Open town meetings were supposed to be a forum for open, civil discussion between citizens and their elected representatives. The 'deathers', who insist a government run health insurance system could, as IA Senator Charles Grassley says, decide "when to pull the plug on grandma", have forever changed that.

Many of the town hall protesters are justly concerned about their health care coverage; happy with what they have, concerned about costs and fearful of single payer universal health insurance.

Others just wanted Obama to fail.

The most vocal element may, as Paul Krugman of the New York Times alleges, have racist motives. Cynthia Tucker of the Atlanta Journal-Constitution estimates that "45-65%" of the protesters are motivated by racism.

If racism is the protesters real problem, then health insurance reform is not our only problem.

Democrats accuse Republicans of staging the town hall protests. Philadelphia Inquirer columnist Dick Polman quotes Republican National Campaign Committee Chairman, Pete Sessions as saying "the days of civil town halls are now over".

If Sessions is serious, we've taken a step backwards in the democratic process.

Misguided, obstructionist or greedy, the protesters, the Republicans and the insurance companies have won. The White House appears to have given up on a public insurance option.

In June Obama told Senate Democrats "I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest."

On August 15, at a Colorado town hall meeting Obama downplayed the public option saying it was "just one sliver of the debate".

How quickly things change, how quickly Obama folded.

With the Administration apparently ready to scrap the public option, health insurance cooperatives are touted as an alternative, a weak option at best. As the non-profit alternative to private insurance, Wisconsin's Farmers Health Cooperative offered me a $10,000 deductible policy with only slightly higher premiums than I now pay for the same level of private coverage. Some alternative.

With no competition from a public option, private health insurance companies will continue to raise premiums and pad their profit margins. USA Today reports that employers could see insurance costs rise 9% in 2010; when their costs go up 9% employees can expect to see their costs increase by double digits.

Premiums could go even higher (11% to 16%) in some areas served by a limited number of private health insurance providers.

The Centers for Medicare and Medicaid Services (Dept. of Health and Human Services) expects per capita medical costs to increase 71% over the next decade. Todays average family premium of $13,000 is expected to rise to $22,000 by 2019.

The town hall protesters see the elimination of any public option as a victory. They better keep their check books handy.

Now that the President has caved in to the health care officials that have frequented the White House since his election, one wonders what's next, privatization of Medicare?