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The town hall meetings being held by government officials to discuss the president's proposed Health Care Reform Plan has so far shown the bad manners of some members of the public and little else.

No one is denying the public's right to be heard, but screaming at one another, at times over issues that have become distorted, accomplishes little. The speakers have forgotten that without some level of health care reform, this country is facing a health care crisis.

A recent survey of primary care physicians indicates that about half would consider leaving their practices in the next three years if they had alternatives. If that happened, there could be a shortage of up to 40,000 primary care physicians by 2025. The number of patients per doctor would spiral, overloading the system.

What is disillusioning doctors is the red tape generated by both government and the insurance companies.

Most of us do not hesitate to call our doctor, not the insurer, when we need medical advice. Yet the doctor is not reimbursed for that time by either Medicare or the private insurers. And if the doctor examines you, he or she is not paid for the red tape required by the insurance company and government and to protect against malpractice suits.

Thus doctors have foregone the closeness between patient and doctor that once existed, and instead use mass production to see as many patients as possible.

That is why there are multiple examination rooms and why associates take your history and do the preliminary work, such as taking blood pressures. There is no other way to produce the needed revenue.

If you are hospitalized, many doctors no longer make daily hospital visits. They have employed "hospitalists," doctors who know you only by the information on your chart. Though it is an impersonal approach, it eliminates traveling down time for the primary physician.

Nor is the shortage in the health care profession confined just to doctors. There is a projection that within the next 10 years, there will a shortage of 1 million nurses.

One of the most important persons assigned to you when you enter a hospital is a case worker whose primary job is to track your remaining health insurance coverage. To be sure, nurses are also assigned, but often they cannot respond immediately when you turn on the light. They are involved with other patients. The growing nursing shortage will only make the delay longer.

One sign carried by many protestors at the town meetings indicates that the proposed health plan will allow government to decide who lives and who dies under the plan. They are misinterpreting the provision about the medical profession helping people with living wills.

Rita and I have living wills, each different, setting forth how much care we desire if the illness is terminal. To leave that decision to survivors is an unfair emotional burden. A living will lifts that burden from family members. Doctors should not only help with developing such a document, but should be paid for that service.

The president's plan calls for the doctor's charge to be an insurable item. It is not government making a decision about who lives and who dies. It is the patients.

Only the government can solve the impending health crisis because of its magnitude. Even the best insurance will be powerless to resolve the crisis without such help.

Paul Gordon is a local historian, and was mayor of Frederick city from January 1990 to January 1994. His column appears weekly. You can reach him at prg202@comcast.net. To submit a letter to the editor in response to this column, log onto www.gazette.

net, and click on the Speak Out tab.