Rep. Carol Shea-Porter had a hard time being heard during parts of her health care town hall meetings yesterday in Manchester and Portsmouth.

Tensions were high from the start, when Shea-Porter, a Democrat, told the Manchester audience that some of the 100 audience members would be selected to ask questions by random drawing by a uniformed Boy Scout.

Who can you trust, she asked, if not a scout?

“Not the federal government!” a man shouted.

From there, few statements went unanswered. When the congresswoman told participants the government would cut costs by targeting waste and fraud, she was met with strong applause and a few noticeable boos. The meetings were held in federal buildings, she said, because
constituents had called in fear of their safety.

Asked how the government could cut costs while requiring around 47
million uninsured Americans to become insured, Shea-Porter told
participants that companies would negotiate the prices of prescription
drugs, target waste aggressively and emphasize preventative care.

She described the health insurance exchange, a marketplace of private
plans and one public option from which citizens could select a plan.
About 30 million people are expected to enter this exchange, she said,
with nine million electing the public option.

“All we’re trying to do here is provide choice and competition,”
Shea-Porter said.

Faced with shouts that health care reform was a government takeover,
she told both audiences that the bill would foster an entrepreneurial
spirit by allowing consumers more choice. The two major health
insurance companies in New Hampshire control 75 percent of the market,
she said.

Reform would also require health insurance companies to negotiate for
drug costs and trim their overhead costs, which can reach 37 percent
compared with a 4 percent rate for Medicare, she said.

“Let me tell you right now, it’s the insurance company standing
between you and your doctor,” she said.

The bill’s requirement that every American have insurance – and that
companies could neither decline people because of preexisting
conditions nor drop them if they become sick – was lauded by some
participants, decried by others

“Eighty percent of medicine is consumed by people like myself, 55 and
older,” said Mark Brighton in Portsmouth. “How can you look me in the
eye, or anyone else my age, and say our health care won’t be
rationed?”

Shea-Porter said grants would be used to educate more primary care
physicians while the system would place greater reliance on nurse
practitioners and physician’s assistants. When participants told her
they did not want to pay for people who would go onto a public health
insurance plan, she replied that each person with health insurance was
indeed picking up the tab for the uninsured.

She asked participants what they thought of the three out of 10 young
people who are uninsured, the 25-year-old who thinks he will “live
forever” and would rather buy dinners out and new CDs.

“I don’t want to pay for them because they don’t want to pay for
themselves,” she said.

Young people were present at each meeting. In the Manchester meeting
was Matthew Gagnon, a 27-year-old bankruptcy attorney who said he
cannot afford health insurance because of student loans. His unease
about not being covered is reinforced by working with people who have
been forced into bankruptcy by health care costs, he said.

“So many of them are affected by the fact they have these
insurmountable medical bills,” he said.

The audience in Manchester stirred when a the ticket-puller called on
Jerry Bergevin, a city resident who sat in the front row wearing a
shirt that read “The Democratic Party is a cult of evil.” He asked if
she practiced Catholicism yet supported “abortion and euthanasia,
which is in the Obama death care fascist program.”

“Will you please repent of this mortal sin before it condemns your
immortal soul?” he said.

Shea-Porter maintained a smile and then thanked him for raising the
“incredible misinformation that’s been spread about death panels.” She
spoke about a provision in one of the health care bills that would
reimburse doctors for appointments with patients who requested
counseling on end-of-life treatment.

Soon after, a woman asked Shea-Porter if the town hall was held for
political purposes. The congresswoman turned toward Bergevin as she
replied.

“Are you kidding?” she said. “Do you think I would have these people
up front if it was a political event?”

At each town hall meeting, at least one participant recorded the
exchanges with a handheld video camera.

Outside the Manchester meeting, state Sen. Lou D’Allesandro, a
Democrat from that city, said he was discouraged by the tenor of some
speakers.

“There has to be a level of civility in order for these things to be
productive,” he said.