DUBLIN, Ind. - Former Senator Tom Daschle, whom President-elect Barack Obama has called the "lead architect" of the new administration's efforts to expand health insurance and rein in medical costs, attended a community meeting Monday where he got an earful about expenses that were too high and coverage that was too little.
Dolly Sweet, 79, said she beat breast cancer 20 years ago but was now battling lung cancer without the medicine her doctor had prescribed. Ms. Sweet told Mr. Daschle that after covering her radiation treatment, Medicare would not pay for follow-up treatment with the drug, Tarceva, which would have cost $32,000 a year.
"Then what happened?" Mr. Daschle asked.
"I'm still here," she replied. "You always look over your shoulder and see someone else who's worse off."
The gathering here in this small eastern Indiana town was one of thousands on health care being held around the country at the behest of the Obama transition, and the first attended by Mr. Daschle, whom Mr. Obama has chosen to be secretary of health and human services and director of the new White House Office of Health Reform.
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Mr. Daschle was joined at the meeting, which was held at the town's firehouse, by several dozen other people. Among them were doctors and administrators from Reid Hospital in nearby Richmond, who told of patients who were flooding the emergency room there because they did not have primary care doctors or insurance coverage.
"Our population hasn't grown, yet our emergency department census has more than doubled," Dr. Michael Baldwin, the department's director, said of changes over the last 24 years. "Everyone used to have his own doctor. Now little more than half do."
Dr. Joseph Fouts, one of the area's few general practitioners, said he dealt nearly every day with patients who had found jobs carrying health benefits but who were denied coverage because of what insurers determined to be pre-existing conditions. In a recent case, Dr. Fouts said, a child of one such person was denied coverage for a cold prescription because he had a cold last year.
After listening for nearly 90 minutes, Mr. Daschle said the system could be changed by citizens' active participation.
"When we combine all the stories we heard in this small town of Dublin and multiply that by 300 million people, we can begin to imagine the scope of the problem," he said. "But I'm hopeful that the country has come together to say: ‘Enough already. We have to fix this.' "