Photos by JUSTIN COOK The Roanoke Times

Jane Evans of Pulaski appears frustrated during a health care forum on the campus of New River Community College on Tuesday.

Photos by JUSTIN COOK The Roanoke Times

Don Shomette holds John Paul and Christopher Lauderback during Tuesday's forum at Edwards Hall at New River Community College.

Frank Brown of Blacksburg said he breathes oxygen from a tank because of lung problems, and that while he has had good health care, he believes that others in America have been left behind.

DUBLIN -- Emotions ran high as about 1,200 people packed an auditorium at New River Community College on Tuesday to tell U.S. Rep. Rick Boucher why they opposed or supported the attempt to overhaul health care.

Boucher, D-Abingdon, said he would not endorse or condemn any legislation during the three-hour town hall meeting, but he did offer insight into his thoughts on some key components of the latest proposals.

A senior Democrat and early supporter of Barack Obama for president, Boucher voiced support for considering a plan to create nonprofit co-operatives as a strong alternative to a new government insurance plan.

"I have a problem with this government option plan," Boucher said. "I'm troubled that the government option plan could become very popular and if it became sufficiently popular it could begin to crowd out the other" private insurance companies.

Furthermore, he said, the public option could "financially destabilize" rural hospitals.

Boucher also cited the need for tort reform.

Boucher, who worked on tort reform legislation as a state senator 30 years ago, agreed with many in the crowd that medical malpractice caps should be part of the health care overhaul.

"The time has come to have national tort reform," he said, adding that it should mirror what Virginia has done at the state level.

The co-op plan was raised by the Senate Finance Committee as public opposition to a government-run public health insurance option has grown.

Over the weekend, Health and Human Services Secretary Kathleen Sebelius appeared to signal the president was open to health care cooperatives as an alternative to the so-called public option. Tuesday, however, White House spokesman Robert Gibbs insisted the Obama administration has not shifted its goals on health care reform or distanced itself from a government-run public insurance option, the Associated Press reported.

Still, Boucher said, having co-ops competing in the market would offer a check on the insurance companies, similar to the purpose behind the government option.

Boucher praised the Senate Finance Committee for considering alternatives, for not rushing to produce a bill and for being bipartisan. In contrast, he criticized the House of Representatives for moving too fast. That was the reason he gave for voting July 31 against sending HR 3200 to the floor when it came up before the Committee on Energy and Commerce, on which he serves. He was one of five Democrats to do so in the close 31-28 vote.

"I simply didn't think we were ready to take that very significant step," he said. "We need to give this process time."

Tuesday's meeting, which began at 9 a.m. and lasted until about 12:15 p.m., was the first of two scheduled town hall meetings dedicated to health care reform being held by Boucher. While the meeting was orderly, occasionally some in the crowd heckled the congressman and other speakers.

Several in the audience, on various sides of the debate, threatened to vote Boucher out of office if his vote on health reform didn't meet their expectations. The repeated comments led Boucher to respond toward the end that he thought the issue was too important for him to heed those threats.

"I'm not going to make this decision based on my political future. Period," he said.

By the end of the meeting, about half the crowd remained, but many people still had their hands in the air hoping to ask a question or make a comment.

A second meeting is scheduled for Thursday in Abingdon.

First elected to Congress to represent Southwest Virginia's 9th District in 1982, Boucher said afterward that Tuesday's town hall was the largest crowd he's drawn to such an event in his legislative career.

"It speaks to the national debate under way on health care," he said. "My overall impression is there is deep concern about various aspects of the legislation and people want to be able to comment fully."

Still, Boucher said, some people are convinced health care reform will lead to certain outcomes that he does not believe to be true. He elicited boos and jeers when he said the public option is not socialized medicine. Many in the crowd also disagreed with his assessment that electronic medical records would help save health care dollars.

He also disagreed with audience members on a range of topics, including the charge that abortion would be covered by government dollars and that a new system would lead to rationing of health care.

"I think the concerns you express are shared by many Americans who frankly don't fully understand what Congress is considering," Boucher said at one point in response to a woman who was worried that under a new system the government would prevent or slow down access to needed medical care.

The woman, Mickey Weikle of Dublin, said she firmly believed bureaucrats in Washington would make decisions about medical treatment and that Boucher didn't give a satisfactory answer.

"He keeps saying that it won't be socialized medicine and all indications are that it will be socialized medicine," Weikle said afterward.

Others, such as John Reedy of Pulaski, said they respected Boucher but didn't think it was necessary to change so many aspects of health care.

"What's laying on the table is so immense," Reedy said.

Reedy also said he was concerned about the cost of the changes and the financial burden that would be left to future generations.

Supporters of the president's reform efforts raised questions about creating a single-payer system and other systems currently not under consideration that would, in their opinion, lower costs.

As he heard stories about individual struggles for insurance coverage and hopes for access to affordable coverage, Boucher said that was why reform is necessary.

He repeatedly said there are about 35 million uninsured U.S. citizens who should be covered. That number differs from the frequently cited census figure of 46 million uninsured in the U.S. In using 35 million as the estimated number of people who need coverage, Boucher said, he was purposely excluding people who are not legal U.S. citizens.

To allow input from the health care community, Boucher invited three guests to answer questions and give short speeches on the troubles facing the medical system. Appearing on stage with Boucher were Dr. Ed Murphy, CEO of Carilion Clinic in Roanoke, C.M. Mitchell, director of pharmacy at Twin County Regional Hospital in Galax and mayor of Galax, and Dr. Glenn Hall, the retired founder of New River Valley Pediatrics.