Closed meeting with Congressman Tim Murphy, June 6 2017

After months of requests for a public town hall, Congressman Tim Murphy agreed to a closed meeting for our group, Mondays With Murphy, limited to 25 people, for a period of one hour. 18 constituents had the opportunity to speak. The majority of the questions focused on the AHCA and Medicaid cuts. Following are my thoughts on the meeting.

June 6, 2017

Dear Mr. Murphy,

Yesterday’s meeting was an interesting experience. I look forward to future meetings, with more constituents, and at hours better suited to a variety of working people. Here are some of my thoughts:

1. Your insistence on not holding a single public town hall is the major reason for the weekly rallies and protests. Your staff aide bitterly complained about music, bullhorns, noise, and disruption of service to the staff inside who are working with constituents, but we are also constituents with needs that are not being heard. We are assembled for one hour, which is a small fraction of the work week. Yesterday, the Young Republicans assembled outside your office, in similar fashion, albeit with fewer people. Our group does not use a bullhorn; that is the tactic of your supporters who assemble across the street and aim their bullhorn directly at your office. Our speaker system is directed into the sidewalk and street. Your staff, whose behavior is generally quite professional, needs to adjust their expectations of the rights of constituents to express their views in the ways that they find available. I urge you to consider a regular schedule of public town halls during congressional recess and to trust that your constituents are not to be feared. Your demeanor will set the tone, but if voices are raised due to the high emotions of the issues, that’s all part of holding public office. Suck it up. It’s not a valid reason to avoid your constituents, and it makes you look weak, whiny, and rigid.

1. The disparity between what you profess to change in the healthcare system and your support of the AHCA is remarkable. Certainly, the medical home model is desirable, but providers are not currently paid to provide that model of care. Slashing the budget for Medicaid will not change that. Expecting that healthcare providers will hold the line on costs and exuberant testing or treatment is a fantasy, when they continue to be paid for piece work, and especially in this litigious society. Tort reform, evidence-based medicine, and a single payer system have the best chance of achieving waste reduction and cost control while providing the greatest number and quality of services to citizens. Everything you discussed will cost more money, not less. The only way the budget survives is to cut services or lives, and you continue to choose the latter.

1. Your rebuke of Democrats in their refusal to work with the Trump administration on the AHCA is disingenuous. The Republicans worked very hard to obfuscate the ACA at every turn, and you were complicit. At a fundraiser some years ago at the home of Bill and Barb McClure, you personally vowed to do everything in your power to oppose anything the Obama administration proposed. Anything. Your Republican compatriots continue to pledge to dismantle every bit of progress of the Obama administration, in the manner of a personal vendetta, led by a man who relentlessly accused Obama of presidential illegitimacy. How can you be surprised at the lack of Democrat support, especially when the majority of citizens want to keep and improve the ACA? If you had broad support for its repeal, you wouldn’t need to go through the budget reconciliation process. The so-called “death spiral” was created by Republicans, who are responsible for blocking reimbursements to insurance companies in the risk corridor, paying only 12.6 cents on the dollar. This, and the Humana/Aetna snit led many insurers to exit the exchanges. They function on profits, not generosity. Let’s not forget that Republican opposition to a single payer plan is the reason that we have a compromise plan such as the ACA. The ACA could certainly use improvement, but deliberate and methodical Republican opposition and interference is responsible for most of its difficulty. Given 10 years and some improvements and adjuistments, the ACA would work as intended.

1. You dismissed my comments about the $3 billion reduction in future Social Security payments due to early deaths. It’s right there in the CBO score for the first analysis, page 33, footnote f. From ThinkProgress: “Approximately 17,000 people could die in 2018 who otherwise would have lived if a House Republican health proposal endorsed by the Trump administration becomes law. By 2026, the number of people killed by Trumpcare could grow to approximately 29,000 in that year alone. That's based on calculations ThinkProgress has done using the numbers in the CBO report plugged into a study that estimates the change in Massachusetts mortality rates after that state enacted the health law that Obamacare was largely modeled after [and promulgated by a Republican]. It found that one death was prevented for every 830 adults aged 20-64 who was covered. From there the math is straightforward: Fourteen million divided by 830 equals 16,867 people potentially sentenced to die by Trumpcare. By 2026, if the CBO's estimate is correct, that number could rise to 28,916 deaths in one year." The revised score from May shows a reduction of $2 billion in outlays for Social Security benefits, page 39 footnote e, so reduce that 16,867 dead people by 33%. These are the people who will die before reaching eligibility for SS, that otherwise would have lived to collect it under the current ACA. How many of them do you know? Probably none, given your privileged status. How many are constituents? Many. Not to mention the 23 million who will lose coverage. Dollars over people. How do you reconcile that? You voted for this! Did you just clear your desk and pass your work on to the next guy in the senate, hoping he’ll fix your mess?

1. You overemphasize detailed mental health administration without looking at the overarching structure of health care. Everything you propose will cost more, not less, unless fewer people can use it. Mental illness treatment for people with chronic health conditions is a great idea and a cost-effective one, but useless if they can’t afford coverage for either. If other congressmen’s eyes are glazing over when you speak about mental health care, it reflects poorly on your ability to explain it. And why are they voting on what they don’t comprehend?

1. Your allegiance to coal is telling. Your voting base in Greene County is small numbers compared to the rest of your district, but your financial support from coal, oil, and gas companies is large. You promoted nuclear energy, an industry on the decline due to high costs, inability to compete, and safety concerns. You made no mention of wind, solar, geothermal or other renewables. You are either living in the past or in deep pockets, at the expense of the environment.

1. Make a stand. Take a stand. Communicate. Your constituents don’t know what you stand for until you vote, and then it’s too late to get their input. Where are your lines? Exactly what kinds of actions would you support in Afghanistan? Do you support the reduced budget for the Department of State and the increased budget for the Department of Defense? You never answered. What’s your position on the Muslim Ban? Exiting the Paris agreement? You claim to not read anything from a constituent written in ALL CAPS or that has foul language. Tell us how you feel about the words of our president, which are far more offensive than any 8th grade curse words said in anger and frustration.

1. It’s safe to say that we agree on very little in matters of governance. That’s part of life, and I’ve been able to rationalize it in past elections that didn’t go the way I wanted. But, Trump. You know, and I know, and everybody else in the world knows, this is different. You, as a mental health expert, know that something is very wrong, and yet you stand by, grabbing the candy while you can. It’s shameful. It's dangerous. It’s un-American.

Elaine Giarrusso