dispute your right to own firearms. I want your employer to thrive, prosper and expand. If you own a business, I wish you luck and hope for your success. I am also deeply concerned about the federal deficit and am concerned that the American people will not support policies that lead to its reduction. I don't believe in federal expansion for it's own sake. I don't like paying taxes. I don't think tax dollars should be spent on initiatives that are unrelated to the public good.

We aren't coming for you. Really.

Politicians

While I was hanging out listening to aspiring Republican senatorial candidate Bill Binnie I was approached by aspiring Republican congressional candidate Bob Bestani. Mr. Bestani was kind enough to entertain a few of my questions. I pressed him on how we'll reduce the deficit, control health care costs, and why American health care costs are vastly higher than those in other countries. His responses were not wildly divergent from typical Republican talking-points. He concluded by suggesting I audit his economics course at Stanford for the full extent of his wisdom.

My encounter with Mr. Bestani left me pondering the fate of Congressional aspirants. What is it like to reach such a position in life? You to put yourself forward. Your quest to be a member of the United States House of Representatives leads to skulking about at the back of a rally, shaking hands, passing out fliers and hoping to score a few votes. The guy at the podium is excoriating the legislative body you hope to join. You're trying to become one of the bums the crowd is demanding to throw out.

By the end of the rally, I had my fill of the New Hampshire chapter of the Tea Party. These people are not part of some formidable, fearsome movement. But nor is it a party I would care to join or in whose hands we can entrust our future.

Me and Scott Brown's Mom: How I Took Down a Fence, Sparked the Tea Party Movement, and Almost Killed Health Care Reform

In the winter of 2003 my wife Christine and I purchased our home from the Brown family. At that time George Bush was President, health care reform was a distant dream, and Scott Brown toiled in obscurity. On that day, as we signed those papers, we had no way of knowing what would transpire in days ahead. We had no way of knowing how our fate would intertwine with that of the Brown family. We could not know how our rash decisions in the years to come might endanger the health of this great nation. Now we know. Only now, can this story be told.

That fateful winter the Brown family was divesting their holdings in Portsmouth following the untimely death of Scott Brown's Grandfather. Their lands were substantial. Standing in what is now our yard, members of the Brown family could look out in any direction and rightly say that everything they laid their eyes upon belonged to them. The houses are in there pretty tight. You can't really see very far. Nonetheless, such a sight must have instilled in the Browns a sense of majesty and pride. Unless they were looking through the window at the pile of black trash bags and the random metal step ladder the tenants kept in the dining room. That was not so majestic.

This corner of Portsmouth was the Land of Brown. It has been thus for many a generation. The sale our home was held up due to a title dispute. Some great ancestor had been willed a portion of the land in the 1860's. The land hadn't been bought or sold since. The lawyers had to locate the papers lost during the Civil War before the sale could proceed.

Proceed it did. We moved into our first home and set about repainting, renovating, and making it our own. This was a time of transition for the Brown family as well. They sold most of the property in the area keeping only the duplex behind our our house as a rental unit. With the substantial income generated by the sale of these homes members of the Brown family would have the opportunity to follow their dreams. An ambitious Brown might have found the means to go into politics, become a nude model in a woman's magazine, or buy a truck.

Looking back now, I can see that the years that followed were, for us, a time of peace and stability. A contributing factor in the neighborhood tranquility was an lovingly constructed but decaying set of white picket fences that ran along each of the property lines, separating all the homes and duplexes. Those who know me best may not be surprised that I purchased a home with a white picket fence. They might also suspect that the painting and maintenance of such a fence is not a task I approach with a lot of energy or enthusiasm.

It was during the fateful spring of 2008 that we decided to take down the back fence. Many have questioned our motivation in this. But our reasons were simple. We had a fence on our property. And we didn't want it. The previous summer, the neighbors had all collaborated on a coordinated fence painting project. The Browns declined to participate claiming the fence was ours to maintain. Considering this and the property line, Christine asked me if we might take down the fence. We would have a more pleasant view from the back porch. Our children would have more space to frolic with their friends and neighbors. I said "Ummm. Sure." The die was cast. Saws and crowbars were deployed. The fence came down. 

For a time the decision to take down the fence seemed like the right one. The new view was an improvement and the neighborhood boys enjoyed multi-family nerf battles. But the good times would not last. Within two weeks Scott Brown's Mom discovered the section of fence had been removed. She was not amused.

Christine observed Scott Brown's Mom examining the space where the fence had been and went outside to confer. My wife was met with a flood accusation. Scott Brown's Grandfather had constructed that fence with his own hand. Why would we tear down a perfectly good fence? Like the Little Tailor confronting an angry giant with a piece of cheese, Christine tore off a chunk of fence remnant with her hand and presented it to Scott Brown's Mom. Scott Brown's Mom was not intimidated by this show of strength. Neither was she convinced of the fence's imperfection. She stormed off cursing our names. We knew she would return.

The men came the next day. They inserted thin metal posts in the ground and attached a 4 foot tall, bright orange, thin, plastic snow fence that ran the full length of the property line. The new fence was an abomination. It came be known as the Fuck You fence. It was a flimsy eyesore that mocked us with it's vastness, it's pointlessness and it's cheapness. It served no aesthetic or protective purpose other than to say "fuck you" to all who gazed upon it.

I placed a call to Scott Brown's Mom seeking to negotiate a settlement between our warring factions. Sadly, the call was not returned and the stand-off continued. For weeks we endured the tyranny of the orange snow fence. Then, one day, we looked out. The Fuck You fence was gone.

That same day, Scott Brown's Mom returned. Christine saw her exploring the fenceless void. Once again she went out in the spirit of inquiry and to extend a neighborly hand. Christine was subject to yet another verbal assault. This one was even more violent, sustained, and expletive laden than the last one. The orange snow fence had not been deliberately taken down by Scott Brown's Mom. It had been dismantled. This was vandalism. Sabotage.

Scott Brown's Mom found the orange fence rolled up on the ground. She tossed it into her car and departed in a storm of rage and recrimination. This would not be the end. This crime would not go unavenged. The police would be looking into this matter.

No doubt the fine officers of Portsmouth Police Department heard about the severed snow fence. They committed all the resources to the investigation that a crime of this severity warranted. And they must have conducted their inquires with great cunning and discretion as their presence went undetected by all.

Within the neighborhood, the case was the subject of intense speculation. Who would dare to perform this brazen deed? Who could have snuck out and struck down the dreaded fence in the dead of night? A thorough canvasing of the neighbors was conducted as well as a full forensic investigation. My son held up a thin strip of orange plastic before me. "Look Dad. This was cut. With scissors." The culprit was never identified.

The new fence was erected within the week. This fence would not be so small or flimsy. Nor would the new fences be constrained by the dimensions of the missing segment. Soon the house behind ours was wrapped end to end in a 9 foot stockade, creating the general impression of a frontier fort meant to repel Apache. But it wasn't quite as ugly as the Fuck You fence.

With the lines of demarcation so firmly established, tranquility returned to the neighborhood. We thought this would the last time we would have to concern ourselves with the Browns. But, of course it wasn't the end. It was just the beginning. 

During the winter of 2010 the nation was embroiled in a great debate about reforming the countries patchwork, expensive health care system. Contributing to that debate was a small but very vocal group of radical right-wing pseudo-revolutionaries that called themselves the Tea Party. At that time Scott Brown was a Massachusetts State Senator. Following the death of Ted Kennedy a special election was being held to determine who would fill the seat of the Lion of the Senate. Scott Brown aimed the win that seat. The Tea Party prepared to rally behind him.

At first glance, it is surprising that hard-line members of the Tea Party would make common cause with a moderate Republican like Scott Brown. The Tea Party was violently opposed to health care reform. Scott Brown has been an advocate and supporter of the Massachusetts health care reforms that had become the model for the national system. What could they possibly have in common?

That winter the Tea Party risked obsolescence. Without an electoral victory they would be forever branded an insignificant fringe movement. They were propped up by partisan media executives that hyped and magnified their every utterance. But their message was incoherent. Their numbers small. And they were seen as beholden to the paranoid ramblings of a crackpot television show host. If they could be seen as crucial to victory in Massachusetts it would catapult them to national prominence. More than anything, the Tea Party was enraged by what they saw as the systemic destruction of the barriers, carefully constructed by the Founding Fathers, between the rights of individuals and the powers of government. They turned to someone who was similarly enraged about the careful dismantling of barriers erected by fathers. They turned to Scott Brown. The Tea Party wanted victory. Scott Brown wanted revenge.

As a state senator Scott Brown's powers dissipated at the New Hampshire border. In the United States Senate he might hold the power to stop health care reform. From this mighty perch he would be able to strike our health, our pocketbook, and our ideals. His formidable will combined with the power of the Tea Party proved unstoppable. He won the election.

But would Scott Brown be too late to stop health care reform? In the weeks before the special election the reform bill had already passed the US Senate with an overwhelming majority. But Scott Brown was sure the Democratic majority would want to try and pass it through the Senate again. This time he would be waiting. With Scott Brown, the Republicans had a 41 seat super-minority. If they stood together they could not be overwhelmed. Heath care reform would be totally impossible. Because lots of people on television said so.

Panic ensued among Democrats and health care reform advocates. Suddenly the dreams of health care reform seemed to be unobtainable. The plan of Scott Brown and the Tea Party was working perfectly.

Just when it seemed that all hope was lost, a Democratic strategist discovered a little-known procedure called "reconciliation". This obscure parliamentary provision has only been used before by every single session of Congress to pass nearly every major piece of legislation in the past 30 years: including the Bush tax cuts, COBRA, and Medicare expansion. It was a bold  gambit but it might just work. They tried it. It worked. Health care reform became law. Scott Brown would not have his revenge.

Are we safe? Or is it just a matter of time before this feud changes form and the battle is joined anew? Even as I write this words, I cannot say what the future will hold. I don't know what fate awaits me, my family, or health care reform. Will we ever be able to extend a hand across the barriers that come between us? I fear there are some rifts that can never be repaired.

NH and the Gay Yuletide

In their end of the year Conventional Wisdom watch Newsweek Magazine notes:

Gay marriage, coming to a state near you... but only if you live in New Hampshire.

I do live in New Hampshire! As the clock tripped over to 2010, gay marriage has come to a state very near and dear to me. Compared with our neighboring states, it has come with remarkably little screaming and fanfare.

In 2003 the Massachusetts Supreme Court issued their ruling that same-sex marriage was a constitutional requirement. A few years later, the Supreme Court in neighboring Vermont affirmed the right to Civil Unions. Both of these events were causes for celebration and signs of progress. Both events provoked an ugly backlash that highlighted the cultural divide and laid bare persistent ignorance and intolerance.

In 2007 New Hampshire passed its own Civil Union law. Last year we followed up, approving Same-Sex Marriage. These were not court mandates. In both cases they were laws passed and approved by the legislature and signed by the Governor.

From Massachusetts and Vermont we had already heard the apocalyptic predictions of destruction of marriage and imminent moral collapse. We had also seen that permitting same-sex couples to marry resulted in none of this. We saw the giddy, goofy couples smooching and celebrating recognition and rights the rest of us had taken for granted. There were voices of protest. But when the final votes were cast, same sex-marriage came to New Hampshire, via the ballot box, with a smile and a shrug. This morning the local paper carries the news of New Hampshire's first gay marriages. It's on page A7. After "MTA to hold 'exchange of information' meeting on York tolls".

It's a pleasure to see this state recognize civil rights for its gay and lesbian residents. I'm glad we can be one of the bright spots in the ongoing struggle for equality. It's unfortunate there aren't more new club members (Seriously. Maine. What happened?). New Hampshire hasn't always been at the vanguard. I remember, growing up, a game called Smear the Queer was a neighborhood favorite. We've come a long way.

But the march for equality continues. Federal law still does not acknowledge same sex marriages, civil unions, or any basic rights for gay couples. Our gay and lesbian soldiers are forced to live in secret even as they sacrifice to to defend our nation. Even in the Granite State there is more work to be done. New Hampshire's adoption laws have not yet been updated and lag behind. Legally married same-sex couples are not recognized as both being parents to their own children. These and other oversights and inequities need to be corrected before we can claim true equality.

The road may seem endless, but we can still stop and acknowledge how far we have come. I raise a toast to you, New Hampshire. Happy New Year.

Dear Senator Gregg

Dear Senator Gregg,

I am writing to you once again, to ask you to support the health care reform. I do not doubt that you are under a lot of pressure to oppose reform. You may have the sincere intention of opposing the current bills. But supporting reform now is the right thing to do. I think you know this.

I do not claim to be a steady supporter of yours. I do think of you as a moderate, sensible voice in the Senate. I appreciate that you are not prone to the partisan hyperbole that seems to permeate so much our national debate. There was a time when you sought to be a member the Obama administration and when they sought to have you. You know they are not monsters. You also know the severity and extent of the problems this administration faces. As you enter your final year as US Senator you have a unique, historical opportunity to do something important.

In your Washington Times editorial of 7/17/2009 you wrote:

"Our health care system is broken and must be fixed. We also agree that we must reform how we pay for this system, and, at the same time, reduce the number of people who lack coverage without disrupting the coverage that insured people already have.

We must encourage quality of care and reduce the skyrocketing medical bills so many families face. These are goals President Obama has endorsed and these should be the center of our bipartisan health reform efforts."

In that article and in subsequent comments you have been highly critical of ongoing reform efforts. Many of these criticisms are legitimate. But you were correct in recognizing the failings of our current system. These problems must be addressed. You should also recognize that the proposed legislation does, however imperfectly, address these concerns. It will vastly reduce the number of uninsured. It will not disrupt current insurance systems. It will not add to the budget deficit. It does make a first, tentative, but essential, attempt to control skyrocketing medical bills. These are important reforms. They are essential for controlling state and federal budgets. The are need by New Hampshire families and business facing ever-escalating costs. They are necessary for the millions of Americans who can't get and can't afford insurance.

Our system is broken. It must be fixed. If we do not reform this system this year when will we? How will we control medical costs in the future? In what year, under which administration, will tens of millions of uninsured, working Americans be able to obtain health insurance? How many more years will pass before we can put a stop to the medical-bill bankruptcies? What will happen to state, federal, business and household budgets during those years? I work for a small company. In the past two years my family's health insurance premiums have increased by 55%. Most insurers in New Hampshire won't sell insurance to my family because my son has a "pre-existing condition". In what year will there be a system that works for my family?

If you are opposed to health care reform out of your own self-interest, or because for political reasons -- if you are voting to maintain the status quo because you think it will hurt one political party or advance another -- then you must realized your reasoning is inadequate and sad. Do you believe that the current health reform bills will make things worse for citizens of this country? Do you think perpetuation of the status quo will be good for my family, and your family, and the people of New Hampshire? Even if you believe this, you know this system is broken. You know this administration is willing to compromise. You know there are deals to be made. You can work to produce a bill that is worthy of your support. You know that all laws are a product of compromise and are all imperfect. You know that the worst thing we could do is nothing at all.

Fixing our health insurance system is not easy. Easy or not, it is broken. It must be fixed. You serve the citizens of this state in the United States Senate. You have the power to fix this. You have the responsibility to fix this. You have been given the opportunity to fix this. The people of this country are relying on you to do what is right. Easy or not. Politically expedient or not. We have put our trust in you.

My Generation

I am an unlikely source of insight on race and immigration issues. I live and grew up in New Hampshire, a state for which the Onion once suggested "Affordable, racially pure living" as an alternate motto. My family tree has white English protestants in all directions.

I grew up in the town of Lebanon, New Hampshire. If, as the name suggests, it was founded by pilgrims from the Middle East, they have long since moved on. Lebanon was not a place of vast cultural diversity. I remember returning after a year of college in upstate New York and a good friend asked me "Are there Jews there? What are they like?"

I married my high-school sweetheart, who grew up in a house 2 blocks away from mine. Her father is French. This fact seemed mostly unremarkable until my father-in-law retired after working in the US for 36 years and returned to the village where he was born, on the Mediterranean island of Corsica. We went to visit him, bringing our young son to meet that side of our family. In a medieval mountainside village of stone houses, we enjoyed long lunches of wine and wild boar with a dizzying, extended cast of aunts and cousins. Listening to the conversations in Corsican and French going on around me, it occurred to me how far I had come. This was my family too. My children might grow up in a little New Hampshire town as I had, but this too would be part of our lives. Suddenly, the family tree had branches extending in some different directions.

As I pondered the fact that I had married into new cultural traditions, I considered the choices made by my close circle of friends, the kids I grew up with, and the few good friends met along the somewhat circumscribed journey of my life. Given my homogeneous beginnings, there was some surprising variety.

Jeff, the friend who asked about the mysterious Jews, had become one. I was the best man when the rabbi officiated his marriage to Alison. The large wedding crowd consisted of Orford farmers on one side of the aisle and Hartford lawyers on the other. Erik moved to Baltimore for a while, where he met and married Krista, who is black. They returned to Maine to make their home. Lee, who is first generation American via German and English parents, married Jennifer whose family is from China. Josh married Talita, and spends his mornings at the Brazilian embassy in an effort to bring his son to meet his grandparents in Sao Paulo. Scott's parents came from Portugal. Anna's are from Serbia. Ömer was my roommate in college, direct from Istanbul. After Hamilton he stayed in the US and married Kate, whose family is Korean. They live in New Jersey.

These are not bonds along the lines of who we will tolerate, or learn to respect, or accept as a neighbor or colleague. These are bonds of matrimony. When given the chance to choose one person who completes us, with whom to share and build our lives, to have and to hold, these were our choices. Our children have sets of grandparents that look different, or speak different languages, or celebrate different holidays. Constraints of mobility, culture, tradition, tribe, and history that guided our parents and our parents parents for generations do not seem to apply us. The cultural divide is not that divisive.

The first US President to come from my generation, is a self-described "mutt" with a story that runs through Kansas, Kenya, Indonesia, and Hawaii. His parent would have met during a very different time. But today he stands as a powerful emblem of our era. A colorful first-family may seem novel to us, and stunning to those who have been alive long enough to see this history in the making. For our children it will be normal. This is how a president looks.

I look at my boys and I wonder who they will meet, where their lives will take them, and what choices they will make. I think about their world. Already, their friends include two cooler and more popular boys, born in Cambodia, being raised by two adoptive fathers. Their perspectives will be broader still.

I think that family tree will keep branching.

Scenes from Health Care Town Hell

Last Saturday I spent a rainy afternoon attending a Health Care Town Hall, here in Portsmouth, NH. This was my chance to make my voice heard, and to participate in the great debate of our day. In the finest tradition of our republic, I and about 150 of my fellow citizens, gathered to address our Congresswoman and to grapple with the thorny question of how best to insure the future health and well-being of the people of this great nation.

Despite dire warnings, the time spent waiting to get into the event went pleasantly. There was a remarkable lack of screaming, and most of the signs seemed to be of the pre-fab, pro-reform variety. I was tapping my toes to the tunes of the local Leftist Marching Band. Everyone was on their best behavior, and my line-neighbors where in good spirits despite waiting in the rain.

After being searched and wanded and passing through several layers of security I was into the main event. Clearly Congresswoman Shea-Porter was preparing for any contingency. If things to too rowdy we would be subjected a power-point presentation consisting of the artistic works for Norman Rockwell. Fortunately, it never came to that.

As I grabbed an empty chair in the middle section, signs of division began to show. Along the sides of the room there were several photographers. The baseball-cap-equipped man seated in front of me singled out the only one with a dark complexion and demanded to know why he was taking pictures of us. A murmur of approval went up around me. I began to realize that the group I was seated in the midst of, were, perhaps, not Obama voters.

Making the most of my situation, I struck up a conversation with the gentleman next to me and asked for his thoughts on Obama's health care reforms. He was opposed. We agreed that the bill itself did not constitute a government takeover, and came to a rough consensus on the contours of the slippery slope. Still, my neighbor wasn't going to get behind the Obama plan.

"I'm a long-term strategic thinker. Always have been. Maybe this bill won't lead to a government takeover. Maybe it won't happen for another 20 or 30 years. But I won't let them take that first step."

My conversation with the long-term thinker (henceforth to be dubbed L.T.) , would turn out to be very fortuitous. He would be my Virgil, my guide throughout the madness, the key to my understanding the events that followed.

At last, Representative Shea-Porter arrived, and the event could begin. The Congresswoman had been swept into office from relative obscurity in what was probably the biggest upset in the 2006 congressional elections. She had survived a reelection rematch in 2008, but was still relatively new to the job. This was the first time I had really seen her in action.

Shea-Porter welcomed us and established some ground rules. The chance to ask questions would be established by lottery. This upset some people who seemed to think priority should come by order or appearance or ranked by belligerence. Shea-Porter had an actual uniformed boy scout draw the numbers --establishing unassailable fairness of the system.

Before the audience Q&A kicked off, the Congresswoman had some invited guests provide their testimonials. One of her guests was a local woman named Laurie McCray. Laurie told the story of trying to buy insurance for her family, which was a kind of nightmare version of my own. Laurie's family members have some "pre-existing conditions" so their insurance policy, which has an obscene deductible and so covers nothing, costs them $2400 a month. And it still doesn't include their son, who has downs syndrome.

Although we came from all sides the political spectrum, naturally, Laurie's story had a profound effect on all of us. There was a shared sense that if it was impossible for a hard-working middle-class family to even buy insurance, then the system was truly broken. Our humanity united us, and there was collective acknowledgement that something had to be done.

Naw, I'm just kidding. That crowd wasn't going to agree on anything. As Laurie's allotted 2 minutes expired there were outbursts. "Time's up!" "Next!". As the next question would indicate, the extent of our differences extended to the very purpose and nature of the event we were attending.

"I've called your office every day for weeks to find out when you were going to face your constituents, who pay your salary, at a health care town-hall meeting." he announced. "I've been waiting since 8AM" (to get into this health care town-hall meeting). "I've been waiting for my number to be called, so I can ask my question, and now my number has been called, and I'm going to ask my question!" His question... "Why are you afraid to have a health care town hall meeting?!?"

The next questioner took things further down the rabbit hole, jumping right to "This is a Nazi plan." He then stepped back, gave a little smile, looking around the room. Clearly, he was impressed with his own courage and creativity and felt it would lead to YouTube stardom. To the audience's credit, there were more groans than gasps. I watched to see if Shea-Porter would go all Barney Frank on him. She went with "I may detest what you say, but I will defend to the death your right to say it." But her heart wasn't in it. "Nazi" has been done to death.

Judging by the boos and clapping, the room was evenly divided between reform advocates and opponents. The opponents were far more boisterous, better prepared with little speeches, and far more memorable. Advocates tended to just thank the Congresswoman, or ask a real question. I was thinking my question would be something really penetrating like: "Since the current system of ever-escalating costs is bankrupting so many citizens, businesses, states, and our federal government, and we have a vast and ever-growing number of uninsured people falling through the cracks in this failing system, do you support President Obama's modest effort to move to more rational, more competitive system, where everyone might be able to get some health insurance?" Shea-Porter indicated in her opening statement that she did support the current plan. So, I was kind of scrambling to come up with a new question.

Since incisive interlocutor didn't seem to be my role in this little drama, my major contribution was that of anti-heckler heckler. I often found myself shouting at someone who was trying to shout down someone else. My moment of triumph came when a grumpy guy jumped in, for the fourth time, with "I waited in the rain for two hours!" and was met with a chorus of "We all did!". I totally started that.

One woman said this was a socialist plan that was taking away our freedoms. She didn't specify which ones. The next speech came from someone who was going on about how there where 35 czars in the Obama administration, and why did he need so many czars? Shea-Porter actually argued with the guy about the precise number of czars there really were. This seemed a little beside the point. My seat-neighbor, L.T., seemed to find the czar argument compelling. I asked if he was aware that they weren't, actually, real czars. The czar nickname is kind of a joke. L.T. informed me that it was "the media" that called them czars. I was envisioning Glen Beck deciding to dub various bureaucrats as czars and then freaking out because there are so many government czars. It's a perfect, paranoid-delusion, feedback loop.

Apparently, one of the czars is even a communist czar. A guy named Van Jones declared himself a communist in 1992. The speaker was going on about his evil communist ideology. I wasn't familiar with the work of comrade Jones myself. Once again, I turned to L.T. for guidance. I did kind of snort in his face when L.T. informed me Van Jones is a "green jobs advisor", but L.T. took it well. I guess we were supposed to be scared that he's a communist. It seems more a comment on the sorry state of communist infiltration these days. Joseph McCarthy had a list of 200 card-carrying communists in the State Department alone. Obama just has one communist? Does he even carry his card? I think those cards are only good for 10 years.

Congresswoman Shea-Porter stayed pretty calm and patient throughout. She was asked if she had read the bill. Clearly she had. She was on a committee that helped draft it, and she was able to quote specific sections, or point out what had been removed or amended. She seemed committed to real reform without being overly dogmatic. When things got rowdy she was able to calm the room with a school-marmy "I can wait." And then she waited. It worked surprisingly well.

In the end there had been a lot of sound and fury of unclear significance. As we filed out, no doubt most of us left with the same opinion of health care reform we had come in with. We had said our bit, shouted at our congressional representative, or shouted at people shouting at our congressional representative, and participated in the democratic process.

Will we, as a country, overcome what divides us, come together and pass some real health care reform? Apparently the democrats, socialists, fascists, Nazis, czarists, and communists all support reform. If they can agree, there's hope for all of us.

Premiums Part II: This Time It's Personal

We hear a lot about how expensive the American health care system is. The true costs are obscured for a lot of Americans. Our employer or the government picks up the tab. There may be a problem, but it's not our problem.

Unhappily, this is not the case for me.

It's not that anyone in my family is sick, or that we don't have insurance. We're healthy. We're insured. However, neither Christine's nor my employer pay for our health insurance. We get to purchase our own. We get to pay the premiums. We notice when they go up.

Five years ago, when yet another tech start-up that employed me went belly-up, I did a brief stint as a consultant. I purchased a $1000 deductible plan from Anthem BCBS for a reasonable rate. We kept the plan and over the years the cost bumped up each spring. In the spring of 2008 our premiums were a mostly-reasonable $765 per month. In April we got a premium hike of over 20%. Anthem assured me this was not a mistake. This April they went up again to $1191 per month.

After a 55% jump in two years, I wanted out. It's not hard to think of ways I would rather spend $1200 every month.

As I shopped around for other health insurance options I had an unpleasant discovery. One of my children has a "pre-existing condition". Nobody would sell us a family policy. Nobody would insure my son. This came as a shock. I had assumed "pre-existing conditions" only applied to people who were, you know, sick. AIDS? Diabetes? It has to be something expensive and potentially lethal, right? We had none of that. The kids are never at the doctors and never miss school. I was looking to spend lots of money on an insurance policy that I had no expectation we would really need. Nobody was willing to sell me one.

Because my son was already insured with Anthem, they couldn't reject him altogether. Three of us got our own "family plan" with a $5000 annual deductible from Celtic. My son stayed on his own plan with Anthem. Total cost $657 per month. Cheaper, but with our deductible, we'll pay all our own bills, and insurance covers next to nothing.

This has been an educational experience for me. It is the lens through which I now view health care reform. Shopping for insurance has made clear to me the limitations of relying on for-profit companies to provide health insurance, and the extent of the monopoly power insurers have. No family wants to risk going without insurance. Insurers can raise rates without fear. To the extent that they compete, they compete to get customers who won't require health care. They are very conservative about guessing who those customers will be. For-profit health insurance companies don't make their money by healing the sick. They make their money by avoiding anyone who might get sick.

We hear about the high cost of health care for individuals and small business. The thought of paying $1200 a month in premiums brought that home for me, because I was writing the checks. This situation isn't very different for people who get insurance from their employer. The average employer-sponsored plan for a family of four cost nearly $13,000 a year -- not much less than I was paying.
The rising cost of health insurance is everyone's problem. The for-profit companies we have rely on are part of that problem.