ATLANTA — First, the ritual obeisance: yes, yes, some of those acting out against health-care reform at congressional town hall meetings are honestly concerned.
With that out of the way, we can move along to the real agenda behind the shouting, the hysteria and all the imputations that President Barack Obama is Hitler and Democrats are Nazis. (And somehow simultaneously socialists. Go figure.)
The aim is not to perfect health care or even to make its many manifest malfunctions and shortfalls an iota better. The aim is to politically trash Obama and his party before they have a chance in next year's congressional elections to entrench their successes of the last two elections.
To that end, the Republican Party's outriders, such as Rush Limbaugh, relentlessly misrepresent provisions of the reform bills under congressional consideration, cynically scaring the whey out of good souls who already are disoriented in changing times and battered by a whipsawing economy.
Hence such grotesqueries as loopy Sarah Palin's Facebook fulmination: "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."
There is, of course, no death panel. This is what Palin made of a perfectly decent provision that would authorize Medicare to cover the cost of doctor visits, for patients who want them, to discuss such end-of-life matters as living wills, hospice care and so on.
You would think that if health-care reform were really their concern, Republicans right off would scramble to disavow such nasty nonsense. But no less a Republican elder than Newt Gingrich let on that Palin had a point. Others nodded concurrence to Gingrich's sagacity, and Palin remains the cheesecake choice of right-wing Republicans for their party's next presidential nominee.
The flash moblets that have been gimmicked up to disrupt the town hall meetings of Democratic members of Congress are of a piece with the anti-tax Tea Parties of last spring and continue a practice begun when the Republican Party turned out shouting crowds to intimidate Florida election officials as they tried to count ballots in the 2000 presidential election.
The point is plainly not to learn about or discuss health-care reform. Representatives and senators are shouted down when they attempt to answer questions or to explain what is in, and what is not in, the pending legislation. This is not dissent, as we are encouraged to suppose by those who alibi for the scenes. This is political hooliganism.
Health care, as it has evolved in this country, is complex, a tangle of interdependencies and contradictions, with as many exceptions as rules, a weave half of knots and half of loopholes. It requires careful study and knowledgeable debate. We are paying for duplicated services and unnecessary procedures even as some 45 million of us go without any coverage at all.
When she was 87, I had to, in that very unlovely phrase, pull the plug on my mother. Such matters, it seems to me, deserve something rather better than the ministrations of Rush Limbaugh, Sarah Palin and the hooting of the worked-up Republican right.
Tom Teepen is a columnist for Cox Newspapers. He is based in Atlanta. E-mail: email@example.com. New York Times News Service