“This,” said Rep. Kevin McCarthy to the audience of 3,000 people, “is what the forefathers thought about when they said government of the people, by the people, and for the people.”

That was before the partisanship started.

“Will you and other Republicans do everything in your power to defeat this bill without compromise?” one woman asked about halfway through McCarthy’s town hall on health care Wednesday night.

It’s not exactly something George Washington would have warmed to.

At times the meeting felt more like a rally than a town hall. Angry tirades drew applause, and the angrier they were, the more applause they drew.

Well, on one side. Billy Olson was pretty angry as he described being kicked off private health care because of multiple sclerosis, and his applause was limited.

The questions were more or less evenly split, but the audience was not.

Still, the partisanship didn’t detract too much from the give-and-take.

“I got booed. And I loved it,” said Marti Hoyt after the meeting.

Hoyt was booed when she defended social programs, such as schools and the post office. She said later that public schools compete with private schools, and the Postal Service competes with UPS and Federal Express. The government should also compete with health insurance companies, she said.

McCarthy’s plan

McCarthy offered some specific steps he would support:

• Allowing people to stay on their parents’ health insurance through age 25. That would make a big dent in the number of uninsured, he said.

• Allowing companies to offer health insurance across state lines, opening up competition. States could still regulate the insurance their residents received, he said, which would keep the market working more like the car insurance market and not like the credit card market, where the companies operate out of the states with the loosest laws.

• For people who can’t afford health insurance, McCarthy would “advance a tax credit” — send you a check — to allow you to afford to buy insurance. Would that pay for the full insurance bill for someone so disabled they are unable to work and need expensive treatment? McCarthy said that’s a question that would have to be explored.

• One solution came from the audience. Les Burson, an emergency room physician, suggested that businesses like his should be able to write off charity care on their taxes. That would cut down on those costs being spread to paying patients.

Fact-checking

There were some questionable statements, both from McCarthy and the audience.

• McCarthy said the Democratic bill prohibits you from ever modifying your private health insurance. That’s on Page 16, he said. In fact, that provision only applies to individual coverage — not coverage through an employer — and specifies that insurance companies can’t change the policy and still have it count as “grandfathered.” After that, individual coverage would have to meet the bill’s minimum standards.

• McCarthy claimed the bill would create 53 new agencies, and he showed a flow chart. But that chart included several pre-existing agencies, such as Medicaid, Medicare, S-CHIP, the IRS, the president and Congress.

• Ramona Thomas said she was upset about “Your Life, Your Choices,” which she said is being given to veterans when they come home, “giving them the option to end their lives if they think they are a burden to their families.”

In fact, the booklet encourages readers to talk to their families about how they want to be handled if they become so ill or were so injured that they can’t speak for themselves.

McCarthy didn’t rebut Thomas, and the packet given out by McCarthy said the booklet magnifies questions about “death panels.”

• McCarthy said the top 5 percent of earners pay 70 percent of all taxes. According to the Center on Tax Policy, the top 5 percent pay 62 percent of federal income taxes, and 40 percent of all federal taxes. (The income tax falls heavier on high incomes, but the payroll tax doesn’t.)

• Sarah Bird Lewis, who said she’s the mother of two disabled boys, worried that the government would choose not to care for her children. “They’re gonna decide whether my child is worth insuring rather than your healthy child, and you know, if you don’t think it’s going to come down to that, you are fooling yourself,” she said.

McCarthy said it was a good point, and he said it came down to “comparative effectiveness.”

Comparative effectiveness is a system of studies to figure out what health-care procedures and drugs are the most effective and cost-effective. McCarthy said he worried it would spin into a case of the government interfering with doctors’ decisions.

McCarthy’s concern, expressed by his ally Minority Leader John Boehner, was rated “false” by Politifact.

Comparative effectiveness is not about classifiying some lives as more valuable than others, and McCarthy didn’t say that it was. But his rhetoric linked the concept with Lewis’ concern, called her concern valid, and certainly forged the two concepts together in his audience’s minds. He didn’t lie, but he had the chance to tell the truth and didn’t.

Constitutional questions

The constitutionality of health care reform was a major topic at the meeting, but the congressman deflected the question for four hours.

It was only two hours after the town hall formally ended, in an exclusive interview with Bakersfield Express (because we were the last media outlet there two hours later) that he gave a direct answer to the question of whether the Democrats’ proposal is constitutional.

“I’m not a constitutional lawyer,” he said. It’s a good question for people to raise, but not one he can answer, he said.

It’s an answer that would have been insufficient for many in the audience. Challenges to the bill’s constitutionality came through the night.

Ralph Robles, a Vietnam vet, started out the questioning.

“Nowhere in the Constitution is the right to health care enumerated,” he said.

First, though, he attacked planned cuts to Medicare. Apparently he had no problem with the constitutionality of that program.

Taft College Professor Harold Pease didn’t share such a split view. He stayed more than an hour after the meeting ended to talk to McCarthy. There’s no role for the federal government in health care, he said, and he wished Republicans in Congress would attack health care on those grounds. What he’d rather see are the 50 states act as “laboratories” to figure out what works and what doesn’t. Then, if the Constitution is amended to give the federal government power over health care, it can pick and choose what has worked.

But Pease also admitted Medicare is not constitutional, according to his view. It’s a good program, he said, just not in the list of powers given to the government.

Join the debate: Read more of our series on “The Health Care Reform Debate At Home.”

Health Care Reform Roundtable: Michelle Quiogue

Health Care Reform Roundtable: John Gundzik

What does health care reform mean to you?