The rules were set: “If you need to yell, yell at me,” cautioned Third District Republican Congressman Erik Paulsen during his town hall meeting, held at Maple Grove High School Friday evening. Though outbursts and harsh attacks have gone hand-in-hand with other Congressional town hall meetings centering on health care reform, the tone at Friday’s event remained at a raucous yet containable level.

There was some amount of booing, a large amount of applause and mostly a back-and-forth amid supporters of health care reform and those opposed to changes proposed in Congress.

Paulsen, a former state legislator from Eden Prairie in his first term in Congress, emphasized certain guarantees he would need to see before he would support any legislation:
First and foremost, the doctor-patient relationship would need to be maintained. He doesn’t want a system where any agency interferes with that.

Secondly, Paulsen said he wanted to make sure there is no delayed or denied care in a reformed health care system.
Thirdly: “We can’t break the bank.”

There are bipartisan reforms that should pass, noted Paulsen. One such example he cited would include ensuring those with pre-existing conditions are covered by insurance companies.
“I think government should be a regulator not a competitor,” noted Paulsen.

One of the many question marks in the health care legislation is the fate of a public option. Proposed reforms from H.R. 3200 (the house version of the bill) would set up an insurance exchange where people could pick their own plan – the idea being that a government-run public plan could be included as an option. In his speech to Congress last week, President Obama affirmed support for a public option, but also implied that they should be flexible in how such an option could go into effect – whether it’s administered by the government or a nonprofit entity.

One audience member from St. Louis Park noted that Minnesota has one of the lowest percentages of uninsured people in this country – “something to be proud of.” One of the ways that level was reached was through tens of thousands of people who have Minnesota Care, which covers those in the state who do not have insurance through an employer, do not have the means to buy insurance, yet do not have income low enough to be eligible for Medicaid, he added.
“That is a public option,” he said. “We have a public option here in Minnesota and it works really well and … it’s a decent model to explore for something that can work in other places.”

Another resident was more skeptical of the idea of an insurance exchange that would eventually dictate standards for the policies offered through private insurance companies: “From where I sit, there isn’t very much difference from being told that I either have to go on the government funded plan or that my private plan has to be changed so it’s just like the government funded plan.”
A Minnetonka man said the question is whether this public option is financially sustainable.

“What would happen if such a public option were adopted and in the first month, it went the way of Cash for Clunkers?”

Two others had concerns with Canada’s single-payer system. An audience member originally from Canada described it as a country “where thousands of patient procedures have been canceled this year because of cost containment.”

In response, Paulsen noted that it’s one of his concerns that the United States could have delayed care which could result in denied care. “We don’t want to go into that direction,” he said.

Citing Paulsen’s concern about interference between doctor-patient relationships, one resident brought a letter from his health insurance company denying the prescription of a particular medication dosage and saying that a different dosage should be prescribed.

“What are the insurance companies doing exactly to deserve the amounts of profits they’re making?” the man asked.

Throughout the evening, comments were broken up by applause and in some cases boos as residents from the Third District chimed in. Paulsen has had tele-town hall meetings and forums with various constituent groups, but this was his first town hall meeting in the district.

It’s a passionate issue, noted Paulsen, but “the debate’s not going to finish up in a week,” he said, adding, “As it shouldn’t.”