Robert - I believe you're right about most items in your discussion, but not about middle class tax increases - at least in one form or another - despite Obama's campaign promise.

America's health care costs are rising far faster than GDP, and so reform will have to pay higher and higher expenses to subsidize low income individuals. Part of the answer, of course, resides in reforming health care itself (outside of insurance) to reduce duplicate and unnecessary facilities, tests, and treatments incentivized by a fee for service paradigm, but this will take many years, and Congress has not even begun to address it seriously. In the meantime, some mechanism must be implemented to match future revenues to health care cost increases, and the only practical way so far mentioned is to tax the insurance that pays for the cost increases, because that insurance will necessarily grow commensurately. This can be done by eliminating the tax exemption on employer based insurance, or by taxing the most expensive insurance plans. For adequate revenue, however, these taxes must extend down into the middle class. Merely surtaxing income won't suffice, because income is rising more slowly than health care costs.

Finally, note that the problem can't be solved by eliminating private insurance (although private insurance certainly needs reform and the competition from a public option). Medicare and Medicaid expenditures are rising faster than other components of health care. That is partly due to demographics, but also demonstrates that cost increases are driven primarily by the expenses of health care itself rather than expenses added by the insurance companies.

Here's the sobering news demonstrating why middle class tax increases are inevitable to help defray the costs of future health care reform -

http://www.concordcoalition.org/issue-briefs/2009/0521/long-range-forecasts-health-care-costs-ominous-and-maybe-even-optimistic

The middle class would be impacted even more severely without reform, so their need to help pay for reform is not an imposition but a substitute for worse expenses in an unreformed system.

Many commenters have depicted the problem as primarily one of insurance, but in fact, insurance reform, while necessary, would go less than half way toward rendering health care affordable for all. The system itself must be reformed to eliminate duplicate and unnecessary services, and to reward providers through fee for value rather than fee for service.

Upon viewing Keith Ellison's townhall, I listened to some astroturfer babbling away about "agreeing" that health care was "a right", but that somehow this right required that we must pay for it on our own..somehow?

This and other "testimonials", relating how Canadian health care left people wanting for care for months, years..or that some chemo drug was illegal in Norway (uh, what?) implied automatically that all these horror stories would come to pass here..of course. Well, welcome astroturfers!

These folks weren't screaming..but then Ellison wasn't responding, either..just going from one person to another. I'm sure they were "ready", if he had. If I ever heard folks reading from scripts, that was it. I've known plenty of folks from countries all over the world, especially including Canada, who swear by their health care programs.

However, America is still, in this day and age, notoriously insulated and wallowing in ignorance. So, you get a busload of mercenaries fomenting fear and mongering rumors and the few folks who might have legitimate concerns and confusion start to worry. RepubliCon/Insura-mafioso handbook..Chapter One, Verse Three.

I'd say that anyone who yells and screams and tries to drown out others (especially the gal or fellow who is supposed to be giving out the answers) is an anarchist. He doesn't believe in the American way..democracy, or the United States.

A legitimately concerned citizen is one who comes with questions..asking for answers, or at least a good discussion! These loud-mouthed, ill-bred clowns are only trying to drown out the opposition. Of course, that accomplishes nothing. Reason? They are TERRIFIED of the truth getting out!

Their "fix" is to stop any opportunity for discourse..for their illogic would immediately be unmasked. That's just a bunch of tyrants, my friends..unAmerican and disgusting..an affront to every real American who is trying to sincerely make sense of this whole business.

Now, legislators are getting death threats..can ya believe..and cancelling one of the most fundamentally democratic, traditionally American methods of resolving our issues..the Town Hall!

Maybe the only way around this is to start having private citizens hold mini-townhalls in their homes, inviting their legislators to speak. If your area has some civic-minded and generous citizen, able to offer a larger venue, then more folks might actually get the chance to participate.

Of course, being private..with a private security force available to throw the rowdies out on their butts..it might take the heat off the legislators. Maybe, at that..the ads or invitations should include the warning that "Respectful discourse is encouraged. Hecklers will be immediately shot". Just kidding..mmm, maybe not.

Pardon me if it seems like I'm beating this issue to death, but I think it's that important: We MUST actively and intelligently resist these so-called 'protesters'. They are deliberately robbing the rest of us of a real chance to play this issue out fairly in the public arena.

I think Mr. Mooten and many, many others have pointed-out in here and in many other places that those who favor reform (at least loosely, in any or all its forms)have a fair degree of logic on their side. We certainly have the edge over the "do nothing" crowd.

In an ideal world, that might be enough, but not in this one we live in. The world we live in places a high value not only on the CORRECTNESS of a conviction, but on the STRENGTH of it. If we are not willing to FIGHT (understand, in this case, I DON'T mean literally, in the physical sense)for what we believe in, we are invariably going to lose to those who ARE willing to do that. History has shown this over and over.

We are involved in a battle (a deliberate term) over not only ideas, but also over perceptions, theatrics, and a variety of subtle unconscious indicators. Health Care is an inherently complex and confusing issue, and a lot of the public (most of it?)is either unable or unwilling to plow their way thru all these complicated details, to finally arrive at a purely logical, sort of mathematical conclusion. Other mental and emotional mechanisms are bound to come into play.

We must be smart enough and committed enough to play well on ALL these fronts.

Very nice rhetoric, Robert.

However, a few quibbles. First of all, Obama isn't that popular anymore. He's running slightly over 50% approval and his policies, including health care, are trailing his personal numbers. The Republicans are probably loathe to attack him because they'll get branded racists, but he's not actually that popular. A lot of people who voted for him (read: myself) are very disenchanted with his love affair with the liberal wing of the party. Obama was elected as a centrist, but since taking office he's been (I'm not just using the label, it actually fits this time) taxing and spending like a caricature of Walter Mondale.

The current version of health care reform amounts to a major giveaway to special interests; the American middle class (and the upper class but since this is TPM we'll pretend that they don't matter) don't benefit at all.

Pitch perfect, Robert.

It's time to take the candidate who became our 44th president out of the bullpen and put him back on the mound. Obama has to carry the game now. And he has to throw strikes.

The story lost on our media is the story of just how corrupt and twisted the Republican machine has become.